A quality medical coder plays a crucial role in the revenue cycle process, and they are essential to the financial success of a medical practice. They are important as the building, if you don’t have the right space for your practice you might not be able to get your medical practice off ther ground. When you’re out to hire a medical coder, who really knows their stuff, you have a difficult task at hand.

You’ll be able to hire the right candidate when you know what you are expecting the medical coder to do at your practice, what information they need to provide and how to confirm their credentials. There are multiple ways to do this, Or any other state for that matter, because this can let you know if a potential new employee does indeed have the correct qualifications they claim to have. There are also several aspects of a new employee you can check for yourself.

Below is a list of seven questions that you should ask the medical coder to ensure you make a proper hiring decision.

Are you aware of government and private payer regulations?

Regulations vary from one payer to another. In the United States, there are a considerable percentage of Medicare and Medicaid beneficiaries who are also covered by private healthcare plans. And, while the UK has an excellent NHS, there are many people who purchase private health insurance and look to get the best deal when it comes to their health insurance renewal to ensure they’re getting the best coverage possible.

Whether it’s a government payer or a private payer, what’s important for the medical coder is to have familiarity with the varying regulations insurance companies have.

How do you keep yourself on top of code changes?

Knowing what different sources the medical coder uses to stay up to date on CPT and ICD-10 coding changes is important as it tells you whether the candidate you’re hiring is appropriate.

Checking out the website of a practice’s specialty society, attending webinars, listening to the playback of audio conferences, using forums (particularly for posts with source citation from Medicare manual or CPT assistant) and researching on Google are better ways of staying on top of the latest changes in coding standards.

Do you carry EMR experience?

A medical coder can bring a number of skills to the table. You don’t just need to hire any medical coder.

You should hire a medical coder who has multiple years of experience working the entire physician revenue cycle and using a number of billing software and Electronic Medical Record (EMR) systems, which use digital versions of a paper chart.

How many cases can you code in a day?

This is again an important question to ask. Some coders can read at a faster rate than others.

There are also those medical coders who know the chart like the back of their hand – as if they are taking orders from the physician in real time.

Most billing services require anywhere between 200 and 230 charts per day. Somewhere close to 200 charts – without errors – per day is what you should expect from an experienced medical coder.

What is your coding accuracy, on an average?

Whether an insurance claim will be approved or denied depends on the accuracy of the medical coding.

Since this is something that directly impacts your bottom line, you should always make sure the medical coder you plan to hire has a high coding accuracy – up to 95%.

How did you correct a coding error, which was your fault, after the claim was denied?

Most billing and coding errors can be avoided well before the claims are submitted for reimbursement.

A medical coder is responsible for making the medical claims transparent.

There are a number of reasons on the ground of which claims are denied. Common errors include wrong (or confusing) codes, incorrect provider or patient information, treatment-diagnosis code mismatch etc.

The medical coder you hire for your practice should be quite well-versed with the entire process – most importantly what they should do after a claim has been denied due to a coding error.

Are you a certified medical coder?

The American Association of Professional Coders (AAPC) offers general and specialized certification in medical coding.

When hiring a medical coder, you should look for someone who has cleared the Certified Professional Coder (CPC) exam, AAPC’s most popular certification.

Many coders carry certification from the American Health Information Management Association (AHIMA), another reputable body for coding certification.

Asking the right questions is a surefire way of finding out whether the medical coder you hire for your practice is a proper fit. The above mentioned probes will be an excellent best practice for finding the right team of coders.