August 10, 2025 • 24 mins
What can I do with a medical coding certification?
With the help of my compadre, AI(Artificial Intelligence), we compiled a list of roles held by medical coders.
To learn more or study to become a medical coder, visit my website.
www.abrahammedicalcodingcoachl...
Become a supporter of this podcast: https://www.spreaker.com/podcast/coding-break-with-tam-talk-podcast--4244224/support.
With the help of my compadre, AI(Artificial Intelligence), we compiled a list of roles held by medical coders.
To learn more or study to become a medical coder, visit my website.
www.abrahammedicalcodingcoachl...
Become a supporter of this podcast: https://www.spreaker.com/podcast/coding-break-with-tam-talk-podcast--4244224/support.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:03):
How they coding pros and welcome back to the Coding
Break podcast. I am your medical coding coach as well
as your Coding Break reminder TAMP talk here to talk
about all things colding related, which includes the good, the bad,
and perhaps some of the ugly side of medical coding.
So on today's episode, I want to talk about or
(00:24):
touch on the subject of the type of roles that.
Speaker 2 (00:28):
A medical coder can fulfill.
Speaker 1 (00:30):
Now, of course, if you study to become a medical coder,
the ultimate goal is to actually do some medical coding.
Speaker 2 (00:37):
And I get that, I understand that.
Speaker 1 (00:39):
But there are so many other options or opportunities that
we can pursue with the medical coding certification.
Speaker 2 (00:45):
So I uh solicited the help of.
Speaker 1 (00:47):
My very friendly compadre AI are artificial intelligence to kind
of help me run through a list of some of
the roles that we can fulfill. And I will say
some of these roles our to me or redundant, and
again it will depend on the organization that is doing
the hiring, and then some of the and I will
(01:08):
also say that some of the roles that I will
touch on are some of the roles I actually fulfilled
and I can attest whether or not certain roles are
like intertwined or again, AI was just very redundant with
the listing of roles.
Speaker 2 (01:26):
But nonetheless, let's get started.
Speaker 1 (01:29):
So of course the ultimate or the number one who
no role is to become a medical coder. Again, a
medical coder. So what exactly does medical coding entails? So,
according to AI, the medical coder role is pretty much
translating medical documentation or aka review the patient medical records
(01:51):
such as the physician or healthcare practitioners notes, lab results, diagnoses, treatments,
and the like, and converting that information into the correct
or their appropriate medical codes which are used in the
ICD tennes c BT medical coding system and so so yeah,
that's pretty much standard. And if I guess to put
(02:13):
it in practical terms, a medical coder is like the
interpreter or the foreign language interpreter of translator of foreign information.
So we are the foreign information or translator interpreter for
medical services or healthcare services, and we translate that into
codes or terms or APA alpha numeric terms let me
(02:35):
said correctly alpha numeric terms for the insurance companies.
Speaker 2 (02:42):
In order to seek reimbursement.
Speaker 1 (02:44):
So we are the communicator of healthcare, healthcare services to
the healthcare payers bottom line. And so we ensure that
the coding accuracy is accurate. And also that we're falling
within the compliance or regulation, the law, the guidelines, so
that we're.
Speaker 2 (03:03):
Following the law.
Speaker 1 (03:05):
And then again, like I said that we communicate with
health care providers. I and I'm go back and said,
I remember when I started out or when I was
in leadership, but some of our colders were nervous, like
nervous to talk to health care providers. It's almost like
the same fear that you experienced when you have to
do public speaking. Some of the colders had that same
(03:27):
fear when it came to communicating with health care providers.
Speaker 2 (03:31):
They're humans, they are humans.
Speaker 1 (03:34):
This is how you get your information, to ensure that
your coding is accurate. So there's no need to be
afraid of your providers, your doctors, your nurse practitioners, pas,
what have you.
Speaker 2 (03:45):
You have to communicate with them.
Speaker 1 (03:47):
That's like one of the biggest parts of the job
is communicating with them. Is to ensure that when you're
coding or you're selecting your codes, that you are getting
the correct or accurate information. So don't be afraid communicate
with your health care provider. And then another job function
that comes along with being a medical coder is just
(04:08):
making sure that you know the claims are being submitted
to the insurance company or the payers appropriately. Again, this
also kind of ties into that billing part or billing road,
but pretty much nonetheless, we are the health information the
health care services interpreter, translator, and all of the above
(04:32):
compliance Like we make sure that we're following the rules,
that we're coding accurately, and that we're doing within the law.
So that's pretty much what encompasses a medical coder. Now
we're gonna take all of that that I just spill
and we're gonna break it out into different roles because
you can, you can, there are actually actual roles for
(04:53):
those different components.
Speaker 2 (04:55):
That I just I just discussed.
Speaker 1 (04:58):
So number two, AI said, coding specialists again, colding specialists,
certified medical colder, medical colder.
Speaker 2 (05:07):
To me, they're all the same, I think.
Speaker 1 (05:08):
Again it goes back to the healthcare organization and how
they entitle or list that particular role in what that
role does encompass.
Speaker 2 (05:17):
Okay, coding auditor.
