Medical Insurance Biller & Coder

Recording and coding patient health information.

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Medical Insurance Biller & Coder

Medical Insurance Billers and Coders are responsible for documenting and recording patients’ health information, including medical histories, symptoms, examination test results, treatments, and other information about health care services provided to patients. Their specific duties vary by employer and by the size of the facility in which they work.

Train to become a Medical Insurance Biller and Coder now at Nevada Career Institute.

The Medical Insurance Biller and Coder program at Nevada Career Institute focuses on teaching the skills and best practices needed to work in a health care or medical office, including medical terminology and basic human anatomy, front office procedures, how to submit medical claims, insurance reimbursement, managed care procedures, computer billing applications and computer medical coding.

Medical Insurance Biller & Coder

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Medical Insurance Biller & Coder Overview

Although Medical Insurance Billers and Coders do not provide direct patient care, they work regularly with physicians, registered nurses and other health care professionals to clarify diagnoses or to get additional information to ensure that patient records are complete and accurate.

Medical Insurance Billers and Coders routinely perform a variety of important tasks, including:

Scheduling appointments for patients.
Checking patients’ records to be sure the data within is complete, accurate, and up to date.
Managing data for clinical databases and registries.
Keeping track of patient outcomes for quality assessment.
Assigning clinical codes for reimbursement and data analysis with the help of classification software.
Electronically documenting data for collection, storage, analysis, retrieval, and reporting.
Upholding the confidentiality of patients’ records.

The Medical Insurance Biller and Coder program at Nevada Career Institute equips students with the skills and best practices required to work in a health care or medical office, including medical terminology and basic human anatomy, front office procedures, how to submit medical claims, insurance reimbursement, managed care procedures, computer billing applications, and computer medical coding.

Nevada Career Institute cannot guarantee employment.

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Medical Insurance Biller & Coder Careers & Work Environment

The Medical Insurance Billing program at Nevada Career Institute is designed to provide the fundamental knowledge and education needed to begin working with medical and insurance records as a Medical Insurance Biller and Coder or medical records and health information technician.

Graduates of the program routinely find jobs working in:

Physician’s offices
Medical clinics
Hospitals
Nursing care facilities
Medical billing companies
Health care insurance organizations
And other health care related facilities.

Quick Facts about Medical Insurance Billers & Coders

The increasing adaptation and use of electronic health records (EHRs) will continue to change the job responsibilities of Medical Insurance Billers.
Most Medical Insurance Billers work full time. In health care facilities that are always open, such as hospitals, they may work evening or overnight shifts.
Medical Insurance Billers and Coders typically work in offices and may spend many hours in front of computer monitors. Some technicians may work remotely or even work from home.

Nevada Career Institute cannot guarantee employment.

*Source: https://www.bls.gov/ooh/healthcare/medical-records-and-health-information-technicians.htm. For the latest national information, please visit U.S. Bureau of Labor Statistics.

Medical Insurance Biller & Coder Course Material

The Medical Insurance Biller and Coder program objectives are to provide the student with a comprehensive working knowledge of all phases of medical insurance, consisting of billing, pre-authorization follow-up techniques, and posting insurance payments. The student will graduate with hands-on experience on the computer and experience in an internship. The student will be prepared to accept entry-level positions in doctor’s offices, clinics, hospitals, and medically related insurance companies. The program is divided into eight class course modules, including a 180-hour clinical externship where students will apply the skills they learn in the classroom in an actual health care practice setting.

Seminar for Success

Orientation and success building course for Career Students. Review of basic math, language, vocabulary, and writing skills. Introduction to core career classes, availability of community resources, outlining, summarizing, managing credit, and other life skills. Outside preparation and study time, in addition to regular classroom activities, is required to complete the class assignments. The type of outside preparation may take the form of homework assignments, projects, reading, and required studying.

Medical History and Fundamentals

This course provides an overview of the roles and responsibilities of the medical paraprofessional and an introduction to medical specialties and subspecialties. This course introduces the student to the structures and functions of the human body. Topics include the history of medicine, the health care team and office environment, interpersonal communications, medical law and ethics, basic keyboarding, and medical terminology. Outside preparation and study time, in addition to regular classroom activities, is required to complete the class assignments. The type of outside preparation may take the form of homework assignments, projects, reading, and required studying.

