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What does a Medical Coding Specialist do?

If you enjoy independent investigative work and are detail-oriented by nature, a career as a medical coding specialist may be ideal for you. There is a true sense of accomplishment when you become well-versed in medical coding, and can efficiently verify information needed on patient charts, forms, claims, and other paperwork. Your role as a medical coding specialist is crucial in the chain of proper health care administration procedures.

Deciphering codes: job description and necessary skills

Medical coding specialists, also called medical coders and health information coders, translate diagnostic information and lab requests from doctors into standard medical codes used and recognized by health insurance companies. By using a standard collection of codes with all parties involved in medical procedures, tests and lab functions are more likely to be performed correctly, and insurance claims can be efficiently processed.

Medical coding specialists may work for health insurance companies, doctor's offices, labs, or larger health care organizations. After a health care provider sees a patient, the examiner's notes must be deciphered and used to produce a claim for the patient's insurance provider. Each type of diagnosis, procedure, and test can be linked to a specific code that the medical coding specialist must enter on insurance claim forms and lab requests. Medical coders become familiar with hundreds of codes and a variety of medical terms to correctly interpret physician notes.

With the increased use of electronic health records (EHR) throughout the United States and elsewhere, strong computer skills are a must for medical coding specialists. Most employers prefer medical coders with at least an associate degree, and many favor those who have taken specialized medical coding courses and training programs.

Career outlook for the medical coding specialist

Following are some examples of the tasks involved for a medical coding specialist in various employment settings:
  • Doctor's Office: Work alongside other office team members, accurately interpret doctors' notes and translate into standard codes for laboratories, other testing facilities and health insurance companies; perhaps perform other office functions such as billing or transcription.
  • Health Insurance Company: Confirm validity of codes attached to claim forms before submitting for further review, return paperwork with incorrect codes, stay up-to-date on Health Insurance Portability and Accountability Act (HIPAA) requirements, and verify specific codes are covered under each patient's specific policy.
  • Laboratory: Review requests for testing and confirm the accuracy of codes, communicate often with doctor's office staff members to verify procedural and testing requests.
Growth and earning potential for all careers in the health care administration field are expected to flourish in the coming years. Employment opportunities for medical coding specialists are projected to grow about 20 percent, much faster than average for all occupations.

For those with great focus and attention to detail, medical coding provides satisfaction and rewards that are hard to surpass.

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