Speaker 1 (05:20):
Now, now this role I have held and I held
this for Yeah, in various organizations and various capacities. Now,
when I became a auditor, I was auditing the providers.
I was audusting the physicians. I was auditing, Yeah, I
was audited the physicians, the mid level providers such as
(05:41):
the nurse practitioners and the physician assistants or pas. I
was auditing the providers. Again, this is when I first
started in auditing. And because we did that, the reason
why we did that is because they were the ones
who were providing the service. Right, So again it in
this case, you definitely have to be able to communicate
with the providers because.
Speaker 2 (06:02):
You're auditing them.
Speaker 1 (06:03):
So what that encompass is of course they provide the services. Now, again,
the audits could be prospective or retrospective. So prospective just
means that it was done prior to being built. Retrospective
is it was uh the audit was performed after it
was built. And so but we or I UH was
(06:26):
able to commun audit the providers and then had to
communicate with the providers what the finers were, whether they
were good batter and difference nonethl. We had to communicate
with the providers. So that's the role of a coding auditor.
Another task that I that is included in the coding
aulitor is how you procure the information, like the the
(06:47):
w how do you know what you're gonna audit? So
you have to come up with the plan or the
organization or your manager have to come up with a
plan on like what we're gonna look at?
Speaker 2 (06:56):
What's the scope?
Speaker 1 (06:58):
You may hear that as an auditor, like what's the
the scope is? What will the audit process consists of
what services are we r are we auditing? What providers
are we auditing? What date range is are we auditing?
And then what are we looking for? And then we
once we do all the once we soilify what the
scope is, then we compile all the information or the
(07:18):
findings and a report and we tr re relate that
information back to the providers or the leadership.
Speaker 2 (07:26):
Or executive team in which I guess oversees.
Speaker 1 (07:30):
That that provider or that provider group practice and so.
And also allows for us as coding educator educators which
I will jump into that that job after this to
find opportunities of to find education, like what what are
the opportunities where do we find that the provider needs
(07:52):
education on like, what are their weaknesses, what's the redundant
issue that we're seeing in the audit that may require
and uh opportunity to educate the provider or they come
across like the provider is not.
Speaker 2 (08:04):
Aware of it.
Speaker 1 (08:05):
Some of them may here where and some of them
are honestly they don't know. So that's an opportunity to
educate the provider. So now that we are talking about education,
let's talk about the education role. So there's many people,
thanks to the Internet, who are deemed and I'm air
quoting to be coding educators and I'm not knocking anybody.
(08:26):
Let me put that disclaiming. I'm not knocking anybody because
everyone has a unique perspective or unique gift to coding
and they want to share that with the world because
there are people who may have that same perspective, and
that's nothing wrong with that.
Speaker 2 (08:41):
I encourage individuals. We have a perspective and you feel
that there is others that are it will.
Speaker 1 (08:48):
Fulfill a need or help another individual by all means
go forward. So no, this is not like to be
little anyone who doesn't meet the requirements of a coding educator.
Everyone one at this point is an educator. But according
to again my friendly friend, AI, a coding educator pretty
(09:10):
much they should have at least an associate degree and
at least five years of experience in the subject matter
in which they are trying to educate another individual one. So,
for example, UH, I have a credential and general surgery.
So if I said I want to teach someone general surgery,
I am qualified according to the requirements to do so,
(09:33):
or I shall say the AAPC requirements to do so
because I have the credential as a general surgery coder,
I have five years at least five years experience as
a general surgery colder, and I've also taught on a
collegiate level as it relates to health care coding and
audisty in general surgery. So I can officially say that
(09:56):
I am educated to I meet the requirements to teach
general of surgery.
Speaker 2 (10:01):
And I will also to say that I do have
my UH credentials as an educator to educate. But there,
like I said, but there are some who may not
have that the years of experience.
Speaker 1 (10:13):
They may not have the credential to be a coding educator,
and or they may have the experience in but they
may not have the credentials either to be uh specified
or a specially c uh educator or uh just a
n A coding educator. But hey, again, the Internet is
available for anyone. If you have a perspective, you can
share that perspective. You're your unique perspective to others. That's
(10:36):
there's nothing wrong with them and so.
Speaker 2 (10:40):
So so that's what the AAPC.
Speaker 1 (10:44):
Again, the AAPC, and and I would assume a human
as well.
Speaker 2 (10:47):
Those are the requirements that.
Speaker 1 (10:48):
Are needed to to educate uh the masses as relates
to medical coding. And it also just kind of solidifies
your qualifications because if someone so for example, if you
offer a course right and.
Speaker 2 (11:04):
Someone or you you you.
Speaker 1 (11:06):
Are sharing your information, your knowledge via the Internet and
regards to coding, and someone may be may be a
d you know, perceptive to your teaching and they want
to learn more, and you offer a course, so they
may go and do the research just to confirm that
you are legitimate or you qualify as an educator, and
(11:27):
so you wanna make sure that you do have those qualifications, right,
You do have those qualifications. Again, you have at least
an associate's degree. You have at least five years of
coding experience and perhaps you know have the credential now
well the associate degree solidified. Do I think that an
(11:47):
associate degree is required?
