Differences Between Medical Billing and Coding - Skills To Get Ahead In Your Career

Medical billing and coding are two vital functions within the health care industry. These professionals, known as medical billers and medical coders, track medical treatments received while at a doctor’s office, during a clinic visit or at the hospital to coordinate payments from insurance companies and patients. Medical billers and coders use many skills while on the job. In this article, we discuss the differences between these processes and skills and explore how to pursue these two career paths.

Medical billing is the means of processing insurance claims and creating invoices for patients. This process involves updating financial records, calculating bills and charges for patients, providing customer assistance and completing financial transactions to settle outstanding balances.

Medical billers are the health care finance professionals who oversee the payments and balances for insurance claims rendered by a health care provider. They are also the liaison between the insurance company representatives and the provider, often confirming patients’ insurance coverage, coordinating payments and following up on outstanding balances.

For the most up-to-date salary information from Indeed, click on the salary link. The national average salary for a medical biller is .css-1v152rs{border-radius:0;color:#2557a7;font-family:”Noto Sans”,”Helvetica Neue”,”Helvetica”,”Arial”,”Liberation Sans”,”Roboto”,”Noto”,sans-serif;-webkit-text-decoration:none;text-decoration:none;-webkit-transition:border-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),background-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),opacity 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-style 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-width 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-radius 200ms cubic-bezier(0.645, 0.045, 0.355, 1),box-shadow 200ms cubic-bezier(0.645, 0.045, 0.355, 1),color 200ms cubic-bezier(0.645, 0.045, 0.355, 1);transition:border-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),background-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),opacity 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-style 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-width 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-radius 200ms cubic-bezier(0.645, 0.045, 0.355, 1),box-shadow 200ms cubic-bezier(0.645, 0.045, 0.355, 1),color 200ms cubic-bezier(0.645, 0.045, 0.355, 1);border-bottom:1px solid;cursor:pointer;}.css-1v152rs:hover{color:#164081;}.css-1v152rs:active{color:#0d2d5e;}.css-1v152rs:focus{outline:none;border-bottom:1px solid;border-bottom-color:transparent;border-radius:4px;box-shadow:0 0 0 1px;}.css-1v152rs:focus:not([data-focus-visible-added]){box-shadow:none;border-bottom:1px solid;border-radius:0;}.css-1v152rs:hover,.css-1v152rs:active{color:#164081;}.css-1v152rs:visited{color:#2557a7;}@media (prefers-reduced-motion: reduce){.css-1v152rs{-webkit-transition:none;transition:none;}}.css-1v152rs:focus:active:not([data-focus-visible-added]){box-shadow:none;border-bottom:1px solid;border-radius:0;}, and they can work in many environments, such as primary care facilities, clinics, hospitals and specialists’ offices.

.css-1v152rs{border-radius:0;color:#2557a7;font-family:”Noto Sans”,”Helvetica Neue”,”Helvetica”,”Arial”,”Liberation Sans”,”Roboto”,”Noto”,sans-serif;-webkit-text-decoration:none;text-decoration:none;-webkit-transition:border-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),background-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),opacity 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-style 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-width 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-radius 200ms cubic-bezier(0.645, 0.045, 0.355, 1),box-shadow 200ms cubic-bezier(0.645, 0.045, 0.355, 1),color 200ms cubic-bezier(0.645, 0.045, 0.355, 1);transition:border-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),background-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),opacity 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-style 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-width 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-radius 200ms cubic-bezier(0.645, 0.045, 0.355, 1),box-shadow 200ms cubic-bezier(0.645, 0.045, 0.355, 1),color 200ms cubic-bezier(0.645, 0.045, 0.355, 1);border-bottom:1px solid;cursor:pointer;}.css-1v152rs:hover{color:#164081;}.css-1v152rs:active{color:#0d2d5e;}.css-1v152rs:focus{outline:none;border-bottom:1px solid;border-bottom-color:transparent;border-radius:4px;box-shadow:0 0 0 1px;}.css-1v152rs:focus:not([data-focus-visible-added]){box-shadow:none;border-bottom:1px solid;border-radius:0;}.css-1v152rs:hover,.css-1v152rs:active{color:#164081;}.css-1v152rs:visited{color:#2557a7;}@media (prefers-reduced-motion: reduce){.css-1v152rs{-webkit-transition:none;transition:none;}}.css-1v152rs:focus:active:not([data-focus-visible-added]){box-shadow:none;border-bottom:1px solid;border-radius:0;}

There are a few skills that enable medical billers to complete their work, including:

This is a multifaceted skill that allows medical billers to speak clearly with patients, medical staff and insurance company representatives. Using a calm, respectful tone and being able to discuss terminology and processes universally are vital communication skills medical billers use to ensure patients understand their medical bills.

Calculating charges and financial records are an essential component of this role, so basic arithmetic, being comfortable working with numbers and bookkeeping experience enable medical billers to efficiently and accurately manage patient accounts.

Medical billers need to arrange files efficiently to ensure physicians and other staff can access up-to-date patient information with ease. In addition, they may be responsible for large numbers of patient accounts each day, requiring time management and focus to complete necessary paperwork, submit claims, communicate with patients or insurance companies and collect payments.

These medical professionals handle sensitive information related to patient medical histories and finances. This position requires a high level of discretion to ensure information remains secure per privacy laws.

Specific requirements can qualify you for a medical billing position. To help you get started, consider the following steps as a guide in your job search:

For many medical biller positions, you only need a high school diploma or GED certificate to secure employment. Many employers may require you to complete medical billing coursework from a community college or a vocational school to ensure you have the necessary knowledge of health care finance and familiarity with medical bookkeeping and patient account software. You can earn a post-secondary certification or an associate degree with a focus in medical billing or health care finance.

