What does a medical coder do?
A medical coder's role is to interpret and analyze a patient's medical record and translate particular details according to the universal medical alphanumeric code. Moreover, a medical coder is primarily responsible for ensuring that the translations are accurate, as this will play a vital factor in processing insurance and receiving treatments. Aside from accuracy, it is also crucial for a medical coder to coordinate with other hospital personnel at all times, especially when there inconsistencies in the records.
Medical coder responsibilities
Here are examples of responsibilities from real medical coder resumes:
- Manage all EDI relate communication with trading partners and assist to produce all operational documents for all end users.
- Manage all aspects of AR including writing letters for medical necessity, claim denials, bundling issues and charge capture.
- Manage health records while applying ICD-10 coding to update and process insurance claims for time and accuracy to various insurance companies.
- Manage the outsourced transcription company.
- Create documentation education classes to general surgery residents, increasing the leveling of reporting which lead to increase revenues.
- Adhere to regulations with CPT-4, ICD-9-CM and HCPCS coding with medical terminology and effort meet all audit requirements.
- Certify through AAPC as a CPC and CEMC.
- Evaluate medical record documentation and charge ticket coding for correct ICD-9 and CPT codes.
- Transition the NextGen interface from LabWest to LabCorp (familiar with HL7 messaging standard).
- Assign appropriate CPT-4 procedure code (s) and/or HCPCS codes to accurately support the need for each physician service.
- Utilize knowledge of CPT, ICD-9-CM, and ICD-10 to properly translate perform services into numerical code for insurance company reimbursements.
- Ensure accurate billing according to Medicare and Medicaid guidelines.
- Verify insurance eligibility, follow-up on all Medicare and Medicaid denials.
- Assign diagnostic and procedure codes to records of discharge patients and coordinate the follow-up on deficient/delinquent discharge records.
- Review medical record documentation and accurately code the primary/secondary diagnoses and procedures using ICD-9-CM and CPT-4 coding conventions.
Medical coder skills and personality traits
We calculated that 11% of Medical Coders are proficient in CPC, Medical Terminology, and ICD-10-CM. They’re also known for soft skills such as Analytical skills, Detail oriented, and Integrity.
We break down the percentage of Medical Coders that have these skills listed on their resume here:
- CPC, 11%
Maintain CPC credentials by attending audio conferences, AAPC Chapter meetings and subscribing to AAPC Cutting Edge and newsletters.
- Medical Terminology, 8%
Adhered to medical coding guidelines, charge capturing, anatomy, medical terminology and physiology to increase accurate reimbursement from payers.
- ICD-10-CM, 7%
Provided timely and accurate ICD-10-CM codes for specific information for statistical purposes.
- AHIMA, 7%
Attended educational seminars for AHIMA certification and educated other staff as needed.
- Patients, 7%
Assigned diagnostic and procedure codes to records of discharged patients and coordinated the follow-up on deficient/delinquent discharge records.
- Clinical Documentation, 5%
Communicated with physicians and clinical documentation specialists to ensure dictation accuracy, as well as with providers to appeal claim denials.
Most medical coders use their skills in "cpc," "medical terminology," and "icd-10-cm" to do their jobs. You can find more detail on essential medical coder responsibilities here:
Analytical skills. The most essential soft skill for a medical coder to carry out their responsibilities is analytical skills. This skill is important for the role because "health information technicians must understand and follow medical records and diagnoses, and then decide how best to code them in a patient’s medical records." Additionally, a medical coder resume shows how their duties depend on analytical skills: "created training spreadsheets and workflows for billing database, charge entry and insurance verifications. "
Detail oriented. Another soft skill that's essential for fulfilling medical coder duties is detail oriented. The role rewards competence in this skill because "health information technicians must be accurate when recording and coding patient information." According to a medical coder resume, here's how medical coders can utilize detail oriented in their job responsibilities: "perform detailed audits on billed insurance charges and physician documentation. "
Integrity. medical coders are also known for integrity, which are critical to their duties. You can see how this skill relates to medical coder responsibilities, because "health information technicians work with patient data that are required, by law, to be kept confidential." A medical coder resume example shows how integrity is used in the workplace: "coded and abstracted inpatient medical records for integrity of data and facilitated improved physician documentation. "
Technical skills. For certain medical coder responsibilities to be completed, the job requires competence in "technical skills." The day-to-day duties of a medical coder rely on this skill, as "health information technicians must use coding and classification software and the electronic health record (ehr) system that their healthcare organization or physician practice has adopted." For example, this snippet was taken directly from a resume about how this skill applies to what medical coders do: "utilize technical coding principals and ms drg reimbursement expertise to assign appropriate icd 9 cm diagnoses and procedures. "
The three companies that hire the most medical coders are:
- Guidehouse612 medical coders jobs
- Change Healthcare336 medical coders jobs
- Banner Health235 medical coders jobs
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Compare different medical coders
Medical coder vs. Health information technician
A health information technician is primarily responsible for managing and handling patient information, ensuring accuracy and confidentiality. They coordinate with various health care workers to gather patient data, laboratory results, test findings, and medical histories, encoding them in clinical databases in a timely and efficient manner. They must analyze every information to detect any inconsistencies, performing corrective measures right away. Furthermore, as a health information technician, it is essential to utilize particular software and systems when processing information, all while adhering to the hospital's policies and regulations.
