By DeVry University
There are many ways for medical billers and coders to advance their careers, including taking advantage of opportunities to develop some additional skills for medical coding and billing.
Besides pursuing the appropriate educational background, you may also need to have core industry skills such as using coding software, the ability to navigate the International Classification of Diseases (ICD) database and Current Procedural Terminology (CPT) and basic knowledge in finance and healthcare.
Also, it's helpful to develop various soft skills that can help you effectively handle the different facets of the job. In fact, your ability to smoothly and successfully process claims and negotiate payment may hinge upon these abilities. Here are some critical skills for medical coding and billing professionals you need to know.
1. Communication Skills
Medical billing specialists spend a lot of time interacting with different people, including health professionals, insurance providers, patients and healthcare administrators.
Clear communications are essential whether you're working with health professionals to complete a patient's record for accurate coding, getting pre-authorization for referrals or following up on outstanding bills with insurance companies and patients. For example, if an insurance company denies a claim, the medical biller must understand the issue, research the claim and communicate the evidence clearly.
No matter who you interact with, you will need to answer questions, explain charges, decipher policies and help people take the next steps to move the billing process along.
2. Active Listening
If you want to communicate effectively, you must first understand what the other party needs and wants. Active listening can help you navigate billing, coding and payment processes that involve multiple parties.
When you work with healthcare professionals, listen to their explanations on how they performed certain procedures and other considerations they had specific to the case so you can apply the appropriate codes. Active listening is also a critical skill in medical coding and billing when you need to contact an insurance provider and understand why a claim is denied.
Lastly, the ability to listen to patients and understand their situations (i.e., when they're having trouble paying their bills) will help you identify solutions that work for both the patient and the healthcare provider.
3. Problem-Solving Skills
The job of a medical billing and coding specialist is more than just matching codes to procedures or issuing bills. You'll need to work with insurance companies and patients when payments are late or when the claim process hits a snag.
Medical billers and coders must develop the ability and attitude to approach every interaction with the goal of reaching a solution that works for everyone. For example, when a claim is denied, you need to know how to be resourceful when doing research and finding evidence to help the insurance company get the claim approved.
Meanwhile, the dynamic will be different when you work with patients. Some don't have the funds to settle a bill in full, so you may need to work with them to design a payment plan while ensuring that the healthcare provider gets paid.
4. Conflict Management
Situations can get emotional and stressful when you’re negotiate payments with patients. Medical billers must be able to stay level-headed and be able to think on their feet to come up with a solution that works for the patient without compromising the financial health of the practice.
To navigate these kinds of situations, medical billers and coders must be agile, resourceful and should be well acquainted with policy and procedure so they can provide assistance. For example, you should know the different ways you can structure a payment plan, work with insurance companies and how submit claims for the best outcome.
Part of developing this skill comes from experience, and part of it comes from your ability to work with a patient's circumstances. Listen attentively and be empathetic. Don't make assumptions but take the time to understand each person's unique situation.
5. Attention to Detail
Medical coding specialists must account for all the steps involved in a medical procedure and pair them accurately to billing codes. Meanwhile, medical billers must ensure that every payment and invoice matches up with the records.
Attention to detail helps prevent the wrong codes from being submitted to insurance providers and delaying claim processing. It can also minimize payment discrepancies from mistakenly entering the wrong numbers into coding and billing software.
Medical billers and coders must be detail-oriented to identify coding errors so they can capture the correct revenue, detail and avoid issues with bookkeeping and tax information.
6. Organization Skills
Medical billers and coders often handle a lot of information for many different cases. You must be able to find the information you need and retrieve it for others when needed.
You should be able to pull up the necessary information about a claim quickly when a patient or insurance company calls. You'll also need to know how to keep track of payments and outstanding balances. Knowing where everything is can help you save time and become more productive. Additionally, increasingly stringent data privacy regulations mean you must keep an inventory of patient information and make sure it's secure.
Keeping financial information organized is particularly important if you're responsible for generating financial statements. Instead of scrambling to assemble the data, a well-organized system allows you to better ensure the accuracy of your reports.
