Medical Billing and Coding Specialist Roles and Responsibilities

Deciding whether a career in medical billing is a good choice requires knowledge of the roles and responsibilities associated with this position.  An insurance billing specialist is mainly responsible for collecting reimbursements for services rendered by physicians, health-care facilities, nurse practitioners, and other health-care related services.  This involves reviewing and coding information on charges, bills, and patient information sheets, as well as making sure the information from sources such as patient registration sheets, hospital admission forms, and other billing records is accurate. 

Accuracy and attention to detail is a must in the medical billing field, and specialists must be comfortable verifying information when needed.  Proper coding requires a billing specialist to be able to use different coding books like ICD – 9 or 10 and CPT, and understand HIPAA regulations. Errors in verification or lack of understanding of coding materials can lead to unpaid billing or lawsuits, which impacts the entire organization. 

Some smaller practices and facilities often require the specialist to handle patient registration, including entering all necessary information in order to schedule procedures or other appointments that may be necessary.  Bookkeeping and accounting is usually required in smaller facilities as well.  This entails posting payments when they are received, as well as making sure all information regarding billing and payments is entered correctly.  To do this, they have to make sure they have all the information that could affect how things are billed, including adjustments, write-offs, and denials.

A career as a medical billing specialist requires absolute honesty and integrity. Patient information must be kept private, which means the typical venting after a rough day is not acceptable.  Discussions concerning patient information must be carried out away from non-medical personnel, and only with those who are directly related to the patient’s care to ensure medical information remains private. 

A career as a medical billing specialist allows people to take part in the medical field in a less hands-on capacity than being a physician or nurse.  This position gives the specialist the ability to help others by ensuring they are billed correctly, and making sure there are no billing errors that could potentially hurt the patient financially.  Also, based on the growth this career has seen already, there is a great demand for those who are willing to get the education and certifications, which definitely helps job security.

The education and certifications required for the medical billing profession is an ongoing process.  Changes in coding books, programs, and technology make further education a necessity in the medical billing field, so a person has to be prepared to take classes as long as they are involved in this career.

Those that pursue a medical billing career have to be prepared to never have a bad or lazy day. One day of not being “with it” can have serious repercussions. There are always going to be new laws and procedures that will require a specialist to be paying attention to every detail on a daily basis.  A specialist needs to be able and willing to work accurately and quickly every day to make sure there are no mistakes. 

A medical billing career can be very rewarding, as long as one is aware of what it takes to succeed in this profession.  The rapid growth being projected for this occupation makes it a lucrative career choice for honest, reliable people who are dedicated to continuing their education, committed to paying close attention to detail, and confident enough to question doctors and other medical personnel when needed.  A career as a medical billing specialist can be challenging, but for those who have the focus and integrity required to succeed it can be a very satisfying and lucrative profession.