Karen Rossignol is a medical coder at Brinks Valley Health Center in rural Vermont.
“The duties of a medical coder vary depending on where they work. Here at Brinks, since we have a relatively small staff, I actually perform a lot of different duties in a typical day. I enjoy that, because a medical coder in a strictly normal hospital setting just converts patient files into alphanumeric billing codes eight hours a day, five days a week, and operates under constant scrutiny for productivity and accuracy. Of course we have high standards here as well, but the day’s schedule is flexible according to what we need from day to day.”
Let’s follow Karen on a typical workday.
7:00 a.m. Karen takes advantage of the quiet morning hours to code as many patient files as possible. Every illness and procedure has a billing code associated with it. These codes are used to process payment and keep records. Because there are so many different codes, Karen makes constant use of several large reference books.
9:30 a.m. The receptionist from the front desk drops off several checks received in the mail today. Karen sets them aside for now and continues coding.
10:30 a.m. Having coded a good deal of files already, Karen switches gears to print out billing summaries. These she folds and packs into envelopes, sending them to the appropriate patients.
11:00 a.m. Karen steps out to the front desk to answer phones and take over reception duties for an hour while the receptionist takes her lunch. “If there’s any time, I’ll code more files or process a few of those checks we received in the mail, whatever I can do to make the time more productive,” Karen says.
12:00 p.m. The receptionist returns, and it’s Karen’s turn for lunch.
1:00 p.m. Karen begins to organize a tall stack of insurance claims. She’ll use these to collect reimbursement for any care given to insured patients at the health center.
2:15 p.m. With the insurance claims reviewed and ready to mail, Karen begins filing claims with Medicare and similar State and federal programs. There are only a few of these to process; they are quickly done.
2:35 p.m. Karen processes the check payments received in the mail earlier today, updates patient records to reflect the changes, and mails updated bills according to the new balance on each patient’s account.
3:00 p.m. More coding. Every patient that enters the door creates more of this work for Karen, so it’s important not to fall behind.
Accuracy is crucial: even one wrong digit in a medical code could cause a problem for the patient and the health center.
“My work is audited often, so I’ve got to be fast and precise. Friends of mine who’re all-day coders at hospitals tell me that’s the most stressful thing about their jobs. I’ve got a lower volume here, but it’s still not easy.”
4:00 p.m. Time to go home.
Karen’s responsibilities don’t always end when she leaves, however: as a medical coder she is required to stay up-to-date on the ever-changing rules, regulations, and standards in the field. She may do this by attending seminars or keeping up with professional publications.