Growth in Career Prospects for Billers & Coders with Medicare & Other Coding Changes!

As Medical Practices face increasing coding regulations and changes, the job scope of medical billers and coders too has broadened. The Medical Billing and Coding sector is witnessing a remarkable growth, and is expected to continue to be among the fastest growing opportunities in the health sector.

Industry Standards State

Medical billing and coding jobs are expected to go up by 21% by 2020 - double the average growth for all jobs in the United States over the next ten years.

Imminent trends and changes- Currently medical billing and coding has become more complex than ever before, affected by various regulations and changes, the most prominent upcoming ones being-

  • The most talked about change of ICD-9- CM to be replaced by ICD-10- CM code set on October 1, 2014, also requiring transaction standards up gradation to Version 5010, demands qualified coders’ key participation to help decipher and assign these new codes accurately.
  • The Accountable Care Organization model with hospitals keen to adopt this model is likely to bring about changes in the hospital billing structure and increase patient volumes. This transition will increase demand of coders to help align this process.
  • Medical Practices with Medicare patients too need to gear up to new coding changes to keep their cash flow stable. CMS since 2004 using the Hierarchical Condition Category (HCC) model to fix capitation payments to practices providing services to Medicare Advantage (MA) plan patients is about the change. CMS has started basing payments on the fee-for-service equivalent pricing using “encounter data” submitted by Medicare Advantage Plans. Even though practices treating original Medicare patients will not be affected, groups treating mainly MA patients will need to get newly trained and experienced medical billers and coders to keep up with the new trends in cost reimbursement.

In this scenario medical billers and coders’ jobs are only growing as all healthcare set-ups including hospitals feel the need of a specialized biller and coder to help sustain their cash flow.

Understanding coders role in groups treating MA patients

Though physicians treating significant numbers of MA plan patients have the entire 2013 to test these new rules, they need to get started now to have a complete approach towards data capture and submission.

Need of experienced billers and coders is inevitable as it will be critical to document and submit both procedure and diagnostic codes precisely within the full encounter data format, as reimbursement will be based on how accurately the complete data is entered into the correct payment format. Practices will require coders’ expertise in these areas to ensure they stay ahead of the curve financially-

  • Help set up high data management expertise in order to accommodate large number of procedure and diagnosis codes
  • Tracking of any rejections by reason codes so issues can be altered and re-submitted quickly
  • Establish a protocol of checks and balances in documentation and also audit a sampling of charts quarterly to determine if the documentation protocols for correct coding has been applied correctly

Getting the help of certified billers and coders right away can help these practices save thousands of dollars in rejected claims once Medicare changes are implemented. As right implementation will equal to maximized revenues for physicians, medical billers and coders’ job growth is expected to increase further with the Medicare changes.

Coders who are proficient with healthcare compliances and new regulations are already on the way to changing their work scope with constantly training and updating their knowledge. experts fulfill this need as key players in the healthcare workplace to deliver quality healthcare by capturing accurate and timely medical data. MBC the largest billing and coding consortium in the US with a countrywide network of highly experienced billers and coders takes particular care of keeping their team updated with the current changes in the industry.

In pace with the US healthcare industry needs, MBC also helps bring medical billers and coders and care providers together through MBC’s job board, catering to both provider and biller needs across US.

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