Medical billing is the process by which health care providers submit claims to insurance providers (payers), government programs (Medicaid/Medicare), and/or patients directly in order to receive reimbursement for services. Besides invoicing and collecting payments, medical billers are involved with handling denied claims and processing appeals.
The main responsibility of a medical coder is to review clinical statements and assign standard codes using CPT, ICD-10-CM, and HCPCS Level II classification systems. Medical billers, on the other hand, process and follow up on claims sent to health insurance companies for reimbursement of services rendered by a healthcare provider. The medical coder and medical biller may be the same person or may work with each other to ensure invoices are paid properly.