Speaker 2 (11:52):
No, I don't think so. Excuse me.
Speaker 1 (11:56):
I don't believe that an associate degree is required to
to teach coding.
Speaker 2 (12:01):
But it just it does show that you were.
Speaker 1 (12:05):
Disciplined enough for two years to get a degree, right,
It does show discipline. And as far as the years
of experience, yes, for me, if you have the years
of experience, you know, the years of experience to me
outweigh the associates degree because your associate degree could be
in a different feel altogether, but your years of experience
(12:28):
that shows that you've been in it long enough to
know at least at a minimum.
Speaker 2 (12:32):
Some of the ends and outs as it relates to that.
Speaker 1 (12:35):
Particular topic that you're talking speaking on when it comes
to coding. So so yeah, so sometimes the experience outweighs
the degree. But get your degree. And I'll use myself
as an example. I have a degree and a social
degree in business management, but I have almost thirty plus
(12:57):
years of coding experience, right, so if someone was to
hire me, they they would say, okay, she went to college.
Speaker 2 (13:05):
Her college, her.
Speaker 1 (13:06):
Degrees in business, but her experience and coding and compliance.
Speaker 2 (13:13):
Far with far outweighs that of her associate degree.
Speaker 1 (13:17):
So yeah, so you see what I'm saying, the experience,
Uh so, yeah, So I kind of went back and
forth over the list. So we talked about autisty, we
talked about just being a medical coder, and we talk
about coding education.
Speaker 2 (13:32):
Now we could talk.
Speaker 1 (13:33):
About consulting, right, we could talk about healthcare consult compliance coding,
and compliance consulting.
Speaker 2 (13:41):
I've done those roles as well. So this is where
I guess you.
Speaker 1 (13:46):
Could say my business comes in, my business degree comes in,
because you have to know how.
Speaker 2 (13:51):
To market yourself.
Speaker 1 (13:53):
You have to know how to network. You have to
pretty much that's what that whole communication thing comes in.
You have to be able to communicate if you're trying
to be a consultant, because you have the network. You
have to to again, have the experience, you have the
education to consult others right to help organizations reach out
(14:16):
to you or to hire you as a consultant, to
train or to complete projects, to whatever it is that
they're needing.
Speaker 2 (14:23):
You to do.
Speaker 1 (14:24):
And so that's why it's important that you have that
so consulting it is a different beast. But I would
say the if you haven't grasped the the some of
the underlying I would say characters or characteristics you should
have or gifts you you should have, And that is
(14:46):
to communicate. Let's see here now as far as like
medical coding, because medical coding can go we can go
down another rabbit hole when it comes to the actual
medical coding role because you have outpatient medical coulders, you
have profit or the professional coder, and then you have
the inpatient or facility coding. So there is various coding
(15:07):
certifications that are out there, and I don't want to
die too deep into that because that's a whole other
episode in itself. But there are different certifications, there are
different perspectives or aspects of medical coding. So there again
there's profit coding. The profit coder is the coders who
specifically code for the practitioner, the physician, the PA, the NP.
(15:32):
They are the profit or the professional coder. They make
sure that the professional coding is accurate for the providers.
Outpatient coding is for services that are done on an
outpatient setting, such as an ambulatory surgery center. Or ASC
and outpatient surgery center, outpatient services, outpatient hospital facility, so
(15:56):
they're focused on the outpatient aspect of healthcare.
Speaker 2 (16:01):
In Patient coding is strictly.
Speaker 1 (16:03):
For like the in patient, like the hospital, like they're focusing,
they're billing or they're coding excuse me, billing and coding
for the hospital the facility.
Speaker 2 (16:13):
So when you go into.
Speaker 1 (16:15):
The hospital for an admission for a stay, there's like
i'm'a say, at least two or three different coders coding
your encounter. You have your profit cause there the profit
is cading for the pr the provider who comes to
treat you. Then you have a coder who who's coding
for the hospital to hospital where you are staying.
Speaker 2 (16:36):
They're r c picking up.
Speaker 1 (16:37):
All those things, the medicine whatever it is that that
that that they're using to treat your sent your system,
your s system, your symptoms or your diagnosis.
Speaker 2 (16:48):
They're building for that or coding for that.
Speaker 1 (16:50):
And then there's another one again if you if I
would say, if you're doing some type of out patient
services or let's say dm mes, that that you have
different coders accesses, accessing or coding your.
Speaker 2 (17:04):
Stay and then you're going to bring.
Speaker 1 (17:06):
In an auditor because let's say they want to audit
the services that were provided those so you have at
least again I'm gonna say even maybe perhaps four different
coders depending on their capacity looking at your hospital stay.
Speaker 2 (17:21):
All right, So yeah, so which one pays more? I've
heard that.
Speaker 1 (17:30):
Well, well, in the past, I said, in the past,
the impatient coders or facility colders were getting paid more,
and they probably still are. But then but you know
those prophy coders are they're making their ways up the chart.
Speaker 2 (17:46):
So it really.
Speaker 1 (17:46):
Depends on your jam, your organization, your skill set, what
you ask for, and what you negotiate.
Speaker 2 (17:53):
When you you know, when you're.
