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In: Nursing

What will you do to maintain the skills learned and what will you do to seek...

What will you do to maintain the skills learned and what will you do to seek employment in medical billing and coding.

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Expert Solution

Medical billing and coding are two closely related aspects of the modern health care industry, both practices are involved in the immensely important reimbursement cycle which ensure that health care providers are paid for the services they perform. for the sake of simplicity, let's dividethe two at the moment and look at them asseperate pieces of a larger process. Medical coding, at it's most basic, is a little like translation. it's the coder 's job to take something that's written oneway(a doctor's diagnosis, for example, or a prescription for a certain medication) and traslate it as accurately as possible into numeric or alphanumeric code. for every injury, diagnosis, and medical procedure, there is a corresponding code. there are thounsands and thosands of codes for medical procedures, outpatient procedures and diagnoses. every code set has its own set of guidelines and rules. certain codes, like ones that signify a pre-existing condition, need to be placed in a very particular order. coding accurately and within the specific guidelines for each code will affect the status of a claim. the coding process ends when the medical coder enters the appropriate codes into a form of software program. once the report is coded, it's passed on to the medical billers. On one level, medical billing is as simple as it sounds, medical billers take the information from the medical coder and make a bill for the insurance company, called a claim.the medical biller takes the codes, which show what kind of visit this is, what syptoms the patient shows, what the doctor's diagnosis is and what the doctor prescribes, and creates a claim out of these using a form or a type of software. the biller then sends this claim to the insurance company, which evaluate and return it. the biller then evaluate this returned claim and figures out how much of the bill the patients after the insurance is taken out. the medical biller therefore, acts as a sort of waypoint bwtween patient's, healthcare providers, and insurance companies. where the coder translates medical procedures into code, the biller translates codes into a financial report.

some other job options in medical coding and billinginclude;- *medical records coordinator, coder, medical coding specialist, medical billing specialist, medical records technician, health information specialist, medical record clerk, health information clerk etc.....

there are some other skills needed for a biller and coder like - attention to deatail, excellent communication ability, good customer sevice, computer knowledge, accounting and bookkeeping, medical terminology, problem solving , being comfortable team work etc.....

To pursue medical coding and billing, the individual must have a bachelor's degree or master's degree, preferably from life science background. one must also have the analytical ability to read and analyse medical records and patient details by using the right codes for the billing procedure.


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