Medical Office Administration

This course will introduce students to the basic procedures of the daily management of a medical office. Activities and simulation exercises related to practice management are provided throughout the course. Topics covered include telephone techniques; appointment scheduling; word processing projects, including resumes and cover letters; insurance claims processing; constructing and managing patient records; medical office management software; and basic keyboarding. Outside preparation and study time, in addition to regular classroom activities, is required to complete the class assignments. The type of outside preparation may take the form of homework assignments, projects, reading, and required studying.

Medical Terminology; Anatomy & Physiology

This course provides instruction in medical terminology with emphasis on word structure, including word roots, suffixes, and prefixes. The course covers word meaning and pronunciation in addition to common medical abbreviations. Students will be introduced to basic anatomy and physiology critical to the understanding of medical coding. A study of common disorders and basic diagnostic procedures related to the body systems will be presented. Outside preparation and study time, in addition to regular classroom activities, is required to complete the class assignments. The type of outside preparation may take the form of homework assignments, projects, reading, and required studying.

Medical Health Insurance

This course provides instruction in all aspects of insurance billing, including but not limited to completing, submitting, tracing, and appealing claims. Guidelines for submitting claims to Medicare, Medicaid, TriCare, CHAMPVA, Worker’s Compensation, and disability programs are covered. Students are also introduced to HIPAA compliance issues as they relate to patient privacy. Outside preparation and study time, in addition to regular classroom activities, is required to complete the class assignments. The type of outside preparation may take the form of homework assignments, projects, reading, and required studying.

ICD-9-CM, HCPCS, & Evaluation Management

This course provides detailed instruction in the history, characteristics, and purpose of the coding and classification systems used in the medical claims industry. Students receive an in-depth review of CPT, ICD-9-CM, and HCPCS medical coding systems using the industry standard codebooks and source documents. Outside preparation and study time, in addition to regular classroom activities, is required to complete the class assignments. The type of outside preparation may take the form of homework assignments, projects, reading, and required studying.

CPT Coding

This course provides detailed instruction in the characteristics of the procedural coding and classification system used in the medical claims industry. Students will learn the principles of procedural coding using the Current Procedural Terminology (CPT) medical coding system and manual. Students will also be exposed to various source documents ranging from simple to complex. Outside preparation and study time, in addition to regular classroom activities, is required to complete the class assignments. The type of outside preparation may take the form of homework assignments, projects, reading, and required studying.

Medical Career Fundamentals

This course introduces students to the various roles and responsibilities of the insurance billing specialist. Instruction is provided in office and insurance claim processing procedures, including completing, transmitting, tracing, and appealing claims. Medical records documentation practices and computerized practice management software and techniques are taught. This course also introduces students to office emergencies and first aid techniques. Basic Life Support training for the health care provider gives students the opportunity to become CPR certified. Outside preparation and study time, in addition to regular classroom activities, is required to complete the class assignments. The type of outside preparation may take the form of homework assignments, projects, reading, and required studying.

Clinical Externship

Upon successful completion of classroom training, medical billing and coding students will participate in a supervised 160-hour externship experience in an office setting. This course is a requirement for graduation.

Medical Insurance Biller & Coder Course Activities

Medical Insurance Billers & Coders organize and manage health information data by ensuring its quality, accuracy, accessibility, and security in both paper files and electronic systems. They use various classification systems to code and categorize patient information for insurance reimbursement purposes, for databases and registries, and to maintain patients’ medical and treatment histories.

Medical Insurance Billers & Coders typically perform the following tasks:

Scheduling patient appointments.
Reviewing patients’ records for timeliness, completeness, accuracy, and appropriateness of data.
Organizing and maintaining data for clinical databases and registries.
Tracking patient outcomes for quality assessment.
Using classification software to assign clinical codes for reimbursement and data analysis.
Electronically recording data for collection, storage, analysis, retrieval, and reporting.
Maintaining confidentiality of patients’ records.

Nevada Career Institute cannot guarantee employment.