What Are Medical Coders & What Exactly Do They Do?

Do you enjoy office work? Then medical coding might be an ideal fit for you

When it comes to healthcare, every patient is familiar with the doctor, and even the attending nurse. But very few patients are familiar with the medical coders who handle one of the trickiest aspects of the profession – ensuring every patient receives maximum coverage while filing claims that guarantee the physician or medical provider gets paid.

Medical coders are the unsung heroes – office administrators whose precise knowledge of up-to-date insurance codes and billing practices makes them indispensible to employers (and highly beneficial to each patient). Let’s take a closer look at what medical billing and coding professionals do, and why it represents such a valuable endeavor.

A look behind the curtain

Medical coders typically work in the billing department of a medical facility, private practice, hospital, or clinical environment. Coders wear scrubs much like a nurse would, but the majority of their work is done behind a desk (primarily via a computer).

Medical coding is the first step toward fulfilling every patient’s insurance claim. Insurance providers – both public and private – require facilities to “code” each process accordingly. This way the insurer will have a clear understanding of what services were provided and how to reimburse the medical facility appropriately.

Medical coders are trained by way of two major classification systems: the International Classification of Diseases (ICD) and the Current Procedural Terminology (CPT). These resources (i.e., texts) include the appropriate codes for every service.

For example, if a patient went to the doctor with a sore throat, and the doctor performed a strep test, a specific code would need to be entered into that patient’s record.

The responsibilities of a medical coder

A day in the life of a medical coder might include any or all of the following:

  • Assigning codes to diagnoses and procedures
  • Entering insurance information into a computer
  • Ensuring codes are accurate and sequenced in accordance with regulations
  • Following up on any documentation that is insufficient or unclear
  • Communicating with clinical staff regarding specific patients’ cases
  • Searching for relevant information regarding cases where the coding is unclear, and
  • Remaining up-to-date on the latest additions to coding procedures.

According to the Bureau of Labor Statistics, the medical coding profession currently employs a little under 200,000 people in this country – a figure that is projected to grow by 22% in between 2012 and 2022, much faster than the average occupation.

Related: “Why Medical Coding Specialists Are Currently in Demand”

Do you think a career in medical coding & billing might be a fit for you? Contact Branford Hall to schedule a tour or request more information.