How to Become a Medical Billing & Coding Specialist in Pennsylvania
Pursuing medical billing and coding jobs in PA is a popular choice for Pennsylvania residents who want to work in the healthcare field but lack interest in hands-on patient care.
Once you enroll in a program and complete the necessary training, you can start applying for billing and coding positions in hospitals, nursing homes, research labs, and other medical facilities in the state.
Education and Training
To work in medical billing and coding in Pennsylvania, you’ll need to complete an accredited degree or certificate program.
How Long Does it Take?
Most trade school courses take about one year to complete, though some choose to go to college and earn a two-year associate’s degree in Applied Science in Medical Billing and Coding.
What Courses Do You Take?
During your education program, you typically take classes on:
- Medical Terminology
- Fundamentals of Human Anatomy and Physiology
- Health Services and Information Systems
- International Classification of Disease Coding
- Health Insurance and Reimbursement
Medical billing courses also include lessons on using coding software and proper data input practices. In addition to the standard classroom instruction, students usually earn practicum hours by shadowing medical record specialists in hospitals, nursing facilities, and doctor’s offices.
During this portion of their programs, students gain hands-on industry experience that can help them in their future careers.
PA State Board Requirements for Medical Billing and Coding
Those who study medical billing and coding in Pennsylvania can start working in this industry as soon as they graduate from their program.
While the state doesn’t require these professionals to have an official license or Certified Billing and Coding Specialist (CBCS) credential, passing the licensing exam could give you an advantage over other candidates when applying for medical billing and coding jobs in PA.
Most medical billing and coding trade school graduates take certification exams to obtain their official license from one of the following organizations:
- The National Healthcareer Association (NHA)
- The American Association of Professional Coders (AAPC)
- The American Health Information Management Association (AHIMA)
Each of these institutions offers certifications for those looking to be medical billers or coders, as well as dual certifications for people who want both credentials.
Depending on which organization you choose, you might even be able to obtain a specialized coding certificate for specific areas of the medical field, such as cardiology, pediatrics, orthopedic surgery, dermatology, or even family medicine.
As a general rule, most medical billing and coding certification boards require applicants to complete an accredited college or trade school course before they can take the licensing exam.
Some institutions might allow high school diploma or GED holders to take the test as long as they also have at least a year of supervised medical billing and coding work experience.
Medical Billing and Coding Licensing Exam
Some medical billing and coding certification exams give test-takers an hour to answer 90 questions, while others give you over five hours to respond to 200 prompts.
However long the test takes, most exams feature questions that gauge your knowledge and expertise in:
- Coding modifiers
- Edits and reimbursement classifications
- Regulatory compliance
- Health record integrity
- HIPPA guidelines
- Healthcare and medical ethics
Medical Billing and Coding Salaries in PA
Medical billers and coders in Pennsylvania typically earn an average of about $24.00 per hour, which is roughly $48,000 a year.
However, the medical billing and coding salary in PA varies across different employers and regions.
Average salaries for medical billers and coders in some of the most populated areas of Pennsylvania are as follows:
- Pittsburgh $45,820
- Philadelphia $55,770
- Reading $50,660
- Bloomsburg $45,200
- Erie $41,980
If you continue your trade school education by completing a two-year medical billing and coding degree, you might be able to find a medical research facility job that pays $60k or higher.
As you gain more experience in the field and earn more specialized certifications, you could start an independent billing and coding business or even become a coding manager or director and earn upwards of $100k per year.
Medical billing and coding jobs require a combination of healthcare knowledge, communication abilities, and basic accounting skills. While many vocational schools and community colleges combine both billing and coding disciplines into a single program, some people choose to pursue one role or the other.
What Are the Responsibilities?
Both medical billers and coders, also known as medical records specialists, are essentially responsible for ensuring that the medical facility they work for receives payment for their services.
What Are Their Job Duties?
Coders use their understanding of medical terminology and the inner workings of the medical insurance industry to:
- Analyze patient medical charts
- Note each examination, diagnosis, and treatment medical personnel performed on their patients
- Use digital coding software to input this information and assign an appropriate code to each service and procedure the patient received
After the coder completes these tasks, the medical biller calculates the total cost of the patient’s care and submits a claim to the insurance company.
Billers also follow up on unpaid claims to ensure that the facility receives the proper reimbursement.
Once the insurance company has paid its share, the biller draws up a medical bill for the patient and works with them to create payment plans if necessary.
While you can study one of these disciplines and get either a medical billing or coding job in PA, having an understanding of both roles can make it easier to find work in the industry. You might even be able to make a better impression on potential employers and request higher wages than people with only one of these abilities.
Experts at the Bureau of Labor Statistics predict a seven-percent increase in medical billing and coding positions between 2021 and 2031, which equates to about 15,000 job openings per year over the next decade. According to reports, medical billing and coding employment opportunities will continue to become available as more coders and billers switch career paths or retire from the industry.