Medical Billing and Coding Career Specialty
In the healthcare system, both doctors and insurance companies use a form of specialized code for billing purposes that can be impossible to understand if you’re not in the know. The people who complete this paperwork and keep patient files up-to-date are known as medical billing and coding personnel. On this page you’ll learn the medical billing and coding training paths you can take, which certification requirements you may need, plus the latest salary and job growth for this career.
What is Medical Billing and Coding?
Medical billing and coding involves the payment process used in healthcare. Medical billing and coding is needed to translate a doctor’s scribbles into a coded shorthand that’s used to maintain consistency across patient records. It’s also submitted to insurance providers to receive payment.
Medical billing and coding is considered a Health Information Technician (HIT) career, which can include other similar positions such as medical transcriptionists. But while transcriptionists focus on physician diagnoses and treatment plans to write their codes, medical billers and coders use patient reports to find the information they need.
Medical billing and coding is a highly specialized field, and the training is equally specialized. And even though medical administrative assistant associate degree programs typically cover some billing and coding courses, don’t expect to get the full range of skills you need from an MA program. You’ll need a specialized billing and coding program for that.
What Do Medical Billers and Coders Do?
Professionals in this field take down information on the diagnosis, treatment, tests, and other important medical notes in a patient’s files and translate them into the universal code used between healthcare professionals and billing offices. The day-to-day job responsibilities of billers and coders include:
- Read and analyze patient records or charts
- Review patient data for preexisting conditions like diabetes
- Assign the right procedure (CPT) or diagnosis (ICD) codes
- Use codes for care or billing purposes, often submitting claims to insurance providers
- Maintain patient data over time through detailed, coded information
- Interact with physicians and assistants to ensure accurate codes
- Function as a liaison between billing offices and healthcare providers
- Protect patient confidentiality and secure information
Although medical billers and coders don’t play an active hands-on role in patient care, they’re commonly found working on-site where patient care takes place. Medical billers and coders may work in various environments, including:
- Physicians’ offices
- Nursing care facilities
- Long-term care facilities
- Home healthcare facilities
- Research facilities
Some workers in this field are self-employed. They may work remotely or on-site at a medical facility they partner with. Most of the work takes place at a desk using a computer, and electronic health records make it easy for this work to be completed anywhere.
What Skills and Traits Are Needed?
Billers and coders need to understand human anatomy, common diseases, and medical terminology to translate medical records into code. In addition, a successful biller and coder has the following vital skills:
- Attention to detail
- Analytical skills
- Comfort working with technology
- Interpersonal skills
Medical Billing and Coding Salaries
According to the United States Bureau of Labor Statistics (BLS), the median annual salary for all HIT careers, which includes medical billing and coding, was $40,350 in 2018.
Salaries vary based on your experience, education, and credentials. Your salary may also be affected by the industry you work in, your job definition, and where you live. Most medical billers find jobs in a hospital or physician’s office, although they may find more lucrative positions working for the federal government.
Medical records and health information technicians, according to the BLS, earned the highest salaries in 2018 in the following industries:
|Annual Mean Wage
|Pharmaceutical and Medicine Manufacturing
|Scientific Research and Development Services
|Federal Executive Branch (OES Designation)
|Business, Professional, Labor, Political, and Similar Organizations
The job outlook for all HIT careers looks good, as the BLS has projected employment to grow 13% by 2026. This is faster than the average rate for all careers, which is expected to grow 7%.
This increased growth is expected due to an aging population that will soon require medical services and the widespread use of electronic health records in the U.S. Medical billers and coders or technicians with computer skills are required to organize the growing amount of patient data.
Because a large amount of the population is reaching old age, there is also a high demand for HIT professionals known as cancer registrars. They review patient records and assign codes for the diagnosis and treatment of various types of cancer.
Medical Billing and Coding Education and Training
There are a variety of paths you can take to enter the field of billing and coding, but each position and employer may require different education levels. Some positions hire those with entry-level experience and no certification. Other employers only hire professionals with college degrees and certification.
Here’s an overview of the variety of ways you can gain medical billing and coding training.
On the Job Training
Many jobs hire entry-level candidates and provide on-the-job training. This hands-on learning experience allows you to work in the field and assess your interest in this type of career before committing to an education program. After two years of work experience, you may be eligible for some certifications.
Most of these positions require a high school diploma and may require completion of courses or certificate programs to continue employment.
Billing and Coding Courses
One-off medical billing and coding classes may help you advance in your career. Working professionals in this field are encouraged to stay up-to-date on best practices. Taking professional development courses in a particular area can help you learn while working. Continuing education courses are perfect for certificate or associate degree holders who want to move into management, for example.
