Medical Billing & Coding

Schools with Medical Billing & Coding Training Programs

The medical payment process is complex and demanding. Because of this, those working medical billing and coding jobs play a crucial role in the field of healthcare.

Doctors and hospitals rely on these people in order to receive compensation for their work.

Education & Training

Requirements for Medical Billing and Coding Jobs

Criteria for getting medical billing and coding jobs may vary. Most employers require candidates to have a medical coding certification or degree in addition to their high school diplomas.

While many aspiring billers and coders earn the necessary credentials through an associate’s degree, there are medical coding schools and programs that can prepare you for an entry-level position in this field.

To be successful in this field, you’ll need a solid understanding of medical terminology, health record maintenance, medical coding software, and the inner workings of the health insurance industry.

Employers often prefer billers with a degree in business administration or accounting.

Previous experience working in a clinical office may be a plus as well.

What Courses Will You Take?

Curriculum for Medical Billing & Coding specialists varies widely from school to school, but most programs will include courses like:

anatomy and physiology
medical terminology
coding systems
insurance policies
data entry skills
report writing
billing methods
health care law

Some institutions have part-time course schedules and evening classes for busy students looking to complete an associate’s degree program. Meanwhile, other medical billing and coding schools offer bachelor’s degree programs.

Additionally, having an internship while attending one of these programs can help you gain real-life experience in the career and potentially land a job sooner.

How Long Does Medical Billing & Coding School Take?

A medical billing and coding certification program usually takes about six months to complete. Associate degree programs can take two years to finish if you’re a full-time student but may take longer if you only attend classes part-time.

Full-time students can earn a medical billing and coding bachelor’s degree in four years.

How Much Does Medical Billing & Coding School Cost?

Medical billing and coding school costs depend on whether you choose a part-time, evening, associate’s or bachelor’s program. On average, you can expect to spend around $1000-5000 in tuition fees for your training program.

Certification exams come at an additional cost, which also varies by organization.

Certification Exams

To become certified as a medical biller or coder, you’ll need to pass two exams:

one for billing
one for coding

Non-certified billers may be able to find jobs in the industry. However, getting the proper certification can make you a more attractive candidate to potential employers and may even help you earn a higher salary.

Multiple national organizations administer medical billing and coding exams and provide certifications to those who pass.

The American Health Information Management Association (AHIMA) is a popular choice for those interested in becoming certified as a medical coder. In order to take the exam, you’ll need to show proof of attending a coding certificate trade program.

Some medical billing and coding programs recommend you earn an associate medical billing and coding degree or another degree related to the field before taking the certification exam.

However, those with a high school diploma or GED can get certified if they’ve completed the proper medical billing and coding school courses.

Some of the certifications in this career path include:

If you have an idea of where you’d like to obtain a medical billing and coding job, contact the company and ask about the credentials they require their employees to have.

Once you complete your exam and earn the necessary certification, you can apply for the job you want. However, you’ll need to remember to recertify according to the issuing organization’s rules for renewal.

Bottom Line

Factors like technological changes in medicine and advancements in diagnostic testing contribute to the high demand for medical billing and coding jobs.

If you’re looking for a position that lets you earn competitive wages while juggling family obligations and other outside responsibilities, a rewarding medical billing and coding career could be perfect for you.

Career Overview

What Do They Do?

People in medical coding jobs decipher patient information into shorthand for physicians and insurers.

Reviewing doctor’s notes, interacting with medical assistants, and checking charts and health histories helps coding specialists learn the details of clients’ medical screenings. Then, these workers use a tailored code to create a report of each diagnosis, service, and treatment the patient received.

Medical coders work closely with nurses, physicians, and receptionists to monitor each patient’s data and track changes in their health. They may also need to apply procedure codes to operative reports that doctors and techs use during surgeries.

To maintain their merit, these workers must keep up with the industry’s latest coding updates and standards.

Coders use electronic medical record software to enter the data they collect, then pass it on to workers in medical billing jobs who send it to insurance companies and other payers.

If the insurance provider denies the claim, medical coders conduct chart audits to confirm the patient’s medical history.

