A medical coder is responsible for making sure doctors, hospitals, and other healthcare facilities are reimbursed for the services they provide. Medical coders do this by assigning standard codes to all tests, treatments, procedures, and diagnoses. These codes are then used to bill patients and third party payers (insurance companies, Medicare, etc.) for the services the healthcare facility provided.
Let's take a look at how this process would work for a regular visit to the doctor. When you're seen by the doctor, all of the doctor's notes are recorded in your patient record. These notes include what the doctor saw you for, what his/her diagnoses was, any tests that were ordered, treatment plans, etc. Within a few days of your visit, the medical coder is responsible for assigning codes to each of those bits of information in your patient record. This information is then used by the medical biller (who in a small practice is often the same person as the medical coder) to bill your insurance company and then you if an additional amount is owed.
If you think of all the different reasons people go to the doctor or hospital, you can start to get an idea of just how complex a medical coder's job is. To further complicate things, there are several standard code sets, each used in different situations, giving coders thousands of codes to work with. The code chosen to represent a given piece of information usually determines how much a provider can be reimbursed, so medical coding and billing is extremely important to a healthcare organization's financial viability.
Because medical coding is so complex and important to each healthcare facility, medical coding careers require specialized training. (Learn how you can choose the best medical coding training.) Career Step is a leading medical coding school that offers the comprehensive, hands-on training you need for medical coding careers.