Medical Coder Job Description: Top Duties and Qualifications

A Medical Coder, or Certified Professional Coder, is responsible for reviewing a patient’s medical records after a visit and translating the information into codes that insurers use to process claims from patients. Their duties include confirming treatments with medical staff, identifying missing information and submitting forms to insurers for reimbursement.

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Medical Coder duties and responsibilities

The duties and responsibilities of a Medical Coder vary from one healthcare facility to another. The main duty of a Medical Coder is assigning codes to medical procedures and diagnoses. Other duties and responsibilities of a Medical Coder include:

  • Making sure that codes are assigned correctly and sequenced appropriately as per government and insurance regulations
  • Complying with medical coding guidelines and policies
  • Receiving and reviewing patients’ charts and documents for verification and accuracy
  • Following up and clarifying any information that is not clear to other staff members
  • Collecting information made by the Physician from different sources to prepare monthly reports 
  • Implementing strategic procedures and choosing strategies and evaluation methods that provide correct results
  • Examining any medical malpractice that has been reported by analyzing and identifying the medical procedures, diagnoses or events that lead to the negligence

What does a Medical Coder do?

Medical Coders work at hospitals, clinics and other healthcare settings to facilitate communication with insurance companies. They spend most of their time interpreting patient files and manually updating them with medical codes. When assigning a code to a patient’s file, Medical Coders use established systems that make it easy for insurers to recognize what kinds of treatment they cover under a patient’s plan. Medical Coders also gather documentation to validate their coding choices and argue against any wrongfully denied claims. They analyze all parts of a patient’s visit, including diagnostic tests, consultations, in-office procedures and prescribed medication.

Medical Coder skills and qualifications

A Medical Coder works in healthcare facilities and is responsible for converting medical diagnosis, equipment and processes into standardized codes that are used when filing insurance claims. The skills and qualifications that a Medical Coder needs in order to achieve this include:

  • A strong understanding of physiology, medical terms and anatomy
  • Proficiency in computer skills including typing speed and accuracy
  • Mathematics skills
  • Excellent written and verbal communication skills
  • Organizational skills
  • Ability to maintain a high level of integrity and confidentiality of medical information
  • Strict attention to details
  • Knowledge of data entry and transcription

Medical Coder salary expectations

A Medical Coder makes an average of $22.10 per hour. However, this pay rate can vary depending on a candidate’s education and level of experience.

Medical Coder education and training requirements

A Medical Coder should have the educational qualifications and training necessary to do the job. Although the educational requirements vary from one employer to the other, most medical facilities prefer a Medical Coder with a master’s degree or at least a bachelor’s degree. However, most entry jobs require the successful completion of a certification program or a bachelor’s degree. Relevant concentrations for certificates, bachelor’s degrees and master’s degrees include medical billing and coding, healthcare administration, health information management or a related field of study.

Medical Coder experience requirements

A proficient Medical Coder should have experiences with medical coding guidelines and procedures such as ICD-9, CPT, ARG and ASA, among several others. Experience in other clinical services search as program management and health records is an added advantage. Medical Coders should have at least 2 years of experience in the medical field, either through work or volunteer roles.

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Frequently asked questions about Medical Coders

 

What is the difference between a Medical Coder and a Medical Biller?

Medical Coders and Medical Billers work together to make sure that healthcare providers receive payment for their claims. Medical Coders work behind the scenes to translate medical records into a series of codes, making it easy for insurers to quickly confirm or deny a claim. After completing a patient’s file, Medical Coders pass the information to Medical Billers, who communicate with patients and insurance representatives about the outstanding balance associated with an account. If an insurance provider denies a claim, Medical Billers prepare invoices for patients to pay out -of-pocket and arrange payment plans when necessary.

 

What are the daily duties of a Medical Coder?

Medical Coders usually work standard office hours alongside other medical office staff. After a patient completes their visit, the Medical Coder reads their chart or file and classifies the information from their appointment into different categories. If they are unsure about the type of code for a certain treatment, the Medical Coder references medical coding guidelines and researches the correct code. They carefully put the codes in sequence and submit them to the patient’s insurance provider or to the Medical Biller on their staff. If there is an issue with a submission, they review existing codes and document any corrections.

 

Do Medical Coders have different responsibilities in different industries?

Medical Coders have the same basic role regardless of what kind of medical office they work in, but they can use different types of coding systems for various specialties. Most standard Medical Coders use three main codes: International Classification of Diseases (ICD), Current Procedural Technology (CPT) and Healthcare Common Procedure Coding System (HCPS). Many types of specialized medical offices use their own coding systems, including emergency departments, chiropractic offices, dermatology practices, pain management centers and plastic surgery centers. Medical Coders need to learn the details of each specialty to appropriately process each type of treatment.

 

What are the characteristics of a good Medical Coder?

The most important characteristic of a good Medical Coder is the ability to pay attention to small details. Many medical codes have a single letter or number that differentiates a treatment from a completely different procedure, and coding mistakes could lead to a claim being denied or a significant delay in receiving payment. Good Medical Coders diligently check their work after translating a file into medical codes, checking that each entry is accurate. They are good at troubleshooting problems with a patient’s file and determining the cause of any discrepancies in someone’s medical history and insurance claim.

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