There are some key differences in the responsibilities of each position. For example, medical coder responsibilities require skills like "cpc," "icd-10-cm," "ahima," and "clinical documentation." Meanwhile a typical health information technician has skills in areas such as "customer service," "patient care," "office equipment," and "transcription." This difference in skills reveals the differences in what each career does.
Health information technicians really shine in the government industry with an average salary of $35,705. Comparatively, medical coders tend to make the most money in the health care industry with an average salary of $52,925.health information technicians tend to reach similar levels of education than medical coders. In fact, health information technicians are 0.1% more likely to graduate with a Master's Degree and 0.4% less likely to have a Doctoral Degree.Medical coder vs. Information management specialist
An information management specialist is responsible for maintaining the security benchmark of all databases across the organization to support business functions and client requirements. Information management specialists sort and file data on the network systems and pull up reports from the storage database. They also analyze project management plans and utilize data tools to identify solutions and collect critical information. An information management specialist handles data management system troubleshooting and provide resolution reports to avoid downtime reoccurrence.
While some skills are similar in these professions, other skills aren't so similar. For example, resumes show us that medical coder responsibilities requires skills like "cpc," "icd-10-cm," "ahima," and "clinical documentation." But an information management specialist might use other skills in their typical duties, such as, "customer service," "patient care," "phone calls," and "cpt."
Information management specialists earn a higher average salary than medical coders. But information management specialists earn the highest pay in the technology industry, with an average salary of $66,785. Additionally, medical coders earn the highest salaries in the health care with average pay of $52,925 annually.In general, information management specialists achieve higher levels of education than medical coders. They're 5.3% more likely to obtain a Master's Degree while being 0.4% more likely to earn a Doctoral Degree.Medical coder vs. Release of information specialist
A release of information specialist is primarily in charge of retrieving and releasing data to qualified recipients while adhering to the guidelines and confidentiality protocols that aim to protect sensitive information. Although the extent of their responsibilities usually depends on their industry or company of employment, it usually includes maintaining records of procedures and transactions, preparing and processing documents, organizing files, producing progress reports to managers, and keeping an eye out for any inconsistencies, resolving them promptly and efficiently.
There are many key differences between these two careers, including some of the skills required to perform responsibilities within each role. For example, a medical coder is likely to be skilled in "cpc," "icd-10-cm," "ahima," and "clinical documentation," while a typical release of information specialist is skilled in "customer service," "roi," "phone calls," and "patient care."
Releases of information specialist earn the highest salary when working in the insurance industry, where they receive an average salary of $51,336. Comparatively, medical coders have the highest earning potential in the health care industry, with an average salary of $52,925.releases of information specialist typically earn similar educational levels compared to medical coders. Specifically, they're 0.9% less likely to graduate with a Master's Degree, and 0.4% less likely to earn a Doctoral Degree.Medical coder vs. Reimbursement specialist
A reimbursement specialist is responsible for analyzing insurance documents, processing reimbursement claims, and releasing accurate billing statements for insurance claims. Reimbursement specialists must have excellent analytical skills, especially on performing clerical tasks to evaluate insurance cases, investigate cases, and update the account information of the clients on the database. They should also have impeccable communication skills and understanding of the insurance processes to be able to coordinate with the clients, explaining the procedures of their claims accurately, and coordinate with the insurance management to improve the claims processes.
Types of medical coder
Updated January 8, 2025
