What does a Medical Biller Coder do?
A medical biller coder is responsible for handling the billing processes and insurance within a hospital, clinic, or similar facility. They must gather patient information and records to analyze and translate them into codes according to the insurance and medical guidelines. Moreover, it is crucial to verify all patient forms and ensure their accuracy as it will serve as a basis on essential documents and medical record-keeping. There may also be instances where a medical biller coder must devise payment plans for patients, communicate with families and guardians, and coordinate with physicians.
Medical biller coder responsibilities
Here are examples of responsibilities from real medical biller coder resumes:
- Manage chart completion (ICD-9-CM and CPT coding), chart assembly and analysis and patient information privacy/security.
- Use EMR software to manage patient records and files reinforce and uphold patient confidentiality as required by HIPAA and clinic.
- Manage chart completion (ICD-9-CM and CPT coding/abstracting), chart assembly and analysis, patient admission and patient information privacy/security.
- Bill insurance claims using HCFA 1500 and UB-92 form.
- Review coding, verify the diagnosis codes (ICD-9) and procedure codes (CPT) are congruent and clinically appropriate.
- Have experience in all commercial insurances and government insurances including Medicare and Medicaid.
- Communicate billing information to providers and insurance carriers in accordance to HIPAA rules and regulations.
- Interpret and review medical record documentation to assign accurate CPT-4 procedure and assign ICD-9 diagnosis codes.
- Correct and resubmit inpatient/outpatient clinic, radiology and laboratory claims electronically to insurance carriers for reimbursement.
- Assist in editing of transcription.
- Utilize the Code3 Encoder/Grouper for DRG assignments in inpatient records.
- Obtain authorizations for PET/CT scans, radiation treatment, and chemotherapy.
- Assist with revising and improving record documentation practices to support DRG assignments.
- Complete AAPC course and pass required test to be a certify professional coder.
- Code daily outpatient and inpatient charge sheets, inserting correct CPT and ICD-9 codes.
Medical biller coder skills and personality traits
We calculated that 17% of Medical Biller Coders are proficient in Patients, Medical Billing, and ICD-10. They’re also known for soft skills such as Analytical skills, Detail oriented, and Integrity.
We break down the percentage of Medical Biller Coders that have these skills listed on their resume here:
- Patients, 17%
Obtained patients' medical history and effectively communicated with insurance companies to verify benefits coverage and eligibility of patients.
- Medical Billing, 5%
Processed daily medical billing and patient information into computer system * Assisted Nursing Staff with administrative office support
- ICD-10, 5%
Managed health records while applying ICD-10 coding to update and process insurance claims for time and accuracy to various insurance companies.
- Customer Service, 5%
Provided excellent customer service by actively listening to customer information and concerns and taking swift and decisive action on their behalf.
- CPT-4, 4%
Interpreted and reviewed medical record documentation to assign accurate CPT-4 procedure and assigned ICD-9 diagnosis codes.
- HCPCS, 4%
Support and participate in process and quality improvement initiatives by maintaining updated files for HCPCS, ICD-9, and PQRI codes.
Common skills that a medical biller coder uses to do their job include "patients," "medical billing," and "icd-10." You can find details on the most important medical biller coder responsibilities below.