Speaker 1 (17:56):
Accepting the role or positioned it as a medical coder
again and then again, what is it that you're going
to be doing as a medical coder? Are you going
to be auditing or are you going to be in leadership?
Are you going to be an educator? Are you going
to be just a I don't want to say plane
Jaine Colder because that's just me differentiating between leadership, coding,
(18:17):
education and all the things of that nature. So you
trust me, you're not playing and so so yes, but
and then how you take take the skills or take
the task, and you you monopolize on that right. So again,
in the past, the facility codes were definitely making more
(18:40):
money or had a bigger income or a salary than
that of a profit coder or.
Speaker 2 (18:47):
The other ones.
Speaker 1 (18:48):
But again I've worked in various capacities. I worked as
a medical coder, an auditor position as well as calling
an auditor a consultant educator.
Speaker 2 (18:58):
As I did, I say leadership, So yes, So it depends.
It really depends. So there's do.
Speaker 1 (19:09):
I what can I what what do I recommend? Honestly
I would have to dem it on a case by
case scenario and then also just kind of get an
idea of what were your heart lies, you know, Like
I've coached individuals who wanted to pursue coding or they
(19:32):
want to pursue a particular area of coding because perhaps
it's something personal to them. Others went in it, again
for the revenue, the income, the salary. Some of some
individuals went in it because they wanted.
Speaker 2 (19:46):
To be remote. So it really depends on what what
it is that you're seeking.
Speaker 1 (19:53):
Like again, personally, I can't put an overall recommendation on
something that may be personal to you because I could
let's say, if I say, okay, you should be an auditor, right.
Speaker 2 (20:05):
But auds it may not be your jam.
Speaker 1 (20:07):
It may not be the thing that that lights your
fire that makes you jump out of bed in the morning,
whether you are remote or you on site, that may
not be what you want to do.
Speaker 2 (20:16):
And so you take that and you do it, do.
Speaker 1 (20:19):
Something else with Like you may want to be a
coding entrepreneur, and that's fine.
Speaker 2 (20:23):
You know, if that's your jam, go for it.
Speaker 1 (20:25):
You may be want of you coding content creating, that's
also fine. So whatever gets you ex makes you excit,
or gets you about the bed in the morning, and
sets your soul on.
Speaker 2 (20:35):
Art, I say, pursue it.
Speaker 1 (20:37):
But the as far as as far as the salary
of these roles I'll have again that's another episode that
I would have to unpack as well, and just to
kind of talk of it, because again that varies. Again
it depending on what your role is as a medical coder.
And i''m sure it also has to deal with experience
(20:57):
or years of experience and things of that nature. But yeah,
so we or I think I unpacked pretty much the
main of the roles because again AI just really broke
them all out, like and some of these are very overlapping.
I said that wrong, but they are overlapping. So again,
we have a medical coder, you have a coding manager director.
(21:21):
And actually I didn't talk on that one. So yeah,
so what they're saying is a coding manager director. They
of course they oversee, that is the key term. They
oversee the coding operations, the magature. They're monitoring or managing
the staff.
Speaker 2 (21:35):
I want to they're.
Speaker 1 (21:36):
Monitoring, but they're managing the staff coding staff. They want
to ensure that they're meeting the productivity standards as well
as the quality standards as relates to coding. They develop
and they implement coding policies and procedures to ensure accuracy
and efficiency. They do the hiring, the training as well
(22:00):
as the evaluation and the performance of medical coders.
Speaker 2 (22:04):
And then of course they they.
Speaker 1 (22:06):
Get with the auditores to facilitate audo teams, so they
have those audo team members to ensure that the coders
that are doing the actual coding are providing accuracy and
efficiency in their day to day coding processes. So yeah,
so okay, so let me go back. So we got
(22:27):
coding management leadership. We have coding auditors, we have medical coders,
we have coding educators.
Speaker 2 (22:33):
So that again, that that.
Speaker 1 (22:36):
Is the basis of what the coding the different coding
roles that are out there, and I'm sure there is more.
Speaker 2 (22:42):
Matter of fact, I know that there there is more.
Speaker 1 (22:44):
I just won't delve into that cause again, that's a
whole nother we'll be down the rabbit hole and we'll
be on the podcast all day if we.
Speaker 2 (22:51):
Go down that rabbit hole. But yes, so.
Speaker 1 (22:56):
It's just having a medical coding sort of. There's plenty
of things avenues you can do with the medical coding certification,
but for the most part of individuals who do study
for medical coding, they want to actually do medical coding.
And I'm not mad with them because I would want
to do that as well. Especially when you're starting out.
You want to get your feet what you want to
get the experience, and then you can pivot.
Speaker 2 (23:18):
From that point. So yeah, so.
Speaker 1 (23:21):
Yeah, so those are some of the roles that you
can pursue again with your medical coding certification. And as always,
if you have any questions, are you interested in learning
more about medical coding, please visit my website and that's
at www dot Abraham Medical Coding Coach LLLC dot com
and I'll repeat that www dot Abraham Medical Codingcoach LLC
(23:47):
dot com.
Speaker 2 (23:49):
I have an online course.
