There are a few ‘work-from-home’ jobs that can get you a six-figure income, ‘Medical Coding and Billing’ being one of them.
Yet, not many people are seen to be going for it. Reason? Well, it might seem a little hard to believe – but it is surprisingly true that a whole lot of people are simply ‘UNAWARE’ of the great opportunities that lie in this field.
The healthcare market can increase three-fold to Rs 8.6 trillion (US$ 133.44 billion) by 2022. Might have heard the saying ‘There is never going to be a recession in the healthcare sector’, and that is absolutely true. With modernization and literacy rates going up day-by-day, people are even more conscious about their health and thus investing in health insurance plans. This significantly increases the demand ‘medical coders’ every year.
It is easy to start a career in medical coding since this field doesn’t compulsorily require a clinical or healthcare degree. However, a basic knowledge of anatomy and physiology will help one get a better understanding. From a medical coding training point of view, the difference between people from life science background and others, is knowledge of medical terminology. From a non-life science background, if you dedicate some extra time to learn medical terminology (which is not tough, but in fact very interesting too), one can easily enter into medical coding career by learning the other aspects of it well. Plus, if you wish to do a certification course (which is usually 3 to 4 months and can be done on a part-time basis) your salary would be surprisingly higher.
So, what is ‘Medical Coding and Billing’ and What are the Career Opportunities in India? Let’s dive deeper into this topic:
Medical Coding and Billing, in simplest terms, is the ‘Bridge’ between Insurance Companies and the Doctors/Physicians/Medical Practitioners.
A medical coder extracts the information from patients’ medical records and converts them to an industry-standard medical code, which is accepted universally. Medical transcriptions from hospitals and clinics are converted to universally accepted codes in diagnosis, procedure and drugs. The codes are then referred to medical billing and insurance purposes.
Career Opportunities in India:
- Online Assignments from US and UK
The healthcare services outsourcing industry is evergreen. India is the preferred destination for offshoring medical coding and medical billing. There is an increasing demand for medical professionals across the globe which means there is good job stability and security. India is emerging as the hub for healthcare outsourcing where coding is the most preferred option by professionals. In fact, 80% of US companies outsource to India. With exposure to both IT and healthcare, the coders find a new avenue to polish their careers. Professionals are able to work in a secured environment with plenty of growth opportunities.
- Certified Professional Coder
A certified professional coder (CPC) is responsible for overseeing the medical coding for healthcare agencies. Coders make sure that medical coding used is in compliance with all medical coding laws and regulations and ensure that the coding used is for reimbursable expenses when necessary. They may provide regular coding, surgical coding, or hospital coding as appropriate. Certified coders are also sometimes responsible for communicating with patients regarding rejected claims or procedures, so effective communication skills are necessary. They must also maintain confidentiality and stay current on changes to insurance coding (especially Medicare).
Certified professional coders usually work independently and report to an office supervisor or manager when necessary. They may interact with doctors, nurses, and office staffs, so good interpersonal skills are helpful. Coders usually work during regular business hours and rarely work overtime or weekends.
- Jobs in Medical Insurance Companies
Medical coding is converting a medical diagnosis or symptoms, procedures, and drugs into codes and Medical billing is billing insurance companies and patients for procedures and office visits. Their work is submitted to insurance companies for payment purposes, data collection, research, billing and quality improvement purposes.
- Reimbursement Specialist
Medical Coders play an important role in the financial success of private medical practices and other health care facilities. The greater the expertise of the Medical Coder in identifying relevant diagnosis for patient encounters, the greater the insurance reimbursement to the physician. This field generates medical coders who specialize in coding after a thorough training program and a certification process.
- Coding Specialist
Medical coding is a procedure of assigning alphanumeric codes to every individual diagnosis and medical procedure. It is a growing industry and has a huge potential. It is a relatively new industry, having a lot of potential and scope. It is a growing industry that offers a lot of potential for employers and job seekers alike.
- Claims Processor/ Claims Reviewer
It is difficult for the employees at the insurance company to understand the complex medical terms that doctors use, hence the validation of their declaration becomes a hectic task. There are different payment provisions for different procedures hence the insurance company has to make sure that they do not end up paying more than what the protocol demands. For this to happen, a technical person is needed who can understand the medical terms and convert them into precise and specific codes. This is where the role of medical coders come in. They make sure that the doctors are neither overpaid, nor are they underpaid.
- Patient Account Representative
In a Chronic disease condition, a Patient Account Representative becomes essential. Patient Account Representatives perform administrative roles in billing and payment issues for hospital patients. They accurately calculate patient invoices and effectively submit, send and record claims, payments and overdue notices. They also work as mediators to create payment plans that are acceptable to providers and affordable for patients. Their other duties include answering the billing and payment related inquiries, resolving billing problems, collecting payments, assisting patients for insurance claims and discharging other tasks as assigned. Certified Patient Account Representatives work at variety of environments such as public and private hospitals, physicians’ offices, clinics, outpatient medical facilities, specialty medical centers, rehabilitation centers, insurance carriers etc.
- Medical Collector
Medical collectors are specialists within the field of debt collecting who focus on the collection of bills due for medical services rendered. Medical collectors are a specific subset of collectors and specialize in all debts relating to health care, including hospitalizations, surgeries and routine checkups. Medical collectors can either work in-house, which is working directly for the health care provider that issued the services rendered on the bill, or they can work for collection agencies that deal with a variety of debts.
- Electronic Claims Processor
A medical claims processor validates the information on all medical claims from patients seeking payment from their insurance company, using a computer software. Some Hospitals and Insurance companies now have their proprietary software that can handle claims processing in which the data can be fed and records can be generated. Claims must be thoroughly reviewed to ensure that there is no missing or incomplete information. In addition, a processor must keep meticulous records of claims and follow up on lapsed cases.