Whether you’re a professional or just starting out, here are some example courses you might take:
- Coding basics
- Professional coding
- Cancer registry management
- Rick adjustment/auditor training
- Clinical documentation improvement
- Certification exam prep
Some schools provide certificate or diploma programs that prepare students for a career in medical billing and coding as well as certification exams. While certificate programs may offer a certificate or diploma for completing the program, they are different from degree programs. However, you may be able to transfer credits to a degree program later if your certificate program is accredited.
You can complete a certificate program or diploma in around a year or less, and courses often cost around $500 per credit. Admission requirements typically include as little as a high school diploma and computer skills.
In this program, students learn about health insurance methodologies and reimbursement, information processing, current medical terminology, and classifying and coding medical data. Many programs are offered online, and you may need to complete an internship or practicum to graduate.
Certificate programs, however, don’t make you a certified billing and coding professional. You may still need to obtain certification. However, many programs prepare students to take certification exam.
Earning an associate degree in medical coding is a popular education path, especially if you want to move up to an advanced HIT career. These degree programs typically take around two years to complete. Associate degrees are commonly offered at community colleges online and in-person.
Students take a combination of the healthcare courses you’d take in a certificate program and general education courses. Core areas of training cover basic medical knowledge, information technology, and data management techniques. In addition to general education courses, you may take classes like anatomy and physiology, medical coding, computerized accounting, medical terminology, pharmacology, and legal issues in healthcare. Students also learn how to file billing forms.
Many programs require a practicum or capstone project where students can use and demonstrate the skills they’ve learned.
It varies by program, but common requirements for an associate degree in medical billing and coding include:
- High school diploma or GED
- Minimum GPA of 2.0
- Transcripts for all previous coursework
Although there is not a bachelor’s degree available in medical billing and coding, those who want to expand their careers into advanced management positions in the field earn a bachelor’s degree in health information management or healthcare administration.
Medical Billing and Coding Certification
Although certification isn’t required to find a job in medical billing and coding, earning certification through an accredited organization is highly recommended. Job seekers with certification may find more career opportunities or earn higher salaries after graduation. Many employers also require certification.
You can earn certification through an accredited program, such as the top two industry organizations: the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). There are also other organizations who provide medical billing and coding certification, but they may not be recognized by all employers.
Various certifications are available. Each requires an exam, but they differ in who is eligible, the exam format, price, and how to maintain the certification. Explore the main types of medical billing and coding certification below to find the right option for you:
- Certified Coding Associate (CCA) – Entry-level coders in physician’s offices and hospitals can receive AHIMA certification with a high school diploma and six months of professional experience.
- Certified Coding Specialist (CCS) – If you want a career in an inpatient facility, you’ll need CSS certification through AHIMA. Applicants need to complete a training program or degree, gain two years of experience and become members of AHIMA for $175. At least 2 hours of continuing education is required every year along with an annual coding self-assessment. There is also CSS-P certification, which is specific to coders in physician office settings.
- Certified Coding Professional (CPC) – Best for those interested in outpatient settings like a physician’s office or clinic, the CPC exam is the most common certification in the field. It’s offered by the AAPC for associate degree holders with professional experience. Applicants must also pay an exam fee and become AAPC members for around $80 to $150. To remain certified, you’ll need to complete at least 36 hours of continuing education classes every two years and attend events.
- Certified Medical Coder (CMC) – The least common certification, CMC is offered by the Practice Management Institute (PMI). Applicants need a year of professional experience and must earn 12 continuing education units annually.
Learn Medical Billing and Coding Online
Medical billing and coding online courses and programs are great for working students who want to continue their education. Scheduling is often flexible, courses are often less expensive, and students can attend from any location.
Individual billing and coding courses are offered through certification organizations like AHIMA. Online certificate and associate degree programs are also available through assorted community colleges, colleges, and universities.
The format of the program varies by who is offering it and the degree level. Typically, course materials come in the form of video lectures and online course files. Certificates and degree that require in-person participation, such as an internship or practicum, may require limited campus visits. However, many programs work with students to find internship or practicum locations in their area.
The Importance of Accreditation
Before you sign up for a program, make sure it’s properly accredited. Not only does accreditation mean the program meets industry standards, it may also be a requirement for some certifications. Many employers also won’t recognize training earned through non-accredited programs.
If you’re planning on continuing your education after earning a certificate or associate degree in medical billing and coding, you should also only consider accredited programs. You may be able to apply some or all of the credits you earn in your program to a more advanced degree program at another accredited school. You’ll also only be eligible for federal financial aid if you enroll in an accredited program.
No matter if you select an online or in-person program, look for programs accredited by American Health Information Management (AHIMA) or American Academy of Professional Coders (AAPC). You should be able to find this information on the program’s website or by contacting their admissions office.
Medical Billing and Coding Schools By State
- District of Columbia
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Rhode Island
- South Carolina
- South Dakota
- West Virginia