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What does a Medical Insurance Coder do?

Brenda Scott
Brenda Scott

As the average life expectancy increases, the need for people working in all aspects of health care continues to grow. In the United States, all medical facilities use universal coding systems to maintain patient information and to request insurance and Medicare reimbursement. A medical insurance coder assigns codes to each symptom, diagnosis, and treatment for every patient and enters the information into a database.

A medical insurance coder analyzes patient records to ensure that all services have been documented. He then uses a computer software program to assign the proper codes so that treatment can be monitored and the correct amounts billed. Attention to detail is extremely important, because miscoding can result in a loss of income for the medical facility. Also, significant penalties can be assessed against an institution for improper billing of Medicare and Medicaid claims.

Medical coding programs should teach students how to use a range of computer equipment and software.
Medical coding programs should teach students how to use a range of computer equipment and software.

This is one career that does not require a four-year college degree. A medical insurance coder training program can be as short as nine months. A person often cannot qualify to take a certification exam, however, unless they have an associate degree, which typically takes two years to complete. Because of this, most health care facilities will only hire applicants with a two-year degree.

Medical codes change periodically, and it is also important to keep up with ethics guidelines and industry issues.
Medical codes change periodically, and it is also important to keep up with ethics guidelines and industry issues.

Generally, associate degrees are not specifically designated as a medical insurance coder degree. They usually cover the broader field of medical information management. The one exception is for medical coders who wish to specialize in cancer registry.

Course work for degrees in health care information management includes training in medical terminology, pharmacology, anatomy and physiology, data coding, and computer science. Most employers offer on-the-job training for new hires, which is more specific to the actually coding systems used. While it is not required for a medical insurance coder to be certified, it is strongly encouraged. Certification increases job options and opportunities for promotion.

A medical insurance coder may work in a hospital or doctor's office.
A medical insurance coder may work in a hospital or doctor's office.

Hospitals, walk-in care clinics, doctor’s offices, home health providers and long-term care facilities all require the services of a medical insurance coder. Other potential employers include insurance companies and government health organizations. The US Bureau of Labor Statistics predicts that the number of job opportunities in field will continue to grow.

A medical insurance coder assigns codes to each symptom, diagnosis and treatment for a patient and enters the information into a database.
A medical insurance coder assigns codes to each symptom, diagnosis and treatment for a patient and enters the information into a database.

Becoming a medical insurance coder offers a chance to enter the healthcare industry with a minimum amount of training. Courses are available at many community colleges, so the education costs are relatively affordable. For someone who enjoys medical information, is computer savvy, and pays attention to detail, this can be a great opportunity.

Discussion Comments

live2shop

Getting trained to become a medical insurance coder and then working for a while as a coder would give a coder experience in becoming familiar with medical diagnosis and symptoms. This may open up other medical career opportunities for that person.

By getting a four year degree, they could have a choice of many different medical jobs, like nursing, technical jobs, and others.

Medical insurance coding could be a great place to start learning a lot about medicine.

Misscoco

I would guess that there will always be job opportunities for medical insurance coders. It's an important job, even though the requirements don't include a four year degree.

I'm sure the job can become quite tedious, but the coder really needs to pay close attention. Putting in the wrong code can cause a patient to have to pay for medical services out of their own pocket. Many patients don't check their bills that carefully, so a billing with a mistake might not be noticed.

LisaLou

Even though a bachelor's degree is not required to get a job as a medical insurance coder, there is a lot of responsibility that goes with the job.

Anytime you have human beings entering the medical information in the system, you have a chance for human error. That is why it is so important to really look over your medical bills and documents very carefully so you are being diagnosed and charged correctly.

It doesn't matter whether you do medical billing at home or work in an office, the importance of accuracy is the same. There is a lot at stake for each patient if wrong information gets coded in to the system.

My niece has worked as a medical coder for many years, and even though mistakes are found and corrected, the process is often long and frustrating.

SarahSon

I have a friend who has worked in the medical field for several years. The company she works for now gave her the opportunity to do medical coding at home.

She is able to log in and use the appropriate software to do her coding. Everything is done over the computer and she does not have to travel in to the office every day for work.

Not everybody would enjoy working at home all the time because you have to be really disciplined, but this is something that has worked out great for her.

sunshined

When my daughter graduated from high school, she had no idea what she wanted to do but had always been interested in the medical field.

After 6 months of working at a job she didn't like very well, she decided to enroll in a course at our local community college.

It took her less than two years to complete the course, get certified and begin her job as a medical billing coding specialist.

She enjoys her job and the benefits that go along with it. The combination of medical knowledge and computer work is a perfect fit for her.

drtroubles

There are plenty of medical billing coding schools out there if you are looking for a job as a medical insurance coder. I am always seeing advertisements that are offering certification in medical billing.

I suppose at the population ages, we're going to need more and more medical billing and coding specialists. It seems like more and more people are dealing with Medicare and Medicaid claims.

My cousin is currently studying to be a medical insurance coder, and apparently the job prospects are quite good. A lot of the students get plucked from the schools where they are studying do to the demand.

manykitties2

When you have something fishy turn up on your medical insurance claim that makes you feel certain that someone has made a mistake, it is best to ask to speak with whomever deals with the medical claims and billing specialist. Medical insurance coders are human too, and even with their medical coding billing training they can still make errors.

For myself I found that my medical insurance claim had been coded wrong, and I was denied coverage. Apparently this happens more often than most companies would like to admit. I suppose people being overworked is probably a big part of the issue.

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    • Medical coding programs should teach students how to use a range of computer equipment and software.
      By: contrastwerkstatt
      Medical coding programs should teach students how to use a range of computer equipment and software.
    • Medical codes change periodically, and it is also important to keep up with ethics guidelines and industry issues.
      By: Gina Sanders
      Medical codes change periodically, and it is also important to keep up with ethics guidelines and industry issues.
    • A medical insurance coder may work in a hospital or doctor's office.
      By: diego cervo
      A medical insurance coder may work in a hospital or doctor's office.
    • A medical insurance coder assigns codes to each symptom, diagnosis and treatment for a patient and enters the information into a database.
      By: xy
      A medical insurance coder assigns codes to each symptom, diagnosis and treatment for a patient and enters the information into a database.