Medical coders/billers are responsible for gathering patient information, including patient medical history, examination results, symptoms, diagnostic tests, treatment history, and more. Once they obtain history, medical coders are then responsible for ensuring the accuracy and patient confidentiality of these files as they present them to healthcare providers or insurance agencies. Medical coders will often communicate with physicians and other healthcare providers in the case that additional patient information is required.
The financial success of a healthcare provider's office often depends on the work of medical coders, as they assume the responsibility of managing the flow of money in and out of the office. Medical coders are responsible for ensuring that healthcare providers receive payment (e.g., from Medicare) for the services that they provide. The main responsibility of medical coders is to create a claim that matches diagnostics, treatments, and procedures with the corresponding numeric codes.
This information will be entered into a database and then sent off to an insurance carrier where it will be approved or denied. Hopefully the claim will be approved, which means that the healthcare provider will be reimbursed. In the case that the claim is denied, the medical coder assumes the additional responsibility of investigating why the claim was rejected and making any updates to the claim.
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