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Medical Billing / Coding Specialist Career

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Medical Billing / Coding Specialist CareerWhat a Medical Billing / Coding Specialist does:

Medical Billing involves submitting claims to insurance companies for services carried out by a health care professional. When a patient undergoes a physical examination, the medical information gathered is evaluated to determine the level of service that will be used to treat the patient.

The Medical Billing / Coding Specialist translates this information into a 5 digit Current Procedural Terminology (CPT) code. This code is then sent to the insurance company for billing.

The CPT code describes the medical, surgical and diagnostic services required. The insurance company examines the validity of the claim, and accepts it or rejects it accordingly. Billing / Coding specialists must have a good eye for detail as errors result in claims being rejected.

The main duties of a Billing / Coding Specialist include:

  • Obtaining medical information from a patients physical examination
  • Determining the level of service to be used to treat the patient from the physicians files
  • Translating the level of service into a 5 digit Current Procedural Terminology (CPT) code
  • Recording codes for communicating to insurance companies, patients and other healthcare professionals
  • Interpreting the code and assessing the patients eligibility to claim

Education & Qualifications:
Becoming a Certified Medical Billing/Coding Specialist is voluntary, but recommended as more and more employers are looking for certification. To become certified you must pass an exam for the medical billing profession. The Certified Medical Reimbursement Specialist (CMRS) certification is one such certification awarded by the Certifying Board of the American Medical Billing Association (AMBA).

Certification through AMBA proves that the graduate has competency in claims handling, compliance, Medical Billing and that his/her skills are up do date. Certification courses vary buy many consist of the same modules e.g. Medical Terminology, Anatomy and Physiology, Computers, Coding and Insurance.

Salary & Job Prospects:
Medical Billing Specialists can earn between $12.20 and $16.00 per hour, depending on qualifications, location, education and position held. As Insurance companies are investing more in combating fraud, medical billing has become one of the fastest growing jobs in the health care sector. Most major employers are now looking for formal Medical Billing training at an accredited training school. Medical Billing programs range from nine months to two years. Any course less than nine months is not recommended as they are not accredited by the AMBA.

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