How to Become a Medicare Coder

Overview

Simply put, a Medicare coder provides billing support to health care providers by accurately analyzing and coding insurance claims. The primary objective of Medicare Coders is to keep accurate medical records and ensure that insurance companies are billed correctly. Since lots of insurance claims are received by hospitals and medical centers, they need to be perfectly sorted out and documented.

Medicare coding is a technical system whereby trained individuals translate medical billing and insurance information for the Medicare system. It requires processing a wide range of information and coding and categorizing it carefully. If you wish to enjoy a steady and quiet office environment in the medical industry, then you should strive to become a Medicare coder. Furthermore, this line of work is ideal for people who do not want to have any association or contact with patients.

Education Requirements

The education requirements for becoming a Medicare Coder are quite straight forward. The most basic education requirements is a one or 2 year program that provides an associate’s degree in medical coding. A post-secondary program in health information technology or a similar area of expertise can also provide entrance into the field of medical coding.

During the period of their education, students will come across courses such as anatomy, physiology, medical terminology, health data requirements, coding systems, healthcare statistics, computer systems, healthcare reimbursement methods and so on. These courses should give students a firm grip and understanding on medical coding.

Certificate programs are also available that are approved by the American Health Information Management Association. The American Academy of Professional Coders provides certification for medical coding. The Registered Health Information Technician is yet another possible certification that you can explore. It is advised you look into certification needs and programs if you wish to climb the ladder of success. Employers may give preference to certified medical coders as a standard of excellence and a minimum guarantee of academic competency are expected.

Furthermore, it is advised that potential Medicare Coders be familiar with HCPCS (Healthcare Common Coding Procedure) as this may be the standardized and recognized system of coding practiced within the industry.

Job Duties

Medicare Coders can work in a variety of settings. Most often they work in hospitals, insurance companies, clinics, physician’s offices and so on. A lot of time is spent behind computers processing information and medical claims. The job duties largely vary depending on work setting and years of experience. Listed below are some common job duties that you can go through to give you a general idea of what to expect in this field of work.

  1. Assign unique codes and codify claims made by Medicare patients.
  2. Keep accurate records on billing, tests, diagnoses, procedures and treatments pertaining to patients.
  3. Categorically file and archive all relevant documents that may be needed for Medicare codification and processing of insurance claims.
  4. Determine the validity and legitimacy of the claim against company policy and compliance.
  5. Ensure that the medical care providers gets their fair compensation for rendering medical services to patients.
  6. Ensure that documents have the correct authorizations prior to processing and filing.
  7. Use specific software that will help with the classification and sorting of patient medical and insurance data.
  8. Ensure that patient records and information are protected and confidential.
  9. Contact various healthcare staff and personnel to ensure that the information on patient records is accurate.
  10. Stay up to date with government policies, insurance policies and the coding system.

Job Outlook

According to the database at the Bureau of Labor Statistics (bls.gov), there is an expected increase in employment of medical records and health information technicians by 21 percent during the period of 2010 to 2020. This percentage increase in employment translates to roughly 37,700 new jobs.

A couple of factors may explain this increase. For starters, societies and individuals are gradually understanding and acknowledging the importance of preventative medicine to avoid problems later on. Secondly, the average age of the population is increasing. Both these reasons mean more tests, more treatments and more medical procedures – all of which will mean more medical claims and reimbursements for public and private insurance provides. This attempts to explain the increase in the need for Medicare coders.

Salary Prospects

The average annual salary for Medicare coders is $34,000 (simplyhired.com). While according to the same source, the average yearly salary for a coding manager is $53,000 – so as you progress further and climb the ladder of success, your earning potential may rise. To further add to these figures, according to the statistical database at the Bureau of Labor Statistics (bls.gov), the average annual salary for medical records and health information technicians, a category in which Medicare Coders belong to, is $32,350.

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