Become a Medical Billing & Coding Specialist in California
The medical world is literally crying out for experienced or knowledgeable members of staff. With excellent future prospects in an industry that will never fade and is virtually recession-proof, the future is definitely bright for the right applicants.
Education and Training in CA
Medical billing and coding programs provide students with the knowledge and skills necessary to complete their jobs. Prospects must attend courses at an accredited institution recognized by employers and associations like the U.S. Department of Education.
Make sure your chosen trade school or community college has the proper accreditation before enrolling.
Medical billers and coders go to school to earn either a certificate or an associate degree. Certificate programs typically take less than a year to complete, while an Associate of Applied Science degree can take as long as two years.
While the shorter certificate program can prepare you for a job in the industry, a degree might improve your chances of obtaining a higher salary.
Medical Billing & Coding Programs in California
Because the role of a medical records specialist is so crucial to the healthcare industry, there are several trade schools in California that offer medical billing and coding career programs. Many schools offer flexible online courses so students with other work, home, or family obligations can fit classes into their busy schedules.
At some medical billing and coding schools, the curriculum includes an externship that allows students to intern at a hospital, doctor’s office, or another healthcare facility. During these on-site classes, students can apply the information and hands-on training they’ve learned in the classroom to real-life situations.
Courses of Study
In California, medical billing and coding programs feature coursework that covers various essential topics, from translating medical diagnoses into specific codes to practicing industry-specific computer skills. For the most part, these programs take both titles into account, training students to work as coders and billers.
Classes typically include:
- Anatomy and physiology
- Medical terminology
- Various coding principals, including CPT/HCPCS
- Electronic health records
- Claims processing
- Health insurance
- Legal policies
How Long Does It Take?
Medical billing and coding schools in California typically offer courses ranging from several months to several years. The precise course you require will depend on the level of computing, billing, and medical knowledge you already possess.
CA Medical Billing & Coding Specialist Requirements
While California lacks a specific educational requirement for medical billing and coding specialists, individuals still must meet the various standards of their school, state, and potential employers.
General requirements for enrolling in a medical billing and coding certificate program in CA include being at least 18 years old and possessing a high school diploma, GED, or equivalent.
Because medical billers and coders work with sensitive information, they must receive the required training and certification to handle this confidential data. The Health Insurance Portability and Accountability Act (HIPAA) ensures all healthcare professionals keep patient health information private.
Medical records specialists can acquire HIPAA certification through their training program.
After attending a certificate program, graduates can take an exam to earn their official medical billing and coding license.
While this is not an official state requirement, many employers prefer to hire individuals who complete the American Academy of Professional Coders exam and obtain their billing and/or coding certification.
Medical billers can take and pass the Certified Medical Reimbursement Specialist (CMRS) exam to earn their license, while the Certified Coding Associate (CCA) certification exam is specific to coders.
Other standard certifications include:
- Certified Inpatient Coder (CIC)
- Certified Professional Coder-Payer (CPC-P)
- Certified Outpatient Coder (COC)
The more qualifications and education you can get the better in terms of career opportunities and salary.
Recertification & Continuing Education
Certified medical billers and coders do not need to apply for annual recertification in California. However, they should stay up to date on changes regarding coding rules and regulations, medical legislation, and other aspects of the job. Some medical billing and coding trade schools and colleges offer continuing education credits for current professionals.
Registered Health Information Technician
Several California medical billing and coding schools offer Registered Health Information Technician (RHIT) courses as well. To obtain this highly desirable qualification, students must complete a two-year degree program and pass the AHIMA exam.
Having this certification can improve a medical billing and coding job seeker’s prospects and help them earn a higher starting salary than non-certified applicants.
This is the equivalent of a two-year degree culminating in an examination set by AHIMA. A number of California medical billing and coding schools offer this course and it is a highly desirable qualification.
Medical Billing and Coding Salaries in CA
California is the fourth top-paying state for medical billing and coding specialists. Compared to the national average of $46k, the mean annual salary of billers and coders in CA is over $57k, which equates to around $27.00 an hour.
Some of the top-paying industries for medical records specialists include insurance carriers, research and development, and mail-order services.
Medical Billing & Coding Specialist Salaries by City
California is home to the metropolitan area with the highest number of employed medical billers and coders in the nation. More than 6,400 medical records specialists in the Los Angeles-Long Beach-Anaheim area of California make an average salary of $57,310.
CA also has several of the highest-paying cities in the nation including:
- San Francisco – $66,980
- San Jose – $66,900
- Stockton – $65,990
- Sacramento – $62,730
What Do They Do?
Medical billing and coding specialists work together to collect information from patient files and medical records. Then, they input the data into specialized computer systems and software programs, calculate the cost of the patient’s treatments and procedures, and request proper payment from insurance companies.
Essentially, medical billers and coders determine whether a healthcare provider receives payment for their services.
Medical record specialists are also responsible for figuring out what procedures an insurance company will cover and which ones the patient must pay for themselves.
Speed and accuracy are crucial for those working in this role.
Medical billing is essentially a branch of billing. However, a medical billing specialist must have a deep understanding and knowledge of medical terms. You must also keep abreast of all changes to HIPAA and Medicare regulations as well as insurance compliance and medical laws.
Generating accurate and timely invoices is essential to the survival of any medical institution; hence a lot of importance is placed on the capabilities of a medical billing specialist.
With so much information, a medical coder needs to be methodical and painstakingly accurate but must also possess excellent knowledge of clinical terminology and a strong set of computer skills.
Billing vs Coding
Medical Billing in CA
People who work as medical billing specialists prepare claims for specific medical treatments, then submit them to insurance companies for payment. Speaking with patients about outstanding balances, assisting with creating payment plans, and collecting and processing payments are also part of a medical biller’s job duties.
Generating accurate and timely invoices is essential to the survival of any medical institution. Therefore, a medical billing specialist must have a deep understanding and knowledge of medical terms.
You must also keep abreast of all changes to federal HIPAA and Medicare regulations and comply with insurance company policies and medical laws.
Medical Coding in CA
Medical coding specialists evaluate and update patient medical records, translate them into a standardized code, and manage that data for billing purposes. They also assign a code to every service the doctor or healthcare provider performs to optimize how medical billers send invoices to insurance companies for payment.
Since they handle so much information, medical coders must be methodical and painstakingly accurate. Incorrect coding could lead to billing issues that result in a lack of payment for their medical institution.
Medical coders must also possess excellent knowledge of clinical terminology and a strong set of computer skills.
A career in medical billing and coding offers considerable room for advancement. The importance of technology to the medical world is becoming more and more evident. Further government legislation is likely to follow in the coming years requiring medical establishments and organizations to keep accountable records.
Currently, it is only necessary to do so when an organization has been audited. However, most organizations are already gearing up for the changes.
According to the Bureau of Labor Statistics, the nationwide employment outlook for medical records specialists is 7%, which is about as fast as the average occupation. As a result, experts predict that roughly 14,900 medical biller and coder job openings per year may be available by the year 2031.
California has the second highest level of employment for this profession, with over 18,000 medical record specialists employed as of 2021. Most medical billers and coders work in general medical hospitals, surgical hospitals, and doctor’s offices. Due to the general aging of the population, especially the baby boomer generation, this career is expected to grow in demand.