Billing and Coding Specialist Responsibilities

Job Descriptions » Specialist Job Descriptions » Responsibilities of a Billing and Coding Specialist

The billing and coding specialist is a highly demanded job profile as the professional is mainly associated with the medical and accountant industry. He has a major part to play in the proceedings of the medical facilities, hospitals or the doctor's offices. Any service rendered by the hospital to the patients is drafted in a written code format which is later recorded in the computer software. The patients also receive an invoice of these services rendered by the hospital. The billing and coding specialist makes sure that the services are properly recorded and the patients receive the appropriate bills. He also ensures that the medical facilities possess the accurate amount of payments received from the patients.

Requirements of a Billing and Coding Specialist

The job requirements of a billing and coding specialist are listed below:

The candidate needs to have a bachelor's degree in the billing and coding program from an accredited college
He should have a professional credential or certification from recognized organizations such as the Board of Medical Specialty Coding (BMSC), American Health Information Management Association (AHIMA), American Academy of Professional Coders (AAPC), etc.
He should possess proficient written and oral communication abilities
He should be well acquainted with the latest technologies and applications that are utilized by the billing and coding specialists
He should be flexible so as to adjust to the changes that take place in the coding and billing procedures and should have the skill to promptly learn the updates or information regarding the same
He should be well versed with the medical terms and must have an expertise in typing, data entry, database maintenance, and creating spreadsheets

Job Responsibilities of a Billing and Coding Specialist

The job responsibilities of a billing and coding specialist are as follows:

The billing and coding specialist keeps an up to date information about the demands of a claim submission and the internal functions of the insurance firms
Every organization possesses different forms of submitting the claims. The billing and coding specialist is required to accurately set the form to the firm. He is also required to ensure that the charges and codings are in an apt format for the processes executed in the organization
He makes an exact assessment of the medical records and diagnostic researches. He then transforms the data in a globally identified ICD-9 identification code or codes
He makes sure that the CPT, i.e. the procedural code suitably fits the research results by making an appropriate identification of ICD-9. For instance, he can adjust the determination of 'laceration' with the 'sutures' process
Most of the insurance firms reject the claims that possess ICD-9 codes, but lack appropriate CPT codes
He may work as a professional who does the processing of the electronic claims. He makes a proper transfer of the digital claims to the insurance firms through a particular program which is dependent on the web
He even channelizes the hard copy of the paper claims in an arrangement that satisfies the needs of the insurance firms for the purpose of electronic transmittance
He may concentrate on the work of the accounts receivable department and perform the tasks that are similar to that of a medical collector
Sometimes, the payment received is found to be faulty or failed to be in correspondence with the regulations of the insurance firms. In that case, the billing and coding specialist may take care of the changes to be done to rectify the payment procedure and execute a proper follow up for such a payment procedure
With a view to maintain a regularity in the flow of payment, the billing and coding specialist keeps a track of the outstanding payments from the patients and the insurance firms

Other Job Responsibilities of a Billing and Coding Specialist

The other important job responsibilities of a billing and coding specialist are given below:

In order to fix an arrangement for the fees to be paid by the patients to the hospital, the billing and coding specialist may work in close relation with the patient's family and the patients themselves
He may execute the tasks of that of a claims reviewer and work generally with the insurance firms, so as to identify the correctness of the charges being applied on the payments
He may also make sure that the identification codes match with the procedural codes. He looks after the contractual indebtedness of the insurance firms may have with the medical institutions
He has the authority to reject or sanction the claims on the basis of the singular merits and the conformity with the laws and regulations of the insurance firms
Many a times, he acts as a link between the insurance firms and the patients
He maintains a record of the leftover payments and co-payments of the patients
He also maintains a documentation of the collections and billings that are expected to receive from the insurance firms

Billing and coding specialist responsibilities will help to pave a way for your victory in the search of an appropriate employment opportunity for the growth of your career.