13 Soft Skills for Medical Coding and Billing Specialists

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.

Effective communication relies on being attuned to the needs of the other party. Active listening is crucial to navigating billing, coding and payment processes that often involve multiple parties.

When working with healthcare professionals, listen carefully to how they performed the procedures that you code so that you can apply the appropriate codes in detail. Active listening is also helpful when you need to speak to an insurance provider to understand why a claim was denied, and work to find a solution.

Lastly, the ability to listen to patients and understand their situations (such as when they're having trouble paying their bills) will help you identify solutions that work for both the patient and the healthcare provider.

Medical billing and coding specialists do more than just match codes to procedures and issue bills. They also work with insurance companies to smooth over hiccups or to find resolutions for denied claims. Medical billers and coders also have to and  be able to communicate clearly and mindfully with patients during the billing process.

As a medical biller and coder, you should approach every issue with the intent of solving it or doing your best to improve the circumstance for the patient. For example, when a claim is denied you need to be able to use the resources at your disposal to search for evidence that can help the insurance company approve the claim.

When you work with patients, the dynamic is different but will still involve a need to be good at problem solving. Some patients may not have all the funds needed to settle a bill in full. When this happens, you will need to work alongside them to design a payment plan that works for both their finances and your care facility.

Situations can get emotional and stressful when you’re negotiating 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 to 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.

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 and avoid issues with bookkeeping and tax information.

Medical billers and coders often handle the information for many cases and patients at once. To carry out your job effectively, you need to be able to retrieve information efficiently and accurately.

You should be able to access claim information quickly when a patient or insurance company comes calling, and also have to know how to keep track of payments and outstanding balances to help your billing department. Building an organizational system for yourself that allows you to quickly retrieve information can help you save time and increase productivity when things get busy. 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. A well-organized system allows you to better ensure the accuracy of your reports, instead of having to scramble to assemble data every time you need to access it.

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.

Switching quickly between tasks can be challenging, but it’s often necessary. Medical billers and coders need to be able to switch their focus multiple times per day to handle incoming requests, tasks or questions.

For example, you’re in the middle of issuing invoices and the phone starts to ring. And if you have an insurance company asking for information, you need to be able to provide it quickly and correctly before returning to your original task.

Luckily, multitasking is a skill you can develop. Try making to-do lists that group and prioritize similar tasks, then track your time to see if it helps you improve your  ability to knock things out faster.

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 requires 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.

Even if you work in a smaller care facility as the only medical billing and coding specialist or work as an independent consultant, you need to know how to interact with many different people in order to do your job effectively.

At a larger facility, you’ll likely work with several other people, including other medical billers and coders. When following up with patients or investigating claims, you may need to reach out to some of the medical professionals involved in the treatment process to check up on information. The ability to communicate and work well with others can go a long way in creating a cooperative dynamic and help you better  fulfill your responsibilities at work.

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.

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.

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.