What’s it Like Working from Home as a Medical Biller and Coder?

What’s it Like Working from Home as a Medical Biller and Coder?

Over the last few years, many jobs have become remote, including many in medical billing and coding.

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Working from home is a great scenario for employees, as it saves them time and money by not commuting, allows them to add more time to their day, and allows for work-life balance.

In the last half of 2017, healthcare became the largest category of jobs in the United States. The Bureau of Labor Statistics also projects that the total of all healthcare jobs will grow by 13 percent between 2021 and 2031. [1]

One healthcare occupation is far more likely to be a work-from-home job than any other: medical billing and coding.

Below, we will look at what working remotely as a medical coder or medical biller is like, roles and responsibilities, tips for successfully working remotely, and job outlook.

What is Medical Billing and Coding?

Medical coders and medical billers are two distinct roles, though in some private practices or medical facilities, these two roles may be combined.

Medical coders update patient records using standardized codes which correspond to every aspect of the patient’s health history. These are used not only by the medical office, but also by the insurance companies to process claims, and compensate the medical facility properly. Because of the requirement for high accuracy and understanding the nuance of the medical codes, and regulations on how the codes may be used, certified medical coders are highly sought after.

Some examples of information that would be transcribed into medical codes: an x-ray is ordered for a patient, a medical assistant takes a patient’s vital signs, the doctor orders a blood test, or writes a prescription. All of these events have specific codes that must be entered to show an accurate record of a patient visit. Each diagnosis, procedure, treatment and action will have a code that corresponds to that piece of information.

Your codes will help the patient’s insurance properly cover a claim, helping the patient afford the treatment, and helping the medical facility get compensated.

Medical billers take the codes prepared by the medical coder and submit claims to the insurance company. They then follow up with both the insurance company and the patients to make sure the medical office is compensated properly, the patient is billed correctly, and timely payments are made.

What do Work from Home Medical Billers and Coders Do?

Here is a basic breakdown of what medical billers and medical coders do. Sometimes these are separate positions, sometimes they are combined into one job.

What Does a Medical Coder Do?

The medical coder transcribes what happens during a patient visit so that insurance companies and health organizations can understand it. Medical coding takes information, such as a physician's diagnosis, patient symptoms, or a doctor's prescription, and turns that into numerical or alphanumerical codes.

These codes describe each injury, diagnosis, prescription, and medical procedure. This is important for both the patient's medical records, the doctor's office or hospital, and the insurance claims processor. The medical coder is a translator for each of these entities, tabulating what happens during a patient appointment.

The standard that is almost universally used are the ICD (International Classification of Diseases). In the United States, HCPCS (Healthcare Common Procedure Coding System) is used to submit claims to Medicare and other forms of health insurance. HCPCS consists of two levels, Level I and Level II. HCPCS Level I is also known as CPT (Current Procedural Terminology).

Whenever you go to see your physician or health care provider, each part of your visit is notated by the doctor or medical assistant. The medical coder uses the coding standards described above to put together a record of your doctor's visit. Each code matches up to a sickness, a service provided by the medical office, a prescription, or test. This record is used by the medical biller to submit a claim to the insurance company.

It is very important for the medical coder to transcribe the record of the visit accurately. Because each code has it's own guidelines, and rules for the order in which they are placed. If the coding is done inaccurately or incorrectly, it can affect the status of the insurance claim.

Once the codes transcribing the patient visit are input into the computer, that information is passed along to the medical biller.

Here is a summary of tasks a medical coder is responsible for:

  • Review and analyze clinical statements & patient records
  • Translate diagnosis and medical information into codes using CPT, ICD-10-CM and HCPS Level II classification systems
  • Interact with physicians and assistants to ensure codes are accurate and ready to be converted into a medical billing claim.
  • Maintaining patient confidentiality and information security

What Does a Medical Biller Do?

A medical biller takes the coded transcript of the patient visit, and inputs that information into special software. This information is submitted to the patient's insurance company as a claim.

After the insurance company pays their portion, the remaining amount is billed to the patient. Any co-pays and deductibles are figured into this revised amount. As with medical coding, accuracy is very important in medical billing.

The medical coder and medical biller work in tandem to make sure that the health services are being tabulated accurately, that information is passed to the insurance company, and the revised invoice is sent to the patient. Both jobs are very important to ensure that the health care facility is reimbursed correctly.

The medical biller plays a vital role in the relationship among medical providers, patients and insurance companies. Although the medical biller is not responsible for patient care, he or she should have a good understanding of medical terminology to be able to discuss medical bills with both insurance carriers and patients. These are a few duties of a medical biller:

  • Audit and submit claims to insurance companies for patient procedures and treatments.
  • Obtain insurance referrals and pre-authorizations for patient procedures.
  • Verify insurance eligibility and benefits.
  • Understand insurance guidelines, including those for HMO/PPO, Medicare and Medicaid.
  • Review patient bills for accuracy and fill in any missing information.
  • Check payments for accuracy.
  • Research and appeal denied claims.
  • Talk with insurance companies about payment discrepancies.
  • Set up payment plans for patients.
  • Collect delinquent accounts.
  • Answer phone inquiries from patients and insurance companies.
  • Use medical billing software to perform job duties.
  • Update software with rate changes.
  • Know Fair Debt Collection Practices.

As a medical biller, you may not perform each of these duties every day, but they are all considered responsibilities of the job.

Can You Work From Home as a Medical Coder and Biller?