After earning a degree or post-secondary certification, consider working an entry-level position at a medical office. Some employers may hire candidates during their education as part-time or internship positions. This is a great way to get additional experience on your resume while learning in various environments. Many employers also accept candidates right after they complete their education.

There are many certifications you can consider to develop your skills further and demonstrate your medical billing expertise to prospective employers. With the right amount of experience, certifications from the American Health Information Management Association and the American Academy of Professional Coders can help you secure more senior positions and increase your earning potential.

Create a resume that includes your medical billing skills and the experiences in which you’ve successfully used and refined them. In the case of having limited professional experience, highlight volunteer roles, relevant skills you’ve developed and accomplishments resulting from your education background, such as GPA and relevant coursework.

Medical coding is the process of compiling a patient’s visit and the services, tests and treatments they received. This information goes into a patient’s medical record, detailing what each charge is for and why they’re assigned a specific treatment or procedure using the provider’s notes on the visit.

Medical coding also extracts billing information from clinical records to create insurance claims and bills for patients. A medical coder, also known as a medical coding specialist, analyzes clinical documentation to select accurate billing codes assigned to specific diagnoses or procedures that a patient receives.

For the most up-to-date salary information from Indeed, click on the salary link. The national average salary for a medical coding specialist is .css-1v152rs{border-radius:0;color:#2557a7;font-family:”Noto Sans”,”Helvetica Neue”,”Helvetica”,”Arial”,”Liberation Sans”,”Roboto”,”Noto”,sans-serif;-webkit-text-decoration:none;text-decoration:none;-webkit-transition:border-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),background-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),opacity 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-style 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-width 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-radius 200ms cubic-bezier(0.645, 0.045, 0.355, 1),box-shadow 200ms cubic-bezier(0.645, 0.045, 0.355, 1),color 200ms cubic-bezier(0.645, 0.045, 0.355, 1);transition:border-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),background-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),opacity 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-color 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-style 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-bottom-width 200ms cubic-bezier(0.645, 0.045, 0.355, 1),border-radius 200ms cubic-bezier(0.645, 0.045, 0.355, 1),box-shadow 200ms cubic-bezier(0.645, 0.045, 0.355, 1),color 200ms cubic-bezier(0.645, 0.045, 0.355, 1);border-bottom:1px solid;cursor:pointer;}.css-1v152rs:hover{color:#164081;}.css-1v152rs:active{color:#0d2d5e;}.css-1v152rs:focus{outline:none;border-bottom:1px solid;border-bottom-color:transparent;border-radius:4px;box-shadow:0 0 0 1px;}.css-1v152rs:focus:not([data-focus-visible-added]){box-shadow:none;border-bottom:1px solid;border-radius:0;}.css-1v152rs:hover,.css-1v152rs:active{color:#164081;}.css-1v152rs:visited{color:#2557a7;}@media (prefers-reduced-motion: reduce){.css-1v152rs{-webkit-transition:none;transition:none;}}.css-1v152rs:focus:active:not([data-focus-visible-added]){box-shadow:none;border-bottom:1px solid;border-radius:0;}, and they typically work at hospitals or doctors’ offices.

Some of the essential skills to be a medical coder include:

Medical coders must be able to review medical records and diagnoses to assign codes correctly for accurate billing. Critical thinking and knowledge of medical terminology can help these professionals determine every billable aspect of a visit to create accurate invoices for insurance companies and patients.

These skills involve collaborating with medical personnel, insurance company representatives and patients on a daily basis. Traits like teamwork, adaptability and conflict resolution are transferable skills that can serve this profession well.

The ability to ask for clarification on procedures, discuss diagnoses with medical professionals and empathize with patients is a highly advanced communication skill that is essential to this role. Being able to effectively communicate with insurance companies about questions, errors or additional information about a patients’ claim is essential to managing a facility’s finances.

Medical coders must use specialized medical classification software to assign diagnosis or procedural codes for insurance billing. They also utilize their health care organization’s electronic health record system. Proficiency with this technology, as well as Current Procedural Terminology codes and ICD-10 codes, which are used to document a patient’s visit, is necessary. Being comfortable working with these programs and codes, as well as typing and data entry, enable these professionals to be efficient on the job.

These professionals also need to be accurate when entering codes and processing patient information to ensure proper documentation and billing for services. This skill helps these professionals collect the correct amount of money from insurance companies and patients to help the organization remain financially stable.

To help you get started, consider the following steps as a guide in your job search:

To be a medical coder, you will need an associate degree or post-secondary certificate in medical coding, health information technology or a closely-related field. These programs provide coursework in medical terminology, insurance policy, and health care finance and regulations, as well as training in medical billing and documentation software that medical coders frequently use in the workplace.

Some employers may hire candidates with newly acquired medical coding education, though many prefer candidates with experience and professional certification. To gain experience, consider pursuing part-time work in a medical billing or medical coding position to become familiar with the processes and software as well as practice customer service, communication and organization skills. While completing your education, consider part-time work, a volunteer role or an internship.

Many employers prefer candidates with medical coding certification, which demonstrates their knowledge of medical codes, ability to accurately review and document medical procedures and diagnoses and use medical billing and coding software.

Certifications from the American Academy of Professional Coders assess your skills and knowledge to prove your expertise to prospective employers. It confirms you’re apt in verifying codes for services, procedures and diagnoses, such as in outpatient settings, same-day surgeries and emergency room visits. These certifications may help you secure employment, advance in your career and increase your earning potential.

Identify the medical coding positions you’d like to apply for, and review the job descriptions for required skills, education, training and experience. Craft a resume that details your experience and skills that align with the expectations of prospective employers.