Medical Coder Practice Test

A Medical Coder is responsible for taking health information, and further converting it into codes that allow the provider to receive reimbursement from health insurance companies. Usually, this person is the main entity in interpreting and coding patient data, entering it into the system, and then submitting the codes and claims to insurance companies. The Medical Biller and Coder is often one person; however, this role can also be conquered by two separate professionals, one Coder and one Biller, that work together to ensure invoices are properly paid.

On the medical coding side of things, the professional would be responsible for reviewing clinical statements, patient records, transcribed notes from the physician, and lab or radiology results, and assigning standard medical codes to each service or diagnosis, using a classification system.

On the billing side of the job description, a Medical Biller would then translate the code into medical claims, to send to insurance companies or other payers like Medicare in a timely manner. This person will then follow the claim, to ensure the provider receives proper reimbursement for the work performed.

A Medical and Coder can generally be found:

• Reviewing patient data and health information
• Assigning codes to the symptoms, diagnoses, treatment, and other relevant information from a patient visit, using classification software
• Ensuring the accuracy, appropriateness, and completeness of this data
• Entering charges into a system, form, or report to create a claim
• Transmitting claims to the appropriate payer
• Posting payments as they are received
• Following up with payers, such as insurance companies and patients

It is the job of the Medical Biller and Coder to tell the whole story of a patient’s encounter with a provider from start to finish, and to ensure the provider gets reimbursed for the services that took place. Medical Billers and Coders often work in physicians’ offices, hospitals, nursing homes, and other clinical facilities. In essence, a Medical Biller and Coder is a medical reimbursement consultant to practices, physician billing services, insurance companies, software companies, healthcare agencies, consulting firms, and State and Federal Government Agencies.

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