What is an RN Coder?

Registered nurses have long been a valuable part of our countrys health care system. But RNs with
certified training in clinical and medical coding are consistently in higher demand than their uncertified
counterparts, thanks in large part to the critical knowledge they provide to hospitals, insurance companies
and doctors offices. RN coders are integral to maintaining an orderly billing process and accurate patient
record keeping while also protecting against insurance fraud.
Primary Duties
Patients who receive care at a hospital outpatient facility, physicians office or ambulatory surgical center
must have all services documented by that provider. As an RN coder, your job is to extract this
information from the various medical reports and assign specific industry-standard codes that correspond
to the services performed. These codes will then allow the medical biller to process a claim for
reimbursement from the insurer. You must research a variety of sources to ensure accurate coding,
including laboratory tests, imaging studies and a transcription of the doctors notes.
Additional Duties
You may be involved in a number of peripheral activities as an RN coder. These include educating
providers on federal compliance mandates where specific billing and coding standards are required,
auditing and refiling appeals of denied claims, and advocating for both patients and providers on medical
coverage issues. In many of these cases, you will also be serving as the medical biller, providing billing
statements and serving as chief liaison to the insurance providers.
Resources
Computer software has made the RN coders job much faster and easier in the 21 st century by partially
automating the process with searchable code databases. The three most frequently used code
classifications are the Current Procedural Terminology, Healthcare Common Procedure Coding and
International Classification of Disease. In addition, the Approved Clinical Supervisor Code of Ethics
addresses questions about your responsibilities and expected behavior.
Required Skills
You must be able to read a patients chart in order to accurately understand what happened and why, you
must be able to retain an encyclopedic knowledge of health care policies and systems, with the ability to
adapt as regulations change. You should understand modern pharmacology, disease management and
clinical intervention procedures. Critical and analytical thinking, ethical behavior, the ability to
communicate clearly and patience in fast-paced, high-stress environments are also essential.
Education and Licensing
RN coders are highly trained. You must first be licensed as a registered nurse, either with a bachelors or
associates degree in nursing or by earning a diploma from a professional nursing school. Most coders
then become certified by completing a medical coding course and passing a Certified Professional Coder
exam administered by an accredited institution. Three of the most prominent institutions include the
American Academy of Professional Coders, American Health Information Management Association, and
American Association of Clinical Coders and Auditors.
Salary and Economic Outlook
RN coders are in-demand personnel that weather recessions well. In 2009, the salaries of credentialed
coders rose 4 percent to $44,750, while those without credentials rose 2 percent to $37,290. The AAPC
claims certification adds more than $7,000 to a coders annual salary. In addition, the forecast for medical
record and health information technicians is especially bright. According to the U.S. Bureau of Labor
Statistics, there were 179,500 jobs in the field in 2010, with 21 percent annual job growth through 2020,
which is far faster than the national average.

Job Description of a Medical Coder

Most patients will never meet a medical coder, but they often have coders to thank for the care they
receive. Medical coders, also known as medical records clerks and health information technicians, help
doctors understand what treatments will work best for specific patients based on prognosis and prior
therapies. Coders also ensure that providers follow laws regarding medical records, and they give
hospitals and doctors the data to track the most effective therapies. A career in medical coding requires
specific educational credentials and offers strong hiring prospects.
Care
Medical coders dont provide health care, but they do help determine whether patients receive the right
treatments. Coders retrieve patient records for doctors and nurses who need to know prior history for
future diagnosis and treatment. They also comb through files to look for preexisting conditions. As
patients receive care, coders keep track of medical records to document improvement or deterioration in
condition. If a patient must be admitted to a hospital or has regained enough health to go home, the coder
processes the admission and discharge paperwork.
Regulations
Medical coders play a key role in ensuring that a health care provider meets regulations that govern
recordkeeping. Its the coders job to protect patient privacy by keeping medical histories confidential.
Plus, coders review records to determine if the records contain the personal information and treatment
details the law requires. When agencies, health professionals or insurers ask about patient specifics,
coders must know legal rules governing the release of that information. Coders also serve as liaisons
between the provider and the billing office.
Data
Medical coders electronically record, store and report on reams of data, and they use those statistics in
several ways. First, coders must organize and keep numbers for clinical databases and patient registries to
help hospitals and clinics track a treatments long-term effectiveness. Coders also follow patient outcomes
to enable providers to evaluate the quality of care. To help providers get reimbursement, coders assign
clinical codes with classification software. Plus, hospitals use coders compilations of medical records to
research how to control costs or enhance care.