Medical Coding Degree: Your Guide to a Rewarding Healthcare Career

Supervisors and bosses can be wonderful, horrible, or somewhere in between. This is true of all occupations, but can be especially noticeable in the medical billing and coding field. Demands for quick claims processing and medical records management clash with the need for quality and compliance. Management usually has to explain any mistakes to a committee of reviewers just moments after answering to operations executives about process efficiency. Often, the heat is passed from management to the billers and coders themselves.

What Not to Do in Bad Situations

When tensions are high and your boss is demanding, you may be tempted to act rashly. Several behaviors come naturally to many in these situations, but individuals often regret such actions later. Here are five things you should never do in a moment of tension or dissatisfaction with your manager.

• Do not quit your job. Walking out in a moment of tension is both unprofessional and poor decision making. At the very least, allow the issue to cool down before making a decision to quit. After the storm blows over, you may find there is not a desire to change occupations after all.
• Do not send an email while angry. Allow yourself to calm down before you send a scathing email and copy it to every vice president in the building. If there is someone you can trust, ask for a private conversation just to vent. Communicating your frustrations in private allows you to blow off steam. Then, you can send a much calmer, professional email detailing the problem.
• Do not sabotage the situation. Sending incorrect claims, falsifying information or any other negative action in response to a poor work environment will only get you in trouble.
• Do not confront your boss in front of others. If you have a serious problem, ask for a private meeting.
• Do not break chain of command unless command is unresponsive. Before going above his or her head, make sure you have tried open, honest communication with your boss. Never communicate the problems to other staff members, as this is a form of gossip.

What You Should Do

Medical billers and coders are responsible for the accuracy of medical records information and claims. Incorrect information can influence company payment and profitability, putting everyone’s jobs in danger. Even worse, inaccurate information on a patient’s file can lead to injury, additional health issues and even death. It is imperative that medical billers and coders act professionally and attend to their job with excellence, no matter what is going on in the business around them. Here are some things you should do if you are having boss problems in your medical billing and coding career.

• Continue to complete work with integrity. An issue with your boss is not connected to your responsibility to provide accurate medical information in records and claims.
• If your boss’s actions are impeding your ability to complete accurate work and attempts to resolve the issue directly have gone unanswered, report the situation in private to your department head, human resources representative or compliance officer.
• Be discreet about any issues once you have reported them and comply with senior management or human resources requests.

It can be stressful to be involved in an issue with your supervisor or boss. Often, the stress leads to actions that make the problem worse. When stress levels reach boiling points, take a break and walk around the parking lot for a few minutes. Vigorous walking is a great release for nervous energy. A healthy, high-protein snack can also provide a break in routine. For a quick spa treatment right in the office, wash your hands in the restroom. Then, run alternating hot and cold water over your fingers in intervals of about 15 second each. You will feel refreshed and ready to face the challenge of stress for the rest of the day.

Once you have completed a course in medical billing and coding or have decided you want to look for a job without attempting education, there are numerous places you can look for work. This article provides a guide to landing a billing or coding position.

Create a Solid Resume

As with any job search, your resume is the first line of fire. It needs to look and sound professional. Use a basic resume template available in most word processing programs to ensure clean lines and proper formatting. Print the resume on quality paper, but avoid decorative or colored paper. In addition to including past jobs and education, ensure you list pertinent skill sets for the occupation you are seeking. If you have medical billing or coding experience, skill sets may be inferred. Otherwise, highlight skills such as:

• Ten-key entry, including speed and accuracy
• Typing, including speed and accuracy
• Proficiency with computers
• Proficiency with numerical and accounting concepts
• Knowledge of medical terminology
• Previous experience with accounting or billing software
• Ability for analytical and detail-oriented task work

Include computer experience even if it is not with medical billing software. Demonstrating the ability to master multiple programs is important for almost any job today, and experience with accounting software often translates to some degree to learning any sort of billing software. Employers like to see details on a resume that indicate someone is analytical and good with numbers, especially for a medical billing job. Other important things to include are ability with Excel, past work in a team environment and any experience that shows the ability to work in a heavily regulated environment.

Open all the Doors

Never limit your job search to a single resource. The local classifieds may be a great resource for the unemployed, but they are not the only resource. Scour the classifieds on a daily basis, search online at Monster.com and Career Builder and put the word out that you are looking for a job. Post a status on your Facebook page regarding the search for medical billing and coding opportunities and make sure anyone you know who works in healthcare is aware of your search. Word-of-mouth is the most powerful advertising tool available to businesses, and you can put it to work in your search for employment.