Speaker 1 (23:51):
Again, I am a credential Medical Coding UH instructor as
well as the coach and consultant. If you have questions
in regards to the course how to register, please visit
my website. If you are looking for consulting or you
want a one on one coaching moment with me, you
can also visit my website to schedule that time with me.
Speaker 2 (24:11):
And yeah, so, as always, cald on until the next
quoding break.
Speaker 1 (24:17):
Take care,
How they coding pros and welcome back to the Coding
Break podcast. I am your medical coding coach as well
as your Coding Break reminder TAMP talk here to talk
about all things colding related, which includes the good, the bad,
and perhaps some of the ugly side of medical coding.
So on today's episode, I want to talk about or
(00:24):
touch on the subject of the type of roles that.
Speaker 2 (00:28):
A medical coder can fulfill.
Speaker 1 (00:30):
Now, of course, if you study to become a medical coder,
the ultimate goal is to actually do some medical coding.
Speaker 2 (00:37):
And I get that, I understand that.
Speaker 1 (00:39):
But there are so many other options or opportunities that
we can pursue with the medical coding certification.
Speaker 2 (00:45):
So I uh solicited the help of.
Speaker 1 (00:47):
My very friendly compadre AI are artificial intelligence to kind
of help me run through a list of some of
the roles that we can fulfill. And I will say
some of these roles our to me or redundant, and
again it will depend on the organization that is doing
the hiring, and then some of the and I will
(01:08):
also say that some of the roles that I will
touch on are some of the roles I actually fulfilled
and I can attest whether or not certain roles are
like intertwined or again, AI was just very redundant with
the listing of roles.
Speaker 2 (01:26):
But nonetheless, let's get started.
Speaker 1 (01:29):
So of course the ultimate or the number one who
no role is to become a medical coder. Again, a
medical coder. So what exactly does medical coding entails? So,
according to AI, the medical coder role is pretty much
translating medical documentation or aka review the patient medical records
(01:51):
such as the physician or healthcare practitioners notes, lab results, diagnoses, treatments,
and the like, and converting that information into the correct
or their appropriate medical codes which are used in the
ICD tennes c BT medical coding system and so so yeah,
that's pretty much standard. And if I guess to put
(02:13):
it in practical terms, a medical coder is like the
interpreter or the foreign language interpreter of translator of foreign information.
So we are the foreign information or translator interpreter for
medical services or healthcare services, and we translate that into
codes or terms or APA alpha numeric terms let me
(02:35):
said correctly alpha numeric terms for the insurance companies.
Speaker 2 (02:42):
In order to seek reimbursement.
Speaker 1 (02:44):
So we are the communicator of healthcare, healthcare services to
the healthcare payers bottom line. And so we ensure that
the coding accuracy is accurate. And also that we're falling
within the compliance or regulation, the law, the guidelines, so
that we're.
Speaker 2 (03:03):
Following the law.
Speaker 1 (03:05):
And then again, like I said that we communicate with
health care providers. I and I'm go back and said,
I remember when I started out or when I was
in leadership, but some of our colders were nervous, like
nervous to talk to health care providers. It's almost like
the same fear that you experienced when you have to
do public speaking. Some of the colders had that same
(03:27):
fear when it came to communicating with health care providers.
Speaker 2 (03:31):
They're humans, they are humans.
Speaker 1 (03:34):
This is how you get your information, to ensure that
your coding is accurate. So there's no need to be
afraid of your providers, your doctors, your nurse practitioners, pas,
what have you.
Speaker 2 (03:45):
You have to communicate with them.
Speaker 1 (03:47):
That's like one of the biggest parts of the job
is communicating with them. Is to ensure that when you're
coding or you're selecting your codes, that you are getting
the correct or accurate information. So don't be afraid communicate
with your health care provider. And then another job function
that comes along with being a medical coder is just
(04:08):
making sure that you know the claims are being submitted
to the insurance company or the payers appropriately. Again, this
also kind of ties into that billing part or billing road,
but pretty much nonetheless, we are the health information the
health care services interpreter, translator, and all of the above
(04:32):
compliance Like we make sure that we're following the rules,
that we're coding accurately, and that we're doing within the law.
So that's pretty much what encompasses a medical coder. Now
we're gonna take all of that that I just spill
and we're gonna break it out into different roles because
you can, you can, there are actually actual roles for
(04:53):
those different components.
Speaker 2 (04:55):
That I just I just discussed.
Speaker 1 (04:58):
So number two, AI said, coding specialists again, colding specialists,
certified medical colder, medical colder.
Speaker 2 (05:07):
To me, they're all the same, I think.
Speaker 1 (05:08):
Again it goes back to the healthcare organization and how
they entitle or list that particular role in what that
role does encompass.
Speaker 2 (05:17):
Okay, coding auditor.
Speaker 1 (05:20):
Now, now this role I have held and I held
this for Yeah, in various organizations and various capacities. Now,
when I became a auditor, I was auditing the providers.
I was audusting the physicians. I was auditing, Yeah, I
was audited the physicians, the mid level providers such as
(05:41):
the nurse practitioners and the physician assistants or pas. I
was auditing the providers. Again, this is when I first
started in auditing. And because we did that, the reason
why we did that is because they were the ones
who were providing the service. Right, So again it in
this case, you definitely have to be able to communicate
with the providers because.
