Important Facts

Medical billing & coding specialists work in hospitals, clinics and physicians' offices to obtain accurate reimbursement for healthcare claims. They use specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Coders also review claims data to ensure that assigned codes meet required legal and insurance rules, and that required signatures and authorizations are in place prior to submission. If a claim is denied due to incorrect coding, the coding specialist conducts medical records research and corresponds with insurance companies and healthcare professionals to resolve the issue.