Digital disruption has taken the world by storm. And it is here to stay. The great news is the plethora of opportunities it is churning in all sectors. It is important to understand that technology is a facilitator and will continue to disrupt the way work is done. The apprehension that technology will take over routine and repetitive jobs is real. However, the good news is that there are certain jobs that will require
human intervention.
Decoding Revenue Cycle Management (RCM)
Healthcare Revenue Cycle Management is a bundle of processes that ensures the financial well-being of a hospital, clinic or physician practice. It commences with scheduling an appointment with the physician, patient registration, physician examination and documentation, medical coding, processing the charges, generating claim and reimbursement from an insurance company. The payment could be made, delayed or denied. If delayed or denied, there is a re-submission process and finally accounts receivables follow-up.
In this cycle, Medical coding is a critical process that involves reading medical records thoroughly and abstracting the correct diagnoses/sis and procedures (if any) and converting them to alpha numeric codes.
Medical Coding – The backbone of RCM
The role of a medical coder is like that of a detective. The physician documentation in a medical record has to be scrutinized for “clues” about signs, symptoms and other related health conditions of patients. Once this is ascertained, a trained Medical Coder can easily convert the diagnoses, procedures, medical services such as labs to alpha-numeric codes based on a set of guidelines and rules which are governed by regulations. An in-depth knowledge of anatomy & physiology is key to become a good coder.
Attributes of a Medical Coder
There are some core competencies that will go a long way for a successful career in Healthcare RCM. Since the work involves reviewing medical records of patients, medical coders will have information about patients and their health conditions which are proprietary and hence confidential. With medical coding being a part of the reimbursement process of the hospital/clinic/physician practice, it is essential that the assigned codes are accurate. Inaccurate codes could lead to fraud or abuse. So, being ethical is important.
Having an eye for details and critical thinking capability also plays a big role in becoming a successful coder.
Employment opportunities of a Medical Coder
Even during a global recession, those working as medical coders will not have to worry about losing their jobs. Training to be a medical coder opens up diverse career opportunities – regionally, nationally and globally.
With the acquired skills, a medical coder can work in large Multi-National Companies or home-grown organizations which serve hospitals in the United States, UAE, Qatar and Australia.
Career – not a Job
The decision to become a medical coder opens up the door towards a successful career. The growth trajectory involves pursuing certifications and engaging in continuous education. Many of the people heading Global RCM companies in India started their career as medical coders. The icing on the cake is that a Medical coder is a
professional.
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