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Coding Consultant

The role and Responsibilities/Tasks of Coding Consultant include:

• Codes patient medical records and submits claims to insurance companies
• Provides coding and invoicing services to various businesses in the medical industry
• Ensures and provides reports that coding and documentation meet compliance and quality standards
• Serve as a coding resource to the entire organization staff
• Provides coding education for physicians, operations and staff, along with performing needs assessment
• Researches and also teaches complex coding issues and concepts
• Maintains a knowledge base regarding coding policies and guidelines from CMS and other payers
• Develop and implement coding improvement plans
• Advises and consults providers and business office staff on coding issues

Salary Range

• Coding Consultant’s average earning capacity in 2012 ranges anywhere between approximately $43,000 - $85,000 per annum depending on organization size or type, area, expertise, industry and so on (figures taken from industry sources)

Certification Needed

Minimum Qualifications-

• Employment requires a high school diploma
• Recommended coursework include- math, biology and data processing
• Certifications or licensing are not generally needed but may be required by certain employers as additional options

Additional certifications generally include-

• The American Health Information Management Association (AHIMA) certification for Registered Health Information Technicians (RHIT), or a Registered Health Information Administrator (RHIA), which requires to be a graduate of an accredited two-year associate degree and passing a written exam
• The American Academy of Professional Coders (AAPC), the Board of Medical Specialty Coding and Professional Association of Health Care Coding Specialists - different credentialing in coding and specialized coding (RHIA, RHIT, CCS, CCS-P, CPC, CCA, and CPC-H)
• Successful completion of ICD_10 (minimum version 2) Introductory qualification
• Added benefit though not compulsory to complete college coursework- accounting or business
• Advantageous to continue education and get updated with current training and practices in coding and billing software

Other skills required include-

• Attention to detail is important to be a successful coding consultant
• Research skills are an added benefit to interpret new industry terminology
• Added advantage to be posses problem solving skills and conflict resolution
• Computer and medical coding skills are required as well
• Specialization in clinical classification and health care reimbursement methods
• Knowledge of Health care environment and commitment to accuracy
• Knowledge of Quality Assurance and accreditation principles
• Communication, presentation, interpersonal and customer service skills
• Preferable to posses knowledge of Medicare compliance issues and healthcare billing and reimbursement in a fee-for-service environment
• Advantageous to have an extensive knowledge about both hospital and clinic experience

Work Environment

• Work as independent contractors, rather than as direct employees, and can be hired by a medical facility or an insurance company
• Since they work independently, they could work at the office or hospital holding their contract, at their own office or even from home
• Employers for billing and coding consultants include hospitals, doctors' offices, outpatient care centers, nursing homes, rehabilitation centers, pharmacies and insurance companies
• According to BLS, employment in billing and coding careers is expected to grow along with many other health information management positions, at a rate of 20% from 2008 to 2018