Medical coding and billing is a job that you can do from anywhere, as long as you have a few things. You will require a computer, a high-speed internet connection or Wi-Fi-connection, and a secure internet connection, for HIPAA compliance.

Many healthcare employers have been using remote positions for medical billing and coding, as all of the work does not require the biller and coder to work in-person at the medical facility. During the pandemic, most employers switched to having medical billers and coders all work remotely, if they had not done so already.

Many employers will have their own unique requirements for HIPAA compliance, privacy, and security.

Medical coding and billing are the most common healthcare positions to be a work-from-home job. Medical coding specialists translate a medical provider’s patient visits, diagnosis and procedure codes into electronic medical records. These are used by the insurance companies for paying claims, and by the medical facility for storing patient medical records.

Likewise, medical billers communicate with the insurance companies, medical office, and patients, ensuring the patient’s insurance company properly pays their portion of a patient appointment. Medical billers work with the information encoded in the patient medical records, taking care that the patient accounts received proper reimbursement.

Advantages to Remote Work

Working from home as a medical coder or medical biller comes with some distinct advantages.

Ability to work from home or remotely. Most healthcare workers have to show up in-person, but medical billing and coding is now mostly remote. You can work from anywhere with a broadband internet connection.

Flexible scheduling. As long as you get your work done in a timely manner, you can work in a more fluid daily schedule. It’s important to hit deadlines, but you can configure that work time to work better for your needs.

No commute time. Driving to an office during rush hour and then back home again is time-consuming, stressful, and requires lots of gas. Working from home saves all of these resources, giving you more time in your day.

Don’t need to attend work in-person at an office. Some people are more introverted and find it easier to work from a home office. You may be more productive working from a home office, without co-workers to distract you.

Physical demands are greatly reduced. For many disabled people, medical billing and coding is an ideal job. You do not need to commute to the medical office, and there is no need to worry about an inaccessible office.

More time for personal and family time. Many stay-at-home parents find medical billing and coding to be an ideal career. Even people without kids will find more time in their day, since they are saving commute time.

Less stressful, as no micromanagement. As long as you are an effective autonomous worker, you might find billing and coding a great career. People who are self-motivated and prefer to manage themselves can excel in a medical coding and billing career.

Professional wardrobe not required. Many on-site jobs require a certain type of wardrobe, which costs money. You may be able to save money each year on business clothing.

You can start a business with little overhead cost. Some medical coders and biller work as independent contractors. These billers and coders can start a business with a computer, internet connection, and up-to-date medical coding and billing software.

Successfully Working from Home as a Medical Biller and Coder

There are some guidelines you should follow to be productive as a remote medical biller and coder.

  • Focus on results. You should spend an adequate amount of time and focus on doing accurate medical coding work. By working with integrity and focus, your work will be stellar, creating good results for the medical office or other employers.
  • Be self-disciplined. Working from home requires great discipline. It is easy to get distracted at home, so it requires self-discipline to get your work done quickly, correctly, ad completely, hitting all deadlines.
  • Maintain a consistent schedule. Getting up at the same time each day, and having a consistent work schedule ensure that you will get your workload done on time each day.
  • Working independently. You must be able to focus your energy on your work and complete your work accurately and on time.
  • Self-organization. People who are able to keep their work area snd schedule organized will do well at medical coding.
  • Dedicate an area for a work office. It is easiest to complete work if you have a work-form-home office or work desk. This is an area where you focus entirely on work.

Job Outlook for Medical Coding and Medical Billing

The Bureau of Labor Statistics projects that medical billing and coding jobs will increase about 7% between 2021 and 2031. This is about as fast as other jobs. As of May 2021, according to the BLS, the median salary of all US medical billers and coders was $46,660. This can vary depending on the state, region, and job market. We put together another article on this site which goes into much greater detail about salary and hourly wage for medical coders and medical billers based on different factors, which you can read here.

How do You Get Training for Medical Billing and Coding?

The path most people follow to become a medical biller and coder is to find, enroll in, and complete a medical billing and coding program. Some programs are two-year programs, but the majority of medical billing and coding training programs are about a year in length.

Be sure to choose a medical coding and billing program that is from an accredited educational institution. Once you complete the training and pass a certification exam, you can apply for work. While medical coding certification is not legally required in any states, most employers are looking for fully-trained candidates. Great accuracy and knowledge of the universal medical codes is crucial for the medical facility, the insurers, and the patients.

There are different exams that each medical billing and coding program prepares you to pass. With the certification program at Campus, you are prepared to take and pass either the Certified Medical Reimbursement Specialist (CMRS) or Certified Coding Associate (CCA) certification exam. Campus is endorsed by the American Health Information Management Association (AHIMA) and American Medical Billing Association (AMBA). Once you pass the certification exam, you will be fully prepared to launch your career in medical billing and coding.

Start Your Medical Billing and Coding Career in About 40 Weeks

Campus offers a Medical Billing and Coding certification program that can be completed in as little as 40 weeks. This program is fully online; all of the coursework can be done remotely from your computer with a broadband internet connection.

If you see working as a medical billing and coding professional in your future, contact our Admissions department today, and they can answer any questions you have about the course.

We’re here to help you start a rewarding career in medical billing and coding.

[1] Note: The data provided above are from a source unaffiliated with Campus, formerly known as MTI College, are for informational purposes only and represent the employment field as a whole. They are not solely specific to Campus graduates and, by providing the above information, Campus makes no representation, direct or implied, or opinion regarding employability.