What is Medical Billing & Coding? Everything You Need to Know

It takes many roles to keep the healthcare system running — even some that don’t involve face-to-face interactions with patients. Among them are medical billers and coders, who work together to translate medical services for insurance providers and guarantee proper claim processing.

There are, however, several key differences in the responsibilities of each job that are worth noting for anyone considering medical coding and billing as a career. Explore employment opportunities, training, and a side-by-side comparison of each position in this blog post.

What Is Medical Billing?

Medical billing involves the review of patient records to determine which medical tests, diagnoses, and treatments were received. With the help of medical coders, that information is conveyed to insurance providers — for possible contribution to payment — and patients. Medical billers ensure that bills are paid, and that providers and patients are clear about the reasoning behind those financial expectations.

Medical billing responsibilities also include:

• Submitting claims to insurance
• Creating itemized bills
• Ensuring payment
• Liaising between medical coders, insurance providers, medical staff, and patients
• Keeping patient records up-to-date
• Planning payments

What Is Medical Coding?

Medical coders can be thought of as translators between healthcare professionals and insurance providers. In this role, universal codes are assigned for each element of patient care for billing purposes. This information allows for clear communication between healthcare and billing offices.

Medical coding also involves:

• Collecting data from health professionals
• Translating information into universally understood code
• Providing insurance companies with patient information as alphanumeric code
• Ensuring technically accurate communication between all parties

Medical Billing vs. Medical Coding

Though medical billing and coding professionals work closely to achieve the same efficiency goals, each role has different responsibilities. The following are some key comparisons:

Medical Biller	Medical Coder
Communicates directly with patients	Communicates only with medical and insurance providers
Understands insurance policies and can convey payment needs	Understands coding systems and medical terminology
Ensures that healthcare providers are paid in a timely manner	Ensures that medical procedures are fairly represented to insurance companies
Must wait for medical coders to finish initial work in order to communicate with insurance providers	Must complete work before medical billers are able to send claims to insurance companies
Concerned with payments and finances	Concerned with medical accuracy

Medical Billing and Coding Training

It is extremely helpful to establish a relevant skill set in pursuit of a career in medical billing and coding. In both roles, communication is key, whether you’re liaising between medical professionals and insurance providers, or with patients.

Like doctors, medical billers and coders have a legal obligation to not disclose private information seen in medical files. This makes discretion equally as important.

The follow lists include additional hard and soft skills often sought by employers:

SOFT SKILLS (Personal attributes)	HARD SKILLS (Quantifiable skills learned through training)
Communication Attention to detail Problem solving Critical thinking Active listening Empathy	Data entry Understanding of the Health Insurance Portability and Accountability Act (HIPAA or privacy laws) Medical terminology Regulatory knowledge Billing practices/insurance verification Relevant software

Medical coding comes with the added requirement of understanding medical terminology. Translating medical testing, diagnoses, and treatments requires an ability to first interpret notes from medical professionals.

With the University of San Diego, you can become well-versed in medical terminology — further proving your commitment to potential employers — on your own time. USD’s newly updated medical terminology course is designed with the longevity of your career in mind, meaning new lecture content and assignments that cover body systems, organs, medical terms, human disease, the outlook of healthcare, and more.

Jobs in Medical Billing and Coding

Job opportunities for medical billers and coders are promising, with the U.S. Bureau of Labor Statistics reporting 7% growth through 2031 — an average of about 14,900 openings each year.

As of 2021, BLS reports that the average annual salary for medical record specialists is $46,600. Earning potential varies by specific position, education level, location, and other employer-specific factors.

Now, with some clarity about the similarities and differences between medical billing and coding, you’re prepared to continue your journey toward a new career. Consider your future and explore these meaningful opportunities.