Medical Billing & Coding Specialist Profile

Interviewee: Pamela Hills
Job Title: Registered Health Information Technician, St. Peter’s Hospital
Years in Field: 12 years

What does a medical coder do?

Coders are investigators. We hunt down the patient’s most important diagnostic, which is based on the lab procedures, signs and symptoms.

Coding involves a lot of rules, there are worldwide guidelines to follow for medical coding — it seems like it would be more straightforward: here’s the diagnosis, find the code. But there are so many guidelines to follow to pick the correct code; it’s not as black and white as it appears.

How did you get into the medical coding field?

I worked for a bank and my position was eliminated, so I went back to school. One of my classes was in medical terminology. I studied anatomy, physiology, medical transcription and coding. Another class covered health information laws like privacy, releasing information, confidentiality, going to court.

I was lucky to find a facility that was willing to train me right out of school. My actual one-on-one training was three months. But it takes about two years to become a proficient coder, to really know what you’re doing.

What’s a typical working day like for you?

I come in, start reading the charts and then begin coding. The coding desk is set up ergonomically to read through charts and enter the documents as I go. We use paper charts, but some facilities are all online.

Each person in our department is dedicated to one type of service: inpatient, outpatient surgery, ER. We all do the kind of coding we like — people are content to stay, but we are cross-trained and we do back up. People have the opportunity to switch if they want to.

What is most challenging about coding?

The physician documentation is not as clear as I would like at times. Sometimes I have to put bits and pieces together to find the answer, and then go back and ask the physician. I read the charts, but 10 or 20 percent of the time I have to ask the physician. The physician’s answer is only as good as my question. I get better answers with better questions. Over time, the physicians learn to document the issue before it comes to me so I don’t have to ask them.

What skills are most useful for people coming into this field?

Computer skills are essential. Coders work with computers all day, using different programs. The computers are updated regularly, so we need to be able to learn new programs. Medical coding requires you to be very detail-oriented. Any experience following national or federal guidelines would help.

Any advice for people who are interested in coding as a career?

You need to assess your personality type. If you’re an independent decision-making, detail-oriented type who doesn’t require a lot of interaction with people, this is a good position. If you like talking to people, then coding not what you want to do.

Medical coding sounds straightforward and simplistic: a patient has a disease and the coder gives the diagnosis a number. But it’s more complex than just assigning numbers. It’s detective work, uncovering a mystery.