Speaker 2 (06:02):
You're auditing them.
Speaker 1 (06:03):
So what that encompass is of course they provide the services. Now, again,
the audits could be prospective or retrospective. So prospective just
means that it was done prior to being built. Retrospective
is it was uh the audit was performed after it
was built. And so but we or I UH was
(06:26):
able to commun audit the providers and then had to
communicate with the providers what the finers were, whether they
were good batter and difference nonethl. We had to communicate
with the providers. So that's the role of a coding auditor.
Another task that I that is included in the coding
aulitor is how you procure the information, like the the
(06:47):
w how do you know what you're gonna audit? So
you have to come up with the plan or the
organization or your manager have to come up with a
plan on like what we're gonna look at?
Speaker 2 (06:56):
What's the scope?
Speaker 1 (06:58):
You may hear that as an auditor, like what's the
the scope is? What will the audit process consists of
what services are we r are we auditing? What providers
are we auditing? What date range is are we auditing?
And then what are we looking for? And then we
once we do all the once we soilify what the
scope is, then we compile all the information or the
(07:18):
findings and a report and we tr re relate that
information back to the providers or the leadership.
Speaker 2 (07:26):
Or executive team in which I guess oversees.
Speaker 1 (07:30):
That that provider or that provider group practice and so.
And also allows for us as coding educator educators which
I will jump into that that job after this to
find opportunities of to find education, like what what are
the opportunities where do we find that the provider needs
(07:52):
education on like, what are their weaknesses, what's the redundant
issue that we're seeing in the audit that may require
and uh opportunity to educate the provider or they come
across like the provider is not.
Speaker 2 (08:04):
Aware of it.
Speaker 1 (08:05):
Some of them may here where and some of them
are honestly they don't know. So that's an opportunity to
educate the provider. So now that we are talking about education,
let's talk about the education role. So there's many people,
thanks to the Internet, who are deemed and I'm air
quoting to be coding educators and I'm not knocking anybody.
(08:26):
Let me put that disclaiming. I'm not knocking anybody because
everyone has a unique perspective or unique gift to coding
and they want to share that with the world because
there are people who may have that same perspective, and
that's nothing wrong with that.
Speaker 2 (08:41):
I encourage individuals. We have a perspective and you feel
that there is others that are it will.
Speaker 1 (08:48):
Fulfill a need or help another individual by all means
go forward. So no, this is not like to be
little anyone who doesn't meet the requirements of a coding educator.
Everyone one at this point is an educator. But according
to again my friendly friend, AI, a coding educator pretty
(09:10):
much they should have at least an associate degree and
at least five years of experience in the subject matter
in which they are trying to educate another individual one. So,
for example, UH, I have a credential and general surgery.
So if I said I want to teach someone general surgery,
I am qualified according to the requirements to do so,
(09:33):
or I shall say the AAPC requirements to do so
because I have the credential as a general surgery coder,
I have five years at least five years experience as
a general surgery colder, and I've also taught on a
collegiate level as it relates to health care coding and
audisty in general surgery. So I can officially say that
(09:56):
I am educated to I meet the requirements to teach
general of surgery.
Speaker 2 (10:01):
And I will also to say that I do have
my UH credentials as an educator to educate. But there,
like I said, but there are some who may not
have that the years of experience.
Speaker 1 (10:13):
They may not have the credential to be a coding educator,
and or they may have the experience in but they
may not have the credentials either to be uh specified
or a specially c uh educator or uh just a
n A coding educator. But hey, again, the Internet is
available for anyone. If you have a perspective, you can
share that perspective. You're your unique perspective to others. That's
(10:36):
there's nothing wrong with them and so.
Speaker 2 (10:40):
So so that's what the AAPC.
Speaker 1 (10:44):
Again, the AAPC, and and I would assume a human
as well.
Speaker 2 (10:47):
Those are the requirements that.
Speaker 1 (10:48):
Are needed to to educate uh the masses as relates
to medical coding. And it also just kind of solidifies
your qualifications because if someone so for example, if you
offer a course right and.
Speaker 2 (11:04):
Someone or you you you.
Speaker 1 (11:06):
Are sharing your information, your knowledge via the Internet and
regards to coding, and someone may be may be a
d you know, perceptive to your teaching and they want
to learn more, and you offer a course, so they
may go and do the research just to confirm that
you are legitimate or you qualify as an educator, and
(11:27):
so you wanna make sure that you do have those qualifications, right,
You do have those qualifications. Again, you have at least
an associate's degree. You have at least five years of
coding experience and perhaps you know have the credential now
well the associate degree solidified. Do I think that an
(11:47):
associate degree is required?
Speaker 2 (11:52):
No, I don't think so. Excuse me.
Speaker 1 (11:56):
I don't believe that an associate degree is required to
to teach coding.
Speaker 2 (12:01):
But it just it does show that you were.
