The main role of medical billing and coding specialists is to ensure health providers are paid for medical services rendered. They are responsible for the accurate flow of medical information and patient data between physicians, patients and third-party payers. Without them, healthcare businesses could not function efficiently.

Medical billing and coding consists of two essential functions:

• Medical Coding – Every medical service is assigned a numeric code to define diagnostics, treatments and procedures. It is the medical coder’s job to enter this information into the facility’s database using medical coding protocol to produce a statement or claim.
  
  
• Medical Billing – The medical biller then acts as a liaison between the facility and payment parties. If the claim is denied by the third-party payer, the medical billing specialist must investigate the claim, verify its information, and update the database.

These two roles are often filled by the same person, especially in smaller clinics. However, they can also be separate positions within the larger facility. Medical billing and coding specialists are also responsible for dealing with collections and insurance fraud.