Analytical skills. To carry out their duties, the most important skill for a medical biller coder to have is analytical skills. Their role and responsibilities require that "health information technicians must understand and follow medical records and diagnoses, and then decide how best to code them in a patient’s medical records." Medical biller coders often use analytical skills in their day-to-day job, as shown by this real resume: "review billing trends and compliance issues charge entry and post and reconcile adjudications research/ analyze unidentified eob for adjustments. "
Detail oriented. Another essential skill to perform medical biller coder duties is detail oriented. Medical biller coders responsibilities require that "health information technicians must be accurate when recording and coding patient information." Medical biller coders also use detail oriented in their role according to a real resume snippet: "printed and highlighted important details on explanation of benefits (eob) forms. "
Integrity. Another skill that relates to the job responsibilities of medical biller coders is integrity. This skill is critical to many everyday medical biller coder duties, as "health information technicians work with patient data that are required, by law, to be kept confidential." This example from a resume shows how this skill is used: "follow policies and procedures to assure that the confidentiality, security and integrity of patient data and information are maintained. "
Interpersonal skills. A big part of what medical biller coders do relies on "interpersonal skills." You can see how essential it is to medical biller coder responsibilities because "health information technicians need to be able to discuss patient information, discrepancies, and data requirements with other professionals such as physicians and finance personnel." Here's an example of how this skill is used from a resume that represents typical medical biller coder tasks: "work billing edits with medical insurance work and maintain all sits assigned interpersonal competencies professional appearance and manner"
Technical skills. Another common skill required for medical biller coder responsibilities is "technical skills." This skill comes up in the duties of medical biller coders all the time, as "health information technicians must use coding and classification software and the electronic health record (ehr) system that their healthcare organization or physician practice has adopted." An excerpt from a real medical biller coder resume shows how this skill is central to what a medical biller coder does: "provided exceptional technical support to customer service representatives and productively trained staff. "
The three companies that hire the most medical biller coders are:
- GGuidehouse51 medical biller coders jobs
- HHospice Of Holland12 medical biller coders jobs
- TThe Toledo Clinic6 medical biller coders jobs
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Compare different medical biller coders
Medical biller coder vs. Health information technician
A health information technician is primarily responsible for managing and handling patient information, ensuring accuracy and confidentiality. They coordinate with various health care workers to gather patient data, laboratory results, test findings, and medical histories, encoding them in clinical databases in a timely and efficient manner. They must analyze every information to detect any inconsistencies, performing corrective measures right away. Furthermore, as a health information technician, it is essential to utilize particular software and systems when processing information, all while adhering to the hospital's policies and regulations.
These skill sets are where the common ground ends though. The responsibilities of a medical biller coder are more likely to require skills like "medical billing," "icd-10," "cpt-4," and "hcpcs." On the other hand, a job as a health information technician requires skills like "patient care," "office equipment," "transcription," and "rehabilitation." As you can see, what employees do in each career varies considerably.
Health information technicians tend to make the most money working in the government industry, where they earn an average salary of $35,705. In contrast, medical biller coders make the biggest average salary, $39,875, in the professional industry.health information technicians tend to reach similar levels of education than medical biller coders. In fact, health information technicians are 1.7% more likely to graduate with a Master's Degree and 0.1% more likely to have a Doctoral Degree.Medical biller coder vs. Information management specialist
An information management specialist is responsible for maintaining the security benchmark of all databases across the organization to support business functions and client requirements. Information management specialists sort and file data on the network systems and pull up reports from the storage database. They also analyze project management plans and utilize data tools to identify solutions and collect critical information. An information management specialist handles data management system troubleshooting and provide resolution reports to avoid downtime reoccurrence.
Each career also uses different skills, according to real medical biller coder resumes. While medical biller coder responsibilities can utilize skills like "medical billing," "icd-10," "cpt-4," and "hcpcs," information management specialists use skills like "patient care," "cycle management," "phone calls," and "cpt."
Information management specialists may earn a higher salary than medical biller coders, but information management specialists earn the most pay in the technology industry with an average salary of $66,785. On the other hand, medical biller coders receive higher pay in the professional industry, where they earn an average salary of $39,875.Average education levels between the two professions vary. Information management specialists tend to reach higher levels of education than medical biller coders. In fact, they're 7.0% more likely to graduate with a Master's Degree and 0.1% more likely to earn a Doctoral Degree.Medical biller coder vs. Release of information specialist
A release of information specialist is primarily in charge of retrieving and releasing data to qualified recipients while adhering to the guidelines and confidentiality protocols that aim to protect sensitive information. Although the extent of their responsibilities usually depends on their industry or company of employment, it usually includes maintaining records of procedures and transactions, preparing and processing documents, organizing files, producing progress reports to managers, and keeping an eye out for any inconsistencies, resolving them promptly and efficiently.
The required skills of the two careers differ considerably. For example, medical biller coders are more likely to have skills like "medical billing," "icd-10," "cpt-4," and "hcpcs." But a release of information specialist is more likely to have skills like "roi," "phone calls," "patient care," and "subpoenas."
Releases of information specialist make a very good living in the insurance industry with an average annual salary of $51,336. On the other hand, medical biller coders are paid the highest salary in the professional industry, with average annual pay of $39,875.releases of information specialist typically earn similar educational levels compared to medical biller coders. Specifically, they're 0.7% more likely to graduate with a Master's Degree, and 0.1% more likely to earn a Doctoral Degree.Medical biller coder vs. Records manager
The records manager is an important position that handles the creation, organization, and disposal of records. They are also responsible for establishing systems for their management and the maintenance, verification, and evaluation of extant systems. It will require technical and analytical skills, as well as a great deal of integrity for handling sensitive information.
Types of medical biller coder
Updated January 8, 2025