To ensure accuracy, these workers stick to one of three standards:

ICD is the International Statistical Classifications of Disease, which helps coders accurately categorize diseases, diagnoses, and treatments. Physicians use it across the nation, and the World Health Organization provides updates as needed.
Current Procedural Technology, or CPT, is the language of the American Medical Association. Similar to ICD, this annually-revised system conveys surgical and diagnostic data to insurance providers and physicians.
Medicare and Medicaid typically use HCPCS, which is the Healthcare Common Procedure Coding System. It’s modeled after CPT and provides reliability when submitting claims to government-sponsored healthcare programs.

Job Duties

Billers must complete insurance claim applications while following strict guidelines and procedures. They ensure compliance of payments and contact insurance companies to resolve errors. They produce accounts receivable reports and contact patients or payers for claims. Another duty involves looking through the explanation of benefits forms to confirm payment from insurers.

Before sending out claims, people working medical billing jobs double check the work of coders to ensure precision. Billers check the accuracy of patient invoices and complete missing or incorrect fields. They seek payment of unpaid claims in a timely fashion and ensure compliance of insurance payments. Sometimes they may need to arrange payment plans for patients and analyze or petition denied claims.

Not only do they input rate changes into specialized software, but billers also compile collection reports and update spreadsheets. They keep track of customer payments and invoicing data. At times, they need to answer patient or insurer questions over the phone. When denied claims come around, billers must find out what happened and decide how to resubmit.

Ultimately, medical billers are responsible for doctors and patients receiving payment from insurers. To verify reimbursement of claims, workers follow up with insurance companies, healthcare practitioners, and individuals. This requires superb organization and time management skills.

What Are Useful Skills for People in This Field?

Comprehension of medical terminology
Excellent communication, speaking, and customer service skills
An understanding of payer requirements and insurance guidelines including Medicare, Medicaid, and HMO/PPO
Knowledge of ICD, CPT, and HCPCS coding
Experience with bookkeeping and accounting

Understanding of computers and calculators
Problem solving and critical thinking abilities
Positive demeanor and composed attitude
Ability to multitask and handle stressful situations
Ability to communicate with a diverse range of people
Capable of delegating tasks and engaging in conflict resolution

Are There Requirements for Medical Billing and Coding Jobs?

Job criteria may vary. Besides a high school diploma, a medical coding certification or degree is usually required. Associate degrees are often preferred, but vocational courses can also prepare workers for entry-level positions. Many medical coding schools offer the necessary credentials.

Success in this field depends on a solid understanding of medical terminology. Previous employment in a clinical office is preferred. For billers, a degree in business administration or accounting is a plus.

Recruits should have an understanding of medical coding software and the inner workings of health insurance. They should be organized individuals with knowledge in health record maintenance. This is why quality medical coding training is so important for job hopefuls.

What Is the Outlook for
Medical Billing and Coding Jobs?

Factors like technological changes in medicine and advancements in diagnostic testing contribute to the high demand for medical billing and coding jobs. If you’re looking for a position that lets you earn competitive wages while juggling family obligations and other outside responsibilities, a rewarding medical billing and coding career could be perfect for you.

The average salary for a person who works in medical billing and coding is $46k. However, those just entering the field may earn less at about $29k a year. T

he top 10% of earners in this field make close to $74k. With proficiency, experience, and enhanced education, hopefuls stand a chance of earning more.

Job benefits often include the following:

Bonuses and special incentives
Profit sharing programs
Paid time off and holiday pay
Dental, vision, and healthcare coverage with low deductibles
401(k) retirement plan with company match

Those working for technical services and state, local, or private hospitals often make more than medical records specialist employees at small private practices. Medical billing and coding specialists often fall into the same category as health technicians, who make a little more on average

What Should Workers Expect?

Coders must be sharp thinkers with good memories. A big part of their job involves reading patient reports to gather detailed health history info. Sometimes they have to translate medical coding for others to understand.

Those who choose this profession interact with medical professionals daily.

Typical duties involve reviewing benefits, confirming patient eligibility, and obtaining treatment referrals.

With so much money on the line, workers must be precise while interpreting patient records.

