1 Introduction to Professional Billing and Coding Careers

Key Terms and Abbreviations admitting clerk centralized billing office (CBO) certifications insurance verification representative managed care medical biller medical coder patient account services (PAS)

Key Terms and Abbreviations registered health information technician (RHIT)

Chapter Objectives After completing this lecture, you should be able to complete the following learning objectives: 1.1: Recognize different types of facilities that would employ allied health personnel. 1.2: Define job descriptions pertaining to a position. 1.3: Discuss options available for certification.

Employment 1.1: Recognize different types of facilities that would employ allied health personnel.

1.1: Employment Allied Health Personnel Employed by a wide range of healthcare facilities and businesses: Solo, small-group, and large-group physician practices Multispecialty clinics Hospitals Patient account services facilities (PAS) Centralized billing offices (CBO)

1.2: Define job descriptions pertaining to a position.

1.2: Job Descriptions Medical Office Assistant Responsible for administrative duties in physician offices such as patient scheduling, reception, telephone communication, and medical records.

1.2: Job Descriptions Medical Office Assistant Job titles include: Medical assistant Administrative medical assistant Secretary Medical receptionist

1.2: Job Descriptions Medical Biller Responsible for submitting insurance claims and obtaining payment for balances due from patients and insurers.

1.2: Job Descriptions Medical Biller Job titles include: Patient account representative Billing specialist Billing coordinator Claims processor Reimbursement specialist

1.2: Job Descriptions Medical Coder Responsible for researching and accurately coding diagnoses and procedures submitted on insurance claims.

1.2: Job Descriptions Medical Coder Job titles include: Health information coder Medical coding specialist Health information technician

1.2: Job Descriptions Registered Health Information Technician (RHIT) Responsible for compiling, processing, and maintaining patient medical records to ensure their accuracy, completeness, and compliance with facility standards and healthcare regulations.

1.2: Job Descriptions Registered Health Information Technician (RHIT) Responsible for compiling, processing, and maintaining patient medical records to ensure their accuracy, completeness, and compliance with facility standards and healthcare regulations.

1.2: Job Descriptions Registered Health Information Technician (RHIT) Job titles include: Medical records clerk or specialist Medical records analyst Medical records director Office manager

1.2: Job Descriptions Payment Poster Responsible for posting payments to patient accounts and making any needed account adjustments. Job titles include: General cashier

1.2: Job Descriptions Medical Collector Responsible for obtaining payment on patient accounts, most often through telephone contact with patients and insurers. Collectors may also handle patient and insurance billing.

1.2: Job Descriptions Refund Specialist Responsible for analyzing patient accounts to determine if a refund is required, and if so, to whom the payment should be made.

1.2: Job Descriptions Insurance Verification Representative Responsible for contacting insurance companies to verify patient benefits and coverage and may also perform precertification and/or preauthorization of services.

1.2: Job Descriptions Admitting Clerk Responsible for greeting and registering patients, obtaining patient paperwork, and data entry of demographic and insurance information. Job titles include: Registrar Front desk representative

1.2: Job Descriptions Privacy Compliance Officer Responsible for educating patients and family members on HIPAA privacy regulations and ensuring that privacy practices are maintained in the handling of patient medical records.

Table 1.1 -- Facilities, Job Titles, and Certifications 1.2: Job Descriptions Table 1.1 -- Facilities, Job Titles, and Certifications

Table 1.1 -- Facilities, Job Titles, and Certifications 1.2: Job Descriptions Table 1.1 -- Facilities, Job Titles, and Certifications

Table 1.1 -- Facilities, Job Titles, and Certifications 1.2: Job Descriptions Table 1.1 -- Facilities, Job Titles, and Certifications

Table 1.1 -- Facilities, Job Titles, and Certifications 1.2: Job Descriptions Table 1.1 -- Facilities, Job Titles, and Certifications

Table 1.1 -- Facilities, Job Titles, and Certifications 1.2: Job Descriptions Table 1.1 -- Facilities, Job Titles, and Certifications

Table 1.1 -- Facilities, Job Titles, and Certifications 1.2: Job Descriptions Table 1.1 -- Facilities, Job Titles, and Certifications

Options for Certification 1.3: Discuss options available for certification.

1.3: Options for Certification Professional Certifications Medical Assistant National Certified Medical Office Assistant (NCMOA) Certified Medical Administrative Assistant (CMAA)

1.3: Options for Certification Professional Certifications Medical Billing Certified Medical Billing Specialist (CMBS) Certified Medical Reimbursement Specialist (CMRS)