• Medical Training Institute of New York
paper in the table with ballpen and stethoscope

Medical Coding Specialist

Course Overview

The Medical Coding Specialist plays a crucial role in the healthcare industry by ensuring that medical services provided to patients are accurately documented and reimbursed. This professional is responsible for translating medical diagnoses, procedures, and treatments into universally recognized codes that are used by healthcare providers and insurance companies for billing purposes.

Key Responsibilities:

  • Code Diagnosis and Procedures: Medical coders use standardized code sets like ICD-10-CM (for diagnoses) and CPT (for procedures) to accurately describe patient conditions and treatments.
  • Ensure Accuracy: They ensure the codes are accurate to avoid errors that could lead to insurance claim rejections or delays in reimbursement.
  • Work with Healthcare Providers: Coders collaborate with doctors, nurses, and other healthcare staff to clarify diagnoses and procedures to ensure accurate coding.
  • Stay Updated: The field is constantly evolving, with new codes and regulations. Coders need to stay informed about updates in coding systems and compliance standards.
  • Confidentiality and HIPAA Compliance: They must adhere to HIPAA guidelines to maintain the confidentiality of patient information.

Program Summary

Skills and Knowledge:

  • Proficiency in Coding Systems: Medical coding specialists must be well-versed in ICD-10-CM, CPT, and HCPCS systems, which are essential for accurate coding.
  • Attention to Detail: A keen eye for detail is crucial to ensure the correct codes are applied, avoiding billing errors.
  • Healthcare Terminology: Understanding medical terminology, anatomy, and physiology is vital to interpret and assign the correct codes.
  • Problem-Solving: Coders often need to resolve issues related to unclear documentation or incomplete records.

Career Opportunities:

Medical coding specialists can work in various settings, including:

  • Hospitals and Clinics: Coders are employed to manage the large volume of patient records and insurance claims.
  • Physician's Offices: Smaller practices rely on coders for accurate billing and reimbursement.
  • Insurance Companies: Coders may work with insurance providers to process claims and verify payment accuracy.
  • Self-Employment: Some medical coding specialists choose to work as independent contractors or start their own business offering coding services.

Certification:

To advance in the field, many employers prefer certified medical coders. Common certifications include:

  • Certified Professional Coder (CPC) by the AAPC
  • Certified Coding Specialist (CCS) by AHIMA

Certification demonstrates proficiency in medical coding practices and can increase job prospects and earning potential.

WHAT YOU'LL LEARN

  • Basics of Writing
  • Basic Math
  • Comprehension Building/Study Skills
  • Medical Law and Ethics
  • Anatomy and Physiology
  • Introduction to Computers
  • Medical Terminology
  • Medical Billing/Insurance
  • CPT/HCPCS Coding
  • ICD Coding/ ICD-10-CM Coding Principle
  • Pathophysiology
  • Medical Coding Internship
  • Certification Exam Review
  • Job Placement Assistant
  • Career Development Skills

WHO WILL BENEFIT

nurse hat

Those Considering Coding and Auditing

Medical Billing and Coding is a great career choice for anyone who wants to be in a non-patient-facing position within the healthcare industry. It also offers the benefits of working from home and having a very flexible schedule

Coders can work in various settings including hospitals. outpatient clinics, urgent care facilities, nursing homes, treatment centers, physician offices, and insurance companies. There are also multiple outsourcing agencies that employ coders to work remotely for a variety of clients.

doctor

Aspiring Medical Professionals

Working as a Coder gives many of us our first taste of working in the medical field. You might gain inspiration to continue that career path and get a more in-depth understanding of the medical world. It's okay to share this desire with your interviewer. It shows your dedication to the field and a willingness to learn

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Job Stability

The demand for medical coders is growing. In fact, the Bureau of Labor Statistics expects this field to grow by 22% through 2026, About 34,300 openings for medical records and medical coding specialists are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire

Schedule of Sessions Options

9:00 AM - 1:00 PM

Morning Schedule

The day program is 41 weeks long. Students attend classes 16 hours a week attending classes Monday through Thursday.

6:00 PM - 10:00 PM

Evening Schedule

The evening program is 41 weeks long. Students complete 16 hours a week attending classes Monday through Thursday.

9:00 AM - 5:00 PM

Weekend Schedule

The weekend program is 41 weeks long, and students complete 16 hours a week attending classes on Saturday and Sunday.

Frequently asked questions about Medical Billers

What is the difference between a Medical Coder and a Medical Biller?
Medical Coders and Medical Billers work together to make sure that healthcare providers receive payment for their claims. Medical Coders work behind the scenes to translate medical records into a series of codes, making it easy for insurers to quickly confirm or deny a claim. After completing a patient’s file, Medical Coders pass the information to Medical Billers, who communicate with patients and insurance representatives about the outstanding balance associated with an account. If an insurance provider denies a claim, Medical Billers prepare invoices for patients to pay out -of-pocket and arrange payment plans when necessary
What are the daily duties of a Medical Coder?
Medical Coders usually work standard office hours alongside other medical office staff. After a patient completes their visit, the Medical Coder reads their chart or file and classifies the information from their appointment into different categories. If they are unsure about the type of code for a certain treatment, the Medical Coder references medical coding guidelines and researches the correct code. They carefully put the codes in sequence and submit them to the patient’s insurance provider or to the Medical Biller on their staff. If there is an issue with a submission, they review existing codes and document any corrections.
Do Medical Coders have different responsibilities in different industries?
Medical Coders have the same basic role regardless of what kind of medical office they work in, but they can use different types of coding systems for various specialties. Most standard Medical Coders use three main codes: International Classification of Diseases (ICD), Current Procedural Technology (CPT), and Healthcare Common Procedure Coding System (HCPS). Many types of specialized medical offices use their own coding systems, including emergency departments, chiropractic offices, dermatology practices, pain management centers and plastic surgery centers. Medical Coders need to learn the details of each specialty to appropriately process each type of treatment.
What are the characteristics of a good Medical Coder?
The most important characteristic of a good Medical Coder is the ability to pay attention to small details. Many medical codes have a single letter or number that differentiates a treatment from a completely different procedure, and coding mistakes could lead to a claim being denied or a significant delay in receiving payment. Good Medical Coders diligently check their work after translating a file into medical codes, checking that each entry is accurate. They are good at troubleshooting problems with a patient’s file and determining the cause of any discrepancies in someone’s medical history and insurance claim.