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Why Medical Coders are the Superheroes in the Healthcare Industry

A medical coder typically codes the claims of a physician, hospital or a therapist. Unfortunately, it is understood that the responsibility of a coder ends with coding alone.

This is not true at all!

Medical Coders do much more than just coding. The job of the coder can vary and grow to more extents, based on the facility or organization that he/she works for. The Healthcare Insurance industry can never function without them. In short, they are the superheroes of the industry.

Let us look at some of the non-coding activities performed by Medical Coders:

1. They act as mentors

The medical coders are the right people to teach and mentor the healthcare industry and the healthcare insurance industry about the coding fundamentals and guidelines. The doctors and administrators also often get coached and receive a lot of crucial information from them about the guidelines.

2. They are on a learning curve always

Getting a job in coding does not mean that the coder has an easy job to do now and he can put his feet up in the air for life. On the contrary, a medical coder has to keep learning how to code unlearn and relearn periodically. Because the coding guidelines keep changing. Like the recent one, ICD 10 transition is going to affect medical coding. Learning new codes, additional guidelines, and mentoring the same across the industry are some of the major responsibilities of the coder. A minor issue in coding can mean that the claims getting denied or underpaid, which no physician or facility appreciates.

3. Deal with the denials

Speaking about denials and underpaid claims remind yet another job of the coders. They are often left to deal with denials, as same as the billing staff. Senior coders are often part of the denial management team. If a claim faces an issue, often coding is checked and, in case of continuous denials, a coder gets into action. He or she would have to check with the insurance company, if the codes are wrong, or reassure them why the specific code is present in the claim.

4. Coders have their plateful

Now, if the coders have received the appreciation of dealing with the codes, insurance knowledge, it is time to extend the applause. For they also take time to learn about LCD, NCD, policy guidelines, HIPAA rules, State and Federal laws and much more. They come handy to them, to keep off from errors.

5. They understand what the doctors mean

Pharmacists are often valued for understanding the writings of a doctor. Next time, the coders should never be forgotten. Pharmacists have the opportunity of reading the names of the pills and medication from the boxes. Sadly, the coders have a lot of patience to decipher what the doctor has prescribed. If there are nursing assistants taking a note of the procedure and treatment process, they have a great day dealing with different set of handwritings for a single claim.

Apart from these, the best struggle of the coder can be considered to have knowledge about the case studies, surgeries, and codes. Coders are often life science background or someone who has something to do with the healthcare industry. That does not mean they can understand all these, and yet, they often are required to discuss these topics, though not a physician.

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