Medical Billers and Coders- What do they do? Why the demand?

by Applied Medical Systems

According to the U.S. Bureau of Labor Statistics, the medical records and health information technician job category is expected to increase 22 percent by 2022. Medical billers and coders fall into this category and their numbers are expected to increase as well. The question is, “Why are these medical biller and coder jobs expected to increase?”. A medical practice can use their existing staff to deal with billing and coding tasks, and many do. However, with around $125 billion being lost on medical billing errors in the U.S. every year, does your staff really have the training, not to mention the time, to meticulously code your charts? If your answer is yes, will they also have enough hours in the day to file claims, stay on top of insurance carriers, and appeal claims that have been denied?

Certified Coders

Medical billers and coders are trained to code charts correctly, create and submit billing claims, and then remain diligent in the process until the payment has been received. Medical billers and coders have a complete understanding of the claims and appeals process, know medical terminology and are familiar with anatomy and physiology. Certified coders must also complete a medical coding course and pass a Certified Professional Coder exam or the equivalent Certified Coding Specialist exam. Certified Medical Coders will also be required to pass an ICD-10 proficiency exam before the new codes are implemented next year. Having specialized medical billers and coders helps to increase insurance claims revenue. Specialized billers and coders are trained and certified in accurately coding and then billing for insurance claims. They are helping practices follow the claims process all the way through, increasing revenue and decreasing money lost or left on the table.

Health Industry Demand for Specialized Billers and Coders

The healthcare industry is seeing drastic changes currently and in the near future. With ICD-10 codes, incentives for transitioning to Electronic Health Records (EHRs), the Affordable Care Act and the aging population, accurate and diligent billing and coding is imperative for healthcare providers moving forward. All of these changes coming to the nation means a lot of transitioning on the billing and coding side of medical practice management. Healthcare providers are starting to realize the need for certified medical billers and coders to make sure their practice or hospital is ready for these transitions. Aging population means more tests and treatment, new codes means a new system for categorizing those tests and treatment, EHRs are a whole new internal system to learn and the Affordable Care Act will require even more claims and appeals. Outsourcing certified medical billers and coders through Applied Medical Systems (AMS) can help assure that you are taking every step to stay on top of the drastic changes to the healthcare industry. AMS also provides practice management consulting to cover all bases moving forward with these changes. For more information about AMS and our services, contact us at our Durham, NC office.