All About Billing & Coding LLC

Medical Billing & Coding Course

I have been in the health care industry since 1998 which seems like a long time. I have held various positions in the healthcare field. I first started out as a CNA which is a certified nursing assistant. I did home health and work in the hospital as a CNA. I can say, I learned so much about patient care and documentation. While working in the hospital, I become a sec-tech, which means I was a unit secretary and the CNA for the unit. My job functions consist of reading orders and entering the billing system, answering calls bells, being there for family members of the patients, and still performing my CNA duties. While in these jobs, I learn so much from providers and nurses. I learn what items were needed for certain procedures, what patient care was going to be like after having a cardiovascular procedure, chemotherapy, PICC lane place, and even the process of admits and discharges. Working in the hospital exposed me to a wide variety of medical conditions and different ages from newborns to adults. 

Then I left the hospital scene and went into medical practice working in medical records. Once again, I took everything I did as a learning experience. I was able to learn how to do referrals, x-rays, check in and check out. The basics of medical practice. As I was working in the medical office, I came across four great account reps. We had coders and in-house billers at the time I was working at Mint Hill Family Practice. Our coders would come in normally around lunchtime and code our encounters from the day before. They made coding look so easy and fun. Sometimes I would just come over and watch them just fly through coding the encounters with their red pen, just as if they were grading school papers. In our office, we also had on-site billers. They were there all day and sometimes I would have to find charts for them or encounter forms because they were trying to fix a denial or make corrections. This part did not look fun not one bit. The billers have more of the headache piece, while the coders just breeze through the coding. Even though the coders had their own challenges. I can only imagine what they had to deal with when collaborating with providers much closer than the biller. But even though I was exposed to these jobs, it was still nothing I wanted to do. 

Then one day, I was given an opportunity to become a patient account rep. I took the job, but at this time, all coders and billers were no longer in the doctor’s office no more. We all were centralized and located in one location. Now when I started this job, I started to learn the hassles and frustration with insurance companies. Insurance is meant to pay and cover the care of the patient. While there are some insurance companies that were easy to work with, there were other insurance companies I wonder why they were in business. They look for every reason why not to the pay claim and hope you will not follow up on time, so they did not have to pay the claim. Then I was selected to do special projects where I learned how to post payments. I did enjoy that process. If there were no issues with an account, posting payments was a breeze. As I was learning to post payments, I was put on another project. Yes, when I went into the CBO (Central Billing Office), it seems like there was always a special project they needed people for. I started entering charges and I work closely with a coder that was responsible for OB-Gyn coding. This is where my decision in my career came too. I was helping put in charge and learning so much from this coder. She taught me so much about anesthesia coding, that I was able to see when the coding needed to be correct on a claim. I was like, WOW coding and billing is the place to be. 

I went off and got my coding certification, but I still did more billing than I did coding. I think my billing and my CNA experience have helped me as a coder. Even though I went for my CPC (Certified Professional Coder), I still did not land a job as a certified coder until 2016. I was able to finally get on to (at that time) Carolinas Healthcare System now known as Atrium Health, into the research finance department. At first, I was still doing billing with a coding title, but it was a different type of billing. I would have never thought that billing or a coding job can be in this department. I am now here to tell you that it is. As time went on, I move into doing Coverage Analysis. Now I know what you say, how is coding and billing needed for that?? Well, I start out reading very thick protocols that tell me why, who, and what they are doing in the clinical trial. I then use my coding skills to pull out CPT codes or HCPCS codes for exams, procedures, labs, and radiology. I use my billing skills to determine what is standard of care and what is research. I do have to say is an extremely exciting piece of work. I am really enjoying clinical research billing. 

The reason I choose billing and coding as my career choice is because I love the everyday challenge it brings. There is never a dull moment in this field. Medicare loves to change stuff and gives us more headaches each day. I love it so much, I got my certification as an instructor to teach it. There is always something new to learn as the world of medicine keeps evolving. I am going to be here trying to learn as much as I can and spread my knowledge to others. 

This is why I become a medical coder and biller.