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Medical Insurance Biller & Coder

Recording and coding patient health information.

More people than ever have access to health insurance and are using health care services today. As the aging population grows, the number of individuals with health insurance will also continue to climb. As a result, there is an increasing demand for trained Medical Insurance Billers and Coders who can organize and manage health care information.

Medical Insurance Billers and Coders and other health information technicians are tasked with documenting the health information for a patient, including their medical history, any symptoms, test results, and treatments, along with any additional information about health care services the patient received. Their responsibilities often depend on their employer and on the size of the health care facility in which they work.

Although Medical Insurance Billers and Coders do not offer hands-on patient care, they often work with doctors, registered nurses, and other health care professionals to clarify diagnoses or to obtain additional information to make sure patient records are complete and accurate.

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Medical Insurance Biller & Coder Overview

Medical Insurance Billers and Coders organize and manage health information data and are tasked with recording a patient’s health information, including their medical history, any symptoms, results from tests or examinations, and treatments, along with any additional information about health care services provided a patient received. Their responsibilities often depend on their employer and on the size of the facility in which they work.

Medical Insurance Billers and Coders regularly take on a number of important tasks, including:

  • Scheduling appointments for patients.
  • Checking patients’ records to be sure the data within is complete, accurate, and up to date.
  • Managing data for clinical databases and registries.
  • Keeping track of patient outcomes for quality assessment.
  • Assigning clinical codes for reimbursement and data analysis with the help of classification software.
  • Electronically documenting data for collection, storage, analysis, retrieval, and reporting.
  • Upholding the confidentiality of patients’ records.

The Medical Insurance Billing program at Glendale Career College equips students with the skills and best practices required to work in a health care or medical office, including medical terminology and basic human anatomy, front office procedures, how to submit medical claims, insurance reimbursement, managed care procedures, computer billing applications, and computer medical coding.

*Glendale Career College is not able to guarantee employment.

The Medical Insurance Biller & Coder program can be taken at the following campuses:

Medical Insurance Biller & Coder Careers

Work Environment

The Medical Insurance Billing program at Glendale Career College is a professional health care training course designed to offer students the fundamental knowledge and education required to start working with medical and insurance records as a medical biller, professional coder, or other medical office professional. Graduates of the program often find employment in:

  • Doctors’ offices.
  • Health clinics.
  • Hospitals.
  • Nursing care facilities.
  • And other medical facilities.

Quick Facts about Medical Insurance Billers & Coders*

  • Employment of Medical Insurance Billers is expected to increase by 15 percent nationally from 2014 to 2024, much faster than the average for all occupations.
  • As more health care facilities use electronic health records (EHRs) and as these records continue to evolve, the job responsibilities of Medical Insurance Billers will also continue to change to adapt.
  • Most Medical Insurance Billers work in full time positions. In health care facilities that never close, including hospitals, they may work evening or overnight shifts.
  • A growing aging population will need more medical services, and Medical Insurance Billers and Coders will be in demand to manage the data related to the older generations’ health information.
  • Medical Insurance Billers usually work in offices and can often spend many hours in front of computer monitors. Some technicians are also able to work from home.

*Source: https://www.bls.gov/ooh/healthcare/medical-records-and-health-information-technicians.htm For more information, including median wages and the job outlook for Medical Insurance Billers in California, see the California Occupational Guide published by the State of California Employment Development Department. For the most up-to-date national information, please visit U.S. Bureau of Labor Statistics.

Medical Insurance Biller & Coder Course Material

The Medical Insurance Biller and Coder program seeks to equip students with a comprehensive working knowledge of all medical insurance phrases, billing, pre-authorization follow-up techniques, and posting insurance payments. The student will complete the program having had hands-on experience on the computer along with an internship experience. The student will be trained for entry-level positions in physicians’ offices, medical clinics, hospitals, and health care related insurance companies. The program is broken down into eight class course modules, including a 180-hour clinical externship where students have the opportunity to take the skills they learn in the classroom and apply them in an actual health care practice setting.

