Medical Coder Careers: Job Description and Education Requirements

Overview

Medical coders play an important role in the medical billing process. Every time a patient receives health care services in a physician’s office, hospital, clinic, outpatient facility or ambulatory surgical center, the provider must record the services provided to the patient. The medical coder pulls this information from the documentation, assigns the correct codes to the services and submits a claim to the patient and/or insurance company for payment.

In many cases, the medical biller and the medical coder are the same person, but sometimes the medical coder and medical biller work together to make sure all services are paid correctly. In this case, the medical coder’s main responsibility is to assign the appropriate codes to the services provided, while the medical biller’s main responsibility is to file the claim with the insurance company and/or patient.

As a medical coder, you can fulfill your responsibilities by collecting information from a variety of sources within the patient’s medical file (physician’s notes, laboratory test orders, imaging study request, etc.) to confirm that the services were provided. Once you have collected the information, your job is to assign the correct codes to the services provided. These codes typically include: CPT codes, ICD-9 codes and HCPCS codes. These codes represent the procedures provided and are needed so that the medical biller can process and file the claim. During the course of a day you may code hundreds of claims.

Educational Requirements

Although a formal degree (associates, bachelors and/or masters) is not needed to be a medical coder; many coders have obtained a bachelor’s and/or master’s degree to increase their earning potential. It is important that you have extensive knowledge in the areas of medical terminology, anatomy and physiology. It is also important that you complete a medical coding training program, pass the Certified Professional Coder (CPC) exam and earn a certificate as a Certified Professional Coder. Certified coders are currently in high demand due to their expertise and credentials.

Job Duties

As a medical coder, the place that you work will depend on your training, experience and credentials. Your day will more than likely consist of reviewing the previous day’s batch of patient notes so that you can code them. In some cases, the notes will be separated by medical conditions and/or services, but this depends on the size of the medical facility and the number of patients seen the previous day. You will work your way through the batch of notes starting with the patient note on the top.

Next you will read the documentation, analyze the patient’s diagnosis, evaluate the tests and/or procedures ordered during the patient’s visit and code the services. If you are the medical coder and medical biller, you will then process and submit the claim to insurance companies or patients. Your main duty will be to collect important information from the patient’s files (physician’s name, procedures and the dates of the procedures, etc.). You will rely heavily on ICD-9 and CPT codebooks and you will need to be very adept at decoding physician notes so that you can correctly code services.

Salary Prospects

According to the U.S. Bureau of Labor Statistics, you can expect to make approximately $49,000, on average, per year, as a medical coder. The annual salary has increased 10% (for smaller private practices) since 2012. Medical coders working in medical facilities made more than those in private practices, but received less promotions and raises.

In 2010, medical coders (in private practices) made approximately $41,000 per year, in 2011, they made approximately $42,000 per year and in 2012, they made approximately $46,000 per year. In 2010, medical coders (in hospital, clinics and medical facilities) made approximately $44,000 per year, in 2011, they made approximately 44,500 per year and in 2012, they made approximately $46,000 per year (bls.gov).

Career Outlook

The career outlook for medical coders is positive. According to the U.S. Bureau of Labor Statistics (2013), medical coding jobs are expected to increase by 22% by 2020. This increase primarily stems from the aging baby boomers. In other words, as the population ages, they will need more and more healthcare services. Medical coders will be needed to code these services, process claims and submit them for payment.

The expansion of private and public health insurance will also contribute to the influx of future medical coding jobs. Health insurance claim forms now require specific coding for payment. Employers will continue to look for coders who can correctly code provider services. As more and more people receive services, the need for medical coders will increase.

References and Further Reading

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