7. Time Management
Most medical billers and coders work independently, giving them a lot of freedom when it comes to how and when they complete their tasks.
A less structured workday means that you need to develop discipline when it comes to managing your workload and work schedule. Medical billing and coding specialists have a variety of responsibilities. Tasks can pile up quickly if you don't have a solid understanding of the steps involved and how long they'll take you to complete.
For some people, switching between tasks can cost as much as 40% of their productive time. To keep productivity up, you should first take stock of what's on your plate. You can then batch the various tasks to improve your focus and reduce the time it takes to pivot your thought process or change tools.
While switching between tasks can be challenging, it's often inevitable. Medical billers and coders need to be able to handle many different responsibilities each day.
For example, the phone may ring when you're in the middle of issuing invoices. While you're helping a patient with a payment plan, you may need to pull up files from multiple systems as you answer an instant message from a co-worker about a completely different issue.
To help yourself multitask, try making a to-do list. Prioritize your tasks and group similar ones (i.e., those performed on the same software) together. Track your time and monitor your progress to see what works best for you.
9. Adaptivity and Agility
Today's medical billers and coders need to be able to work with quickly evolving healthcare technologies and have a solid grasp of emerging diagnoses and treatment options. Additionally, you'll need to be able to navigate ever-changing insurance policies, government-subsidized programs and data privacy regulations.
For instance, the introduction of ICD-11 will require medical coding specialists to learn a new coding system and apply new diagnostic codes. Since ICD-11 allows for more integration with other software such as EHR platforms, you may need to adjust to new workflows.
Every workplace offers different services and does things differently. Successful medical coding and billing professionals must be able to adapt to new processes and learn new information quickly.
10. Collaboration and Teamwork
Even if you're the only medical billing and coding specialist in a small practice or work as an independent consultant, you still have to interact with different people in order to get your job done.
If you work in a larger medical facility, you'll likely be working with other medical billing and coding professionals. When you follow up with patients or investigate a claim, you may have to circle back with healthcare professionals and other specialists involved in the treatment. The ability to work with others can help you gain their cooperation and facilitate the process so you can fulfill your responsibility and meet your deadlines.
11. Empathy and Compassion
It's easy to get caught up in the technical and number-crunching side of medical billing and coding. However, the ability to work with patients is just as important as knowing the technical side of things.
Medical expenses from chronic illness can strain patients' finances and their lives. When you negotiate payment with patients, you need to be able see the circumstances from their perspectives and help them feel that you're on their side.
People working in the healthcare field must be compassionate toward the people they help. Medical billing and coding professionals should use their knowledge and skills to advocate for patients to help them navigate insurance policies and help get more of their claims covered.
12. Proactivity and Self-Motivation
As we said, the role of most medical billers and coders can be quite independent. It's often up to you to ensure that tasks get done on time and with minimal supervision.
To manage your responsibilities and help yourself perform at a high level, be proactive in setting yourself up for success. You can create a system to help you track payments, follow up with claims and resolve discrepancies. Instead of waiting for patients or insurance companies to call, you might consider reaching out to the other parties to ensure the timely resolution of any issues.
The same goes for internal communications. You can avoid delays further down in the billing process by reaching out to medical professionals about questions or missing information on a patient record as soon as you see them.
13. A Positive Attitude
A positive outlook can benefit anyone, and can be particularly helpful for medical billing and coding specialists who interact with many people on a daily basis.
Positivity can help you interact productively with co-workers or navigate difficult conversations with patients or insurance company representatives. A positive, can-do attitude is helpful in tackling complicated and challenging situations, and it can also help you deal with stress.
Interested in a Career in Medical Coding and Billing?
If you’re thinking about a career in medical billing and coding, there's no better place to start than with your education. Let DeVry help you take the first step with our Online Undergraduate Certificate in Medical Billing and Coding.
You’ll have the opportunity to develop skills for medical coding and billing from experienced faculty, learn principles of working with ICD and CPT codes and begin preparation to pursue the AHIMA’s Certified Coding Associate (CCA) and Certified Coding Specialist (CCS) certifications, with exam prep built right into our curriculum.
Medical Billing and Coding classes start every 8 weeks and can be done 100% online.