Courses for this program include:

  • Seminar for Success – This is an orientation and success building course for Career Students that includes a review of basic math, language, vocabulary, and writing skills. It offers an introduction to core career classes, explains the availability of community resources, and covers outlining, summarizing, managing credit, and other life skills. Outside preparation and study time, in addition to regular classroom activities, is necessary to finish the class assignments. The type of outside preparation may include homework assignments, projects, reading, and required studying.
  • Medical History and Fundamentals – This course offers an overview of the roles and duties of the medical paraprofessional along with an introduction to medical specialties and subspecialties. This course also gives students an introduction to the structures and functions of the human body. Topics covered include the history of medicine, the health care team and office environment, interpersonal communications, medical law and ethics, basic keyboarding, and medical terminology. Outside preparation and study time, in addition to regular classroom activities, is necessary to finish the class assignments. The type of outside preparation may include homework assignments, projects, reading, and required studying.
  • Medical Office Administration – This course gives students an introduction to the basic procedures of the daily management of a health care office. Students will have the chance to participate in activities and simulation exercises to help them practice management. Course material will also cover telephone techniques; scheduling appointments; word processing projects, including resumes and cover letters; processing insurance claims; creating and managing patient records; medical office management software; and basic keyboarding. Outside preparation and study time, in addition to regular classroom activities, is necessary to finish the class assignments. The type of outside preparation may include homework assignments, projects, reading, and required studying.
  • Medical Terminology; Anatomy & Physiology – In this course, students will receive instruction in medical terminology with an emphasis on word structure, including word roots, suffixes, and prefixes. Course material includes word meaning and pronunciation along with common medical abbreviations. This course also introduces students to basic anatomy and physiology crucial to understanding medical coding. In addition, students will study common disorders and basic diagnostic procedures related to the body systems. Outside preparation and study time, in addition to regular classroom activities, is necessary to finish the class assignments. The type of outside preparation may include homework assignments, projects, reading, and required studying.
  • Medical Health Insurance – This course covers all aspects of insurance billing, including but not limited to completing, submitting, tracing, and appealing claims. Students will learn the guidelines for submitting claims to Medicare, Medicaid, TriCare, CHAMPVA, Worker’s Compensation, and disability programs. Course material also explains HIPAA compliance issues as they relate to patient privacy. Outside preparation and study time, in addition to regular classroom activities, is necessary to finish the class assignments. The type of outside preparation may include homework assignments, projects, reading, and required studying.
  • ICD-9-CM, HCPCS, & Evaluation Management – This course offers students in-depth instruction on the history, characteristics, and purpose of the coding and classification systems used in the medical claims industry. Students will gain a detailed review of CPT, ICD-9-CM, and HCPCS medical coding systems using the industry standard codebooks and source documents. Outside preparation and study time, in addition to regular classroom activities, is necessary to finish the class assignments. The type of outside preparation may include homework assignments, projects, reading, and required studying.
  • CPT Coding – In this course, students receive in-depth instruction on the characteristics of the procedural coding and classification system used in the medical claims field. Course material also covers principles of procedural coding using the Current Procedural Terminology (CPT) medical coding system and manual. In addition, students will be have the chance to see various source documents, ranging from simple to complex. Outside preparation and study time, in addition to regular classroom activities, is necessary to finish the class assignments. The type of outside preparation may include homework assignments, projects, reading, and required studying.
  • Medical Career Fundamentals – This course introduces students to the large number of duties and responsibilities held by an insurance billing specialist. Students will have the chance to learn office and insurance claim processing procedures, including completing, transmitting, tracing, and appealing claims. Course material also covers medical records documentation practices and computerized practice management software and techniques. In addition, students will review office emergencies and first aid techniques. Students will have the opportunity to become CPR certified through Basic Life Support training. Outside preparation and study time, in addition to regular classroom activities, is necessary to finish the class assignments. The type of outside preparation may include homework assignments, projects, reading, and required studying.
  • Clinical Externship – Upon successfully finishing classroom training, medical billing and coding students will engage in a supervised 160-hour externship experience in an office setting. This course must be completed for graduation.

Medical Insurance Biller & Coder Course Activities

Medical Insurance Billers & Coders manage data related to health information by making sure it is accurate and accessible, but also secure in both paper files and electronic systems. Using different classification systems to code and categorize patient information for insurance reimbursement purposes, databases, and registries, they maintain patients’ medical and treatment histories.

Medical Insurance Billers typically perform the following tasks:

  • Schedule appointments for patients.
  • Check patients’ records to make sure data is complete, accurate, and up to date.
  • Organize and manage data for clinical databases and registries.
  • Track patient outcomes for quality assessment.
  • Assign clinical codes for reimbursement and data analysis with the help of classification software.
  • Electronically document data for collection, storage, analysis, retrieval, and reporting.
  • Uphold the confidentiality of patients’ records.

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