Speaker 1 (12:05):
Disciplined enough for two years to get a degree, right,
It does show discipline. And as far as the years
of experience, yes, for me, if you have the years
of experience, you know, the years of experience to me
outweigh the associates degree because your associate degree could be
in a different feel altogether, but your years of experience
(12:28):
that shows that you've been in it long enough to
know at least at a minimum.
Speaker 2 (12:32):
Some of the ends and outs as it relates to that.
Speaker 1 (12:35):
Particular topic that you're talking speaking on when it comes
to coding. So so yeah, so sometimes the experience outweighs
the degree. But get your degree. And I'll use myself
as an example. I have a degree and a social
degree in business management, but I have almost thirty plus
(12:57):
years of coding experience, right, so if someone was to
hire me, they they would say, okay, she went to college.
Speaker 2 (13:05):
Her college, her.
Speaker 1 (13:06):
Degrees in business, but her experience and coding and compliance.
Speaker 2 (13:13):
Far with far outweighs that of her associate degree.
Speaker 1 (13:17):
So yeah, so you see what I'm saying, the experience,
Uh so, yeah, So I kind of went back and
forth over the list. So we talked about autisty, we
talked about just being a medical coder, and we talk
about coding education.
Speaker 2 (13:32):
Now we could talk.
Speaker 1 (13:33):
About consulting, right, we could talk about healthcare consult compliance coding,
and compliance consulting.
Speaker 2 (13:41):
I've done those roles as well. So this is where
I guess you.
Speaker 1 (13:46):
Could say my business comes in, my business degree comes in,
because you have to know how.
Speaker 2 (13:51):
To market yourself.
Speaker 1 (13:53):
You have to know how to network. You have to
pretty much that's what that whole communication thing comes in.
You have to be able to communicate if you're trying
to be a consultant, because you have the network. You
have to to again, have the experience, you have the
education to consult others right to help organizations reach out
(14:16):
to you or to hire you as a consultant, to
train or to complete projects, to whatever it is that
they're needing.
Speaker 2 (14:23):
You to do.
Speaker 1 (14:24):
And so that's why it's important that you have that
so consulting it is a different beast. But I would
say the if you haven't grasped the the some of
the underlying I would say characters or characteristics you should
have or gifts you you should have, And that is
(14:46):
to communicate. Let's see here now as far as like
medical coding, because medical coding can go we can go
down another rabbit hole when it comes to the actual
medical coding role because you have outpatient medical coulders, you
have profit or the professional coder, and then you have
the inpatient or facility coding. So there is various coding
(15:07):
certifications that are out there, and I don't want to
die too deep into that because that's a whole other
episode in itself. But there are different certifications, there are
different perspectives or aspects of medical coding. So there again
there's profit coding. The profit coder is the coders who
specifically code for the practitioner, the physician, the PA, the NP.
(15:32):
They are the profit or the professional coder. They make
sure that the professional coding is accurate for the providers.
Outpatient coding is for services that are done on an
outpatient setting, such as an ambulatory surgery center. Or ASC
and outpatient surgery center, outpatient services, outpatient hospital facility, so
(15:56):
they're focused on the outpatient aspect of healthcare.
Speaker 2 (16:01):
In Patient coding is strictly.
Speaker 1 (16:03):
For like the in patient, like the hospital, like they're focusing,
they're billing or they're coding excuse me, billing and coding
for the hospital the facility.
Speaker 2 (16:13):
So when you go into.
Speaker 1 (16:15):
The hospital for an admission for a stay, there's like
i'm'a say, at least two or three different coders coding
your encounter. You have your profit cause there the profit
is cading for the pr the provider who comes to
treat you. Then you have a coder who who's coding
for the hospital to hospital where you are staying.
Speaker 2 (16:36):
They're r c picking up.
Speaker 1 (16:37):
All those things, the medicine whatever it is that that
that that they're using to treat your sent your system,
your s system, your symptoms or your diagnosis.
Speaker 2 (16:48):
They're building for that or coding for that.
Speaker 1 (16:50):
And then there's another one again if you if I
would say, if you're doing some type of out patient
services or let's say dm mes, that that you have
different coders accesses, accessing or coding your.
Speaker 2 (17:04):
Stay and then you're going to bring.
Speaker 1 (17:06):
In an auditor because let's say they want to audit
the services that were provided those so you have at
least again I'm gonna say even maybe perhaps four different
coders depending on their capacity looking at your hospital stay.
Speaker 2 (17:21):
All right, So yeah, so which one pays more? I've
heard that.
Speaker 1 (17:30):
Well, well, in the past, I said, in the past,
the impatient coders or facility colders were getting paid more,
and they probably still are. But then but you know
those prophy coders are they're making their ways up the chart.
Speaker 2 (17:46):
So it really.
Speaker 1 (17:46):
Depends on your jam, your organization, your skill set, what
you ask for, and what you negotiate.
Speaker 2 (17:53):
When you you know, when you're.
Speaker 1 (17:56):
Accepting the role or positioned it as a medical coder
again and then again, what is it that you're going
to be doing as a medical coder? Are you going
to be auditing or are you going to be in leadership?
