where do medical billers work

Where Do Medical Billers and Coders Work?

Medical billing and coding is an emerging and essential component of the healthcare system. The field is largely dedicated to reimbursing health providers for the work they do. Without medical billers and coders, physicians and other care practitioners would not get paid for their services. And, in turn, medical facilities could not function effectively. 

If you are detail-oriented, have a knack for numbers, and are seeking behind-the-scenes work in the medical field, medical billing and coding is the path for you. Within this profession, there are many different duties you can take on, as well as many different places you can work. In general, though, all medical billers and coders are responsible for reviewing patient records, organizing patient data, and classifying it using a field-standard medical code. These codes are then interpreted by insurance agencies, medical providers, and health researchers, and can be used for billing purposes, patient care, and occasionally, public health statistics. You can learn more about medical billing and coding here. 

While medical billers and coders do not provide direct patient care, they often work with registered nurses and doctors to understand patient data. They also interact with insurance agencies, requesting and following up on payments, and with public agencies to help gather research data. Because their work touches various aspects of the healthcare field, they can be employed in a variety of settings. 

Top 5 Settings Where Medical Billers and Coders Work 

As noted above, medical billers and coders can take on different responsibilities, depending on the employer and the place of work. If you are considering this career path, you may be wondering what those different job environments might entail. Where do medical coders work? Where might you find work as a medical biller and coder? Below, we outline some of the top workplaces within the profession. 

  1. Hospitals and Clinical Practices 

Medical billers and coders can work in almost every type of clinical facility, including hospitals, doctors’ offices, and outpatient centers. They are needed to document and code each medical procedure a patient receives, and to process bills and insurance claims accordingly. 

Medical billers and coders do not work in patient care units, but rather, in office settings on-site. This allows them to communicate with doctors, nurses, and medical assistants to better understand patients’ medical histories. From there, they work independently to code the data and bill for services. They may research codes and/or use specialized medical coding software to assign the proper classifications. 

Today, more than one-third of medical coders work in hospital settings, while 19 percent work in physician’s offices. An additional five percent of medical coders work in nursing care facilities. 

2. Health Insurance Companies 

Insurance companies, such as UnitedHealthcare and BlueCross Blue Shield, hire medical coders to help resolve insurance claims. Medical coding professionals in this setting are responsible for reviewing members’ insurance claims, verifying their accuracy/completeness, and comparing any services received to their insurance plan, to see what and how much is covered. This is essential for reimbursing medical facilities. In addition to patient claims, medical coders may also handle Medicare and Medicaid claims.  

3. Law Firms 

One unexpected place that you can find medical coders, is amongst a legal team or in the courtroom. Law firms and courts often hire coding specialists to conduct research, investigate, and testify as experts on fraudulent medical claims. In this setting, you would examine medical records, de-code the coded iterations, and determine whether the code mistakes were intentional, the result of billing fraud, or just innocent mistakes. Billing fraud is a major problem for healthcare providers, and medical coders can be extremely valuable in detecting and assessing this crime. 

4. Public/Government Agencies 

Medical coding specialists are often found working in public entities such as government agencies and departments. In these settings, medical coders take on their normal job duties of reviewing medical information, auditing claims, and assigning codes. However, the data they put forth is used more broadly. For example, you may work for the state’s Medicaid department, and contribute to statewide projects and research. Or, you may be employed by the National Center for Health Statistics, and play a part of larger evaluations of the United States’ healthcare system. While most medical coders are hired for billing purposes, those working for government agencies also help to compile valuable population health data for wide-scale research and nation-wide reforms. 

5. Work from Home! 

Remote work has become the norm for many in 2020, but medical billers and coders are not new to the concept. Depending on where they work, experienced and credible coders often have the ability to work from home. Some do so through an employer, while others do contract or freelance work. In this setting, well, the setting is up to you! You may have a dedicated workspace in your home, or may take your work anywhere with internet access. Medical billing and coding work is primarily digital, which is why remote work is an option for coders who are trustworthy and well-versed in their work. 

Medical billing and coding is a profession with potential. Once earning a medical billing and coding certificate, you will have the option to work in a variety of clinical, administrative, and even government settings. Nearly every aspect of healthcare requires a medical biller and coder today.  

At Goodwin University, graduates have found successful careers in a variety of industry settings, such as: 

  • Billing Companies 
  • Consulting Firms 
  • Hospitals/Clinics 
  • Insurance Companies 
  • Large Medical Groups 
  • Resident Care 
  • Software Companies 
  • State and Federal Government Agencies 

If you are interested in launching your career in medical coding, do not hesitate to reach out to Goodwin. As a leading healthcare school in Connecticut, we have helped aspiring medical coders into careers they love. Call 800-889-3282 or visit us online to learn more.