Everything To Know About Medical Billers and Coders

The medical billing and coding industry is a fast-growing industry and rightly so since technology is boosting the development of the healthcare industry. Moreover, when it comes to medical billing specialists, is one of the most sought-after occupations in the U.S medical industry. Medical billing and coding are getting quite the recognition because of how crucial it has become for any hospital these days. The medical coders and billers are being recognized under the BLS (United States Bureau of Labour Statistics) segregation of medical secretaries which in total has a total employment of 22%.

Who Is A Medical Billing And Coding Specialist?

Medical Billing & Coding Specialists, also known as Medical Billing & Coding Technicians, play a key role in the delivery of patient care

A medical billing and coding specialist acts as a connector between the insurance companies and the medical organization. It is no secret that every hospital out there no matter how big or small always requires a dedicated team of medical billers and coders to look after the submission of claims to make the process of reimbursement simpler and easier. It is the job of the medical coders and billers to create the required invoices for the patients which then get sent with the claims to the insurance payers. 

One of the reasons why doctors and other medical staff are not given this duty is because they have to focus on taking care of the patients; if they were burdened with administrative tasks such as this one it can create an unnecessary ruckus. 

Medical professionals are in charge of taking care of their patients, whereas medical billers and coders are in charge of the important administrative work. Medical billing and coding specialists are adept in the field of medical billing and coding and when you hire experienced individuals you will not come across any coding and billing errors whatsoever. Hire a reputed company that can work coherently with your business. They are trained in the medical billing and coding process which is why their demand is increasing day by day. 

The medical billing specialists help the medical organizations to control invoices, payments and insurance claims in a proper manner. The daily work of the medical billing and coding specialists includes various activities such as:

  1. Follow up with the insurance companies and patients about all the outstanding bills
  2. Keeping a proper track of the payments
  3. Correct all of the claims that have been rejected
  4. Prepare and send the claims or invoices required for the payment
  5. Properly code the procedures, services, treatments and diagnoses


While the workers tend to work in the same medical organization where all of the patients go for their treatment, the work is mainly administrative as opposed to the clinical work that the medical professionals have to do. It is the work of a medical MEDICAL BILLING to spend a larger time in front of the computer to review and enter all of the information besides updating the previous information. 

Understanding The Difference Between Medical Coding and Billing

What Is a Medical Coding and Billing Specialist?

The work of medical billers and coders is oftentimes clubbed together and shown as one job, however, technically speaking the job of a medical biller and a medical coder is different. The responsibilities and tasks of the medical billers and coders are different. The majority of the time medical organizations tend to hire one single person to do both the job, however, if the hospital is larger where the inflow and outflow of patients are more than the work gets divided into different positions. It is important to distinguish between the two job roles. 

The Medical Coder

It is the work of a medical coding expert is to take the medical provider’s procedural and diagnostic notes and convert them into proper codes to track and produce the right medical bill. The codes are always up to the industry standard and are a combination of both alphabets and numeric which further helps to understand the services that are being billed. Therefore, it is crucial to understand the relevance of each medical code and how they are used in the medical coding and billing process.

  1. CPT – Also known as Current Procedural Terminology is used mainly to understand the particular examinations and procedures that are performed.


  2. ICD-10 – Also known as the International Classification of Diseases which is mainly used to classify different medical diagnoses.


  3. HCPCS – Also known as Healthcare Common Procedure Coding System and it includes all of the codes that have not yet been covered under CPT or ICD-10. These codes include all of the supplies and medical devices needed for non-medical services. 

The codes are followed extensively in the process of medical billing and the medical coder must follow the required guidelines while inputting the required data into the billing software. 

The Medical Biller

Basic Working of Medical Billing and Coding Process

After the process of medical coding is complete, it is the work of the medical billers to generate the required invoices after which the claims are then sent to the insurance payers. The codes must be proper because if they are not the insurance company can reject the claims thereby stopping the process of reimbursement. 

The process of billing starts right from the part when the patient takes an appointment with the doctor. The codes are entered and then submitted to the insurance payer to get a pre-approval. This determines the number of expenses that will be spent from the pocket of the patient, which will allow the office to charge the required amount during the patient’s next visit. 

The medical biller must understand the medical codes that are used in the healthcare industry even when it is the job of the medical coders. However, it must be remembered that the medical billing specialist is responsible for reviewing any insurance claims that have been denied. Before the submission of the initial claim is done, they have to make sure that the codes used in the claim are correct or not. After the medical bill gets settled by the insurance company, the remaining amount then gets invoices to the patient. If you are looking for a company that can help you with medical billing and coding, Synergy HCLS can be a great choice!