Are you going to be an educator? Are you going
to be just a I don't want to say plane
Jaine Colder because that's just me differentiating between leadership, coding,
(18:17):
education and all the things of that nature. So you
trust me, you're not playing and so so yes, but
and then how you take take the skills or take
the task, and you you monopolize on that right. So again,
in the past, the facility codes were definitely making more
(18:40):
money or had a bigger income or a salary than
that of a profit coder or.
Speaker 2 (18:47):
The other ones.
Speaker 1 (18:48):
But again I've worked in various capacities. I worked as
a medical coder, an auditor position as well as calling
an auditor a consultant educator.
Speaker 2 (18:58):
As I did, I say leadership, So yes, So it depends.
It really depends. So there's do.
Speaker 1 (19:09):
I what can I what what do I recommend? Honestly
I would have to dem it on a case by
case scenario and then also just kind of get an
idea of what were your heart lies, you know, Like
I've coached individuals who wanted to pursue coding or they
(19:32):
want to pursue a particular area of coding because perhaps
it's something personal to them. Others went in it, again
for the revenue, the income, the salary. Some of some
individuals went in it because they wanted.
Speaker 2 (19:46):
To be remote. So it really depends on what what
it is that you're seeking.
Speaker 1 (19:53):
Like again, personally, I can't put an overall recommendation on
something that may be personal to you because I could
let's say, if I say, okay, you should be an auditor, right.
Speaker 2 (20:05):
But auds it may not be your jam.
Speaker 1 (20:07):
It may not be the thing that that lights your
fire that makes you jump out of bed in the morning,
whether you are remote or you on site, that may
not be what you want to do.
Speaker 2 (20:16):
And so you take that and you do it, do.
Speaker 1 (20:19):
Something else with Like you may want to be a
coding entrepreneur, and that's fine.
Speaker 2 (20:23):
You know, if that's your jam, go for it.
Speaker 1 (20:25):
You may be want of you coding content creating, that's
also fine. So whatever gets you ex makes you excit,
or gets you about the bed in the morning, and
sets your soul on.
Speaker 2 (20:35):
Art, I say, pursue it.
Speaker 1 (20:37):
But the as far as as far as the salary
of these roles I'll have again that's another episode that
I would have to unpack as well, and just to
kind of talk of it, because again that varies. Again
it depending on what your role is as a medical coder.
And i''m sure it also has to deal with experience
(20:57):
or years of experience and things of that nature. But yeah,
so we or I think I unpacked pretty much the
main of the roles because again AI just really broke
them all out, like and some of these are very overlapping.
I said that wrong, but they are overlapping. So again,
we have a medical coder, you have a coding manager director.
(21:21):
And actually I didn't talk on that one. So yeah,
so what they're saying is a coding manager director. They
of course they oversee, that is the key term. They
oversee the coding operations, the magature. They're monitoring or managing
the staff.
Speaker 2 (21:35):
I want to they're.
Speaker 1 (21:36):
Monitoring, but they're managing the staff coding staff. They want
to ensure that they're meeting the productivity standards as well
as the quality standards as relates to coding. They develop
and they implement coding policies and procedures to ensure accuracy
and efficiency. They do the hiring, the training as well
(22:00):
as the evaluation and the performance of medical coders.
Speaker 2 (22:04):
And then of course they they.
Speaker 1 (22:06):
Get with the auditores to facilitate audo teams, so they
have those audo team members to ensure that the coders
that are doing the actual coding are providing accuracy and
efficiency in their day to day coding processes. So yeah,
so okay, so let me go back. So we got
(22:27):
coding management leadership. We have coding auditors, we have medical coders,
we have coding educators.
Speaker 2 (22:33):
So that again, that that.
Speaker 1 (22:36):
Is the basis of what the coding the different coding
roles that are out there, and I'm sure there is more.
Speaker 2 (22:42):
Matter of fact, I know that there there is more.
Speaker 1 (22:44):
I just won't delve into that cause again, that's a
whole nother we'll be down the rabbit hole and we'll
be on the podcast all day if we.
Speaker 2 (22:51):
Go down that rabbit hole. But yes, so.
Speaker 1 (22:56):
It's just having a medical coding sort of. There's plenty
of things avenues you can do with the medical coding certification,
but for the most part of individuals who do study
for medical coding, they want to actually do medical coding.
And I'm not mad with them because I would want
to do that as well. Especially when you're starting out.
You want to get your feet what you want to
get the experience, and then you can pivot.
Speaker 2 (23:18):
From that point. So yeah, so.
Speaker 1 (23:21):
Yeah, so those are some of the roles that you
can pursue again with your medical coding certification. And as always,
if you have any questions, are you interested in learning
more about medical coding, please visit my website and that's
at www dot Abraham Medical Coding Coach LLLC dot com
and I'll repeat that www dot Abraham Medical Codingcoach LLC
(23:47):
dot com.
Speaker 2 (23:49):
I have an online course.
Speaker 1 (23:51):
Again, I am a credential Medical Coding UH instructor as
well as the coach and consultant. If you have questions
in regards to the course how to register, please visit
my website. If you are looking for consulting or you
want a one on one coaching moment with me, you
can also visit my website to schedule that time with me.
Speaker 2 (24:11):
And yeah, so, as always, cald on until the next
quoding break.
Speaker 1 (24:17):
Take care,
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