Can You Work Remotely?

Some medical billing and coding jobs allow employees to work from home.

A health care facility sends coders the necessary info electronically so they can do their interpreting and data entry remotely.

Remote employees must follow the same health privacy laws they would adhere to in an office.

It is important to maintain the safety of medical records and other patient information.

Do Billers and Coders Have Any Other Options?

Medical billing and coding specialists also sometimes fall under the title of medical records technician.

Knowledge in medical billing and coding may also lead to a career as a cancer registrar. In this role, workers apply specific codes to convey tumor diagnoses and treatment methods. They ensure the correctness of patient records by reviewing pathology reports.

Like standard coders, registrars keep track of cancer treatment through yearly checks. They gather client information for analytical and research purposes.

Other similar healthcare careers include pharmacy technician and surgical technician.

There are several other options for people with this skill set. Billers and coders can move into more focused roles such as reimbursement specialists, patient account representatives, and claims assistants.

Question and Answer: Medical Billing & Coding

Q&A session with a medical coding clerk, Melissa Wright, who works in Houston, Texas.

Q: Can you tell us who you are currently employed with?

A: I work for Dr. Ashmir at his offices in Houston, Texas and I am a medical coding clerk.

Q: What is the most requested service you provide?

A: Well, Dr. Ashmir has a busy family practice health clinic and I make sure the different services he provides are then paid for by insurance and government agencies.

Q: How long have you been a medical coding clerk?

A: I have been doing the coding at the office for three years. I started in the reception area 7 years ago after graduating high school.

Q: Can you tell us a little about your training and school experience?

A: I had been working for Dr. Ashmir for a few years already, working with the patients prior to and after seeing the Doctor and I wanted a way to make more money but at the same office. So, I spoke about it with Dr. Ashmir and he suggested that I look at learning how to do medical coding and he would be sure to give me a position if I completed some school first. I enrolled in the AHCP Academy of Health Care Professionals here in Houston and completed my courses there before I began to work in the coding office.

Q: What’s your favorite part about having you position, and in contrast, what is the worst part?

A: The best thing about my position is that I am now able to earn more than I did before at reception. I’m making more per year now and I have an opportunity to do work for other doctors’ offices here in the medical building.

Q: Tell us about an average day.

A: When I come to the office at 8AM there are a number of patient files that I have to go through. I do my normal organization so that once I’m done I can put the information back where it came from in the office. Once I begin to go through the appointment procedures and notes from the doctor. The diagnostic coding that is done for us to request payments gets completed from the files that we keep here. The process is pretty regular at our office because of the amount of patients we see. Beside our lunch, we are collecting information and preparing it for processing by the companies who are responsible for payment. There will be a number of calls to our department from those who are interested in the information in the files. We report on the files when requested and if the request is warranted. I usually leave the office about 5:15 PM, having closed the work I was in the process of doing around 4:30.

Q: If you ever take the next step in business, what would that be?

A: The reason why I went to school was because I wanted to make more money. I like the people I work with and the people I work for. If I would want to add anything to that, I can always take on more work at home.

Q: Did your previous work history have anything to do with your current business position?

A: I love working in the doctor’s office where I am now. It was the reason I began doing what I do now. So, I would say that my job experience kept me wanting to be in a position where I could make more money and have extra responsibility than I had in the beginning.

Q: In your field of work, what kind of benefits do you receive?

A: We get a great insurance program plus sick and vacation time that accrues throughout the year. I had a total of three weeks of vacation this year and I did not even use all the time I had available. The coding that I do for other doctor’s hear do not give me anything in benefits except a chance to earn more money.

Q: Tell me about the money you make.

A: This year I will earn $34,000 from Dr. Ashmir. Last year I added $9,000 from the extra work that I did for other offices.

Q: What makes someone good at this profession?

A: Attention to detail, the ability to determine well the files that they are handling, and an ability to communicate about the files and the billing as they have been trained.

Q: Would you recommend this career path to others who are looking for the same things you were when you started?

A: Oh yes. I am happy that I spent the time to get some extra education to build a better career. I hope that anyone who does this can be as happy as I am where I work.