medical biller, Medical coder

What Is The Difference Between A Medical Coder and a Medical Biller?

If you’re in the medical field, or are currently taking a medical coding and billing class, you’ve no doubt heard the words “medical coder” and “medical biller.” You might even think these jobs are the same because the names sound similar. Sometimes (especially in smaller practices) these roles are combined. But even though these positions are definitely related, each one is different. Here is a breakdown of the differences in a very general way.

Medical coders read the patient reports and assign ICD-10-CM and CPT, HCPCS (or ICD-10-PCS if you’re an inpatient coder) codes. It takes a great deal of knowledge of not only the code sets you’re using, but of disease processes and terminology. You will also need to know about the different insurances you’re billing and their requirements. Basically you have to know your stuff. The simple fact of the matter is–it takes time to get to the level where you can do this completely independently. Bear in mind– many medical coding jobs have production and accuracy requirements. To add insult to injury–if you do not meet these requirements, many times you could be fired. Can anyone say stressful? On the plus side though, if you don’t like dealing with the public very much, you really don’t have to as a medical coder. Usually your job is completely behind the scenes. You also will need to have at least one certification from either AAPC or AHIMA. (There is a new certification for coders from AMBA, but it is not highly recognized yet. I believe it will be though in the future).

A medical biller usually work the claim denials and tries to fix them to get them paid. Many times they read patient EOB’s and eventually need to call the insurance company to figure things out. They also probably talk to patients either on the phone or in the office and explain their bills to them and/or ask for payment. To be a successful medical biller, you should have a basic understanding of the common codes used in your practice and what they mean. Usually a certification is not required but there are billing certifications available from AAPC and AMBA.

So, that is it in a nutshell. The tasks of medical coders and medical billers are related, but different. As a side note-working as a medical biller first, is a great stepping-stone to working as a medical coder later. Good luck to those of you just starting in the field!

Thanks for reading,

Lindsay

 

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