Keep the Doors Open

Once you have opened a door, keep people from shutting it in your face by being professional. If you announce your employment intentions via social media, be aware that recruiters may check you out. If your profile information contains inappropriate information or photographs, it could hurt your chances at a job. The same holds true for circulating your information via friends and family already working in healthcare. Even in a large city, healthcare communities are networked. Insulting a single physician or nurse, even unintentionally, could result in dozens of lost opportunities. During your search for a job, treat everyone with respect, conduct yourself professionally and put your best foot forward, whether online, on the phone or in person.

Ace the Interview

• Business experts have written dozens of books on the best way to ace an interview. Here are a few solid tips to help improve your performance in a medical billing and coding interview.
• Come prepared. This sounds obvious, but the number of people who show up to interviews without a copy of their resume or list of references is staggering. If you are touting your detail-oriented nature on your resume, show it off in the interview.
• Be prepared to talk about your strengths, your weaknesses, why you want the job, how you work with others and how you manage your time.

Be professional, but be yourself. Do not conform to a cookie-cutter personality you think the employer will like. Stand out in the crowd and make an impression.
Follow up. Send a card thanking the employer for his or her time with you.

Building a solid resume, conducting a thorough job search and maintaining a professional presence are all keys to landing a medical billing and coding job.

Possibly the most important task for a medical biller or coder working in the claims billing process is to send clean claims. Clean claims are error free claims that pass through payer filters without raising flags. Clean claims support a faster collection cycle, reduce denials and avoid unnecessary payer audits.

Faster Medical Billing Cycles

Many payers use automated processing systems for a majority of claims. Claims that are below utilization guidelines and free of errors route through systemic payment processing. This means payment on a clean claim can be received in less than 14 days. Faster collection time means better cash flow and reduced accounts receivable.

Avoid Denials and Payer Audits

Claims with errors result in payment denial. When a claim is denied, it takes time and resources to refile the claim or appeal the denial. Payments on many denied claims are never recovered. Even if the claim is later paid, the amount of money spent working the issue reduces the profit for the order or service.

Additionally, too many denials can result in unnecessary payer audits. Payer audits due to claim errors can take several forms, all of them bad for business. Some examples of denial related audits include:

• Prepaid claims reviews where payers request detailed medical records prior to processing any claims;
• Prepaid claims reviews where payers choose random claims and request records before processing for payment;
• Postpaid claims reviews where payers ask for supporting documentation after the claims are paid and take money back if documentation is not provided.

If providers perform poorly in audits after receiving numerous denials, payers may decide to revoke the provider’s ability to submit claims. This is especially true of managed care, federal and state payers.

Tips for Clean Claims

Once you understand the importance of clean claims to the sustainability of a medical facility or provider, you will want to do everything you can to ensure claims are accurate. Each provider will have different processes and software to ensure quality claims. Regardless of the software or size of the provider, there are some things every medical biller and coder can do to help increase clean claim rates.

• Check your work. Ever since second grade math teachers started telling students to look over their problems before turning in assignments, there have been people who refuse to check their work. Giving a claim the once over before sticking it in an envelope or pressing the submit button can save hundreds of lost dollars over simple mistakes.
• Pay attention to decimal points! Check diagnosis codes, quantities and dollars to ensure you have not moved the decimal point.
• Make sure diagnosis codes and procedure codes match, especially if the codes were provided by the system or someone else. Insurance companies will not pay for heart procedures on a claim that only shows diabetes as a diagnosis, for example.
• Double check the insurance subscriber ID and group number. A single letter or number error can cause a claim to drop from the system. Whenever possible, compare insurance information on the claim to a copy of the insurance card.
• Compare the patient name to the insurance card as well. No matter which spelling is actually correct, bill with the name as it appears on the insurance card.
• Follow payer guidelines for information that must accompany claims. Common documents that are required with certain claims include letters or certificates of medical necessity, doctor’s orders or prescriptions, referrals from primary care physicians, lab results or copies of medical records.

Providing accurate, complete claims submission is an essential skill set for any medical biller or coder. Accuracy does not only increase the cash flow for your employer. Medical billers who consistently provide accurate, efficient billing are more likely to keep their job and move up in an organization.