Why Medical Billing & Coding?
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.
If you aspire to make a meaningful impact behind the scenes of patient care, where your attention to detail and organizational skills contribute to the smooth functioning of healthcare operations, a medical billing and coding career might be for you
Education & Training
Traditional Trade Schools
- Pima Medical Institute
- ACI Medical & Dental School
- Northwest Career College
- Aiken Technical College
- Herzing University
- Pinellas Technical College
- Trident University International
- Santa Barbara Business College (SBBC)
- National Career College
- National American University
- Dawn Career Institute
- Central Coast College
- Blackstone Career Institute
- Berkeley College
- Joyce University of Nursing and Health Sciences
- U.S. Career Institute
- Interactive College of Technology
- Houston Community College
- Charter College
- Ashworth College
- Rasmussen College
- Centura College
- American Career College
- American National University
- American Institute Trade School
- Brookline College
- Bryan University
- Carrington College
- City College
- The College of Health Care Professions
- All-State Career School
- Altierus Career College
- Coyne College
- Delta Technical College
- Dorsey College
- Eastwick College
- Florida Career College
- Brightwood Career Institute
- FORTIS College
- Grantham University
- Keiser University
- Miller-Motte College
- Southern California Health Institute
- South Texas Vocational Technical Institute
- Southern Careers Institute
- Southern Technical College
- Penn Foster College
- HoHoKus School of Trade & Technical Sciences
- YTI Career Institute
- Porter and Chester Institute
- Hunter Business School
- Institute of Technology
- IntelliTec Colleges
- Lansdale School of Business
- Laurus College
- Lincoln Tech
- McCann School of Business & Technology
- Midwest Technical Institute
- Pioneer Pacific College
- Remington College
- Ross Medical Education Center
- Southeastern College
- Sullivan University
- UEI College
- Vista College
Diagnosis and treatment data needs to be accurate when sent to insurance providers. In order for this to happen, health information technicians take on a number of responsibilities. Billing and coding duties are often split up between separate workers to make the process more efficient.
How Long Do Medical Billing & Coding Programs Take to Complete?
Certificate programs, specifically focusing on the skills and knowledge required for accurate medical coding and billing, may take several weeks to 1 year to complete. These programs emphasize the practical aspects of translating medical services and diagnoses into standardized codes.
On the other hand, associate’s degree programs in health information management or medical coding may require approximately 2 years to complete. These programs often provide a broader curriculum, encompassing subjects beyond medical coding, such as health information systems, legal aspects of healthcare, and medical terminology.
Factors influencing the duration of your education include its structure (full-time or part-time), the individual pace of the student, and any additional clinical or internship requirements.
How Much Do Medical Billing & Coding Programs Cost?
Short-term certificate programs tailored to medical billing and coding may range from $500 to $3,000.
For more extensive programs, like associate’s degree programs in health information management or medical coding, the costs could span from $2,000 to $8,000 per semester. It’s important to note that these expenses typically cover tuition, fees, and sometimes required textbooks or materials. Financial aid, scholarships, or grants may be accessible to help offset these costs.
Individuals considering medical billing and coding training programs should diligently research the costs associated with specific schools or institutions, inquire about potential additional expenses, and explore available financial assistance options. Additionally, some employers may reimburse or assist employees pursuing further education in relevant fields.
What Courses Will You Take?
A course in medical billing and coding will, at minimum, address:
- Medical Terminology: The structures and functions of the human body, disorders, medical procedures standard to each anatomical system, and critical terminology specific to medical billing and coding.
- Medical Coding Fundamentals: The main coding manuals used in practice today (ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II) and how to code diagnoses, services, and procedures.
- Legal, Ethical, and Regulatory Concepts: Key concepts central to the field, including HIPAA compliance and third-party guidelines for filing insurance claims.
Curriculum for Medical Billing & Coding specialists varies widely from school to school, but most programs will also include courses like:
- insurance policies
- data entry skills
- report writing
- billing methods
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.
Benefits of Taking a Course
Enrolling in an online medical billing and coding course can offer many advantages to enhance your career prospects in the healthcare field.
Through a distance learning program, you will gain valuable hands-on experience, acquiring practical skills that are directly applicable to the job demands.
You will be awarded a certificate upon successful completion, signifying your proficiency in medical billing and coding and positioning you for professional certification.
Online courses prepare you for certification exams and often even provide vouchers for the exam of your choice, allowing you to select the certification that aligns best with your specific interests and career goals.
Additionally, pursuing a remote educational pathway grants full-time access to a wealth of study materials tailored to your chosen certification exam option, whether you opt for the Certified Professional Coder (CPC) exam from the American Academy of Professional Coders (AAPC), the Certified Coding Associate (CCA) exam from the American Health Information Management Association (AHIMA), or the Certified Billing and Coding Specialist (CBCS) exam from the National Healthcareer Association (NHA).
According to the Bureau of Labor Statistics, medical records specialists responsible for billing and coding earn an average salary of $22.69 per hour or $47,180 per year.
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
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
The profession is expected to grow by 8% over the next decade–tremendously faster than the average of 2% for most other professions–making a career in medical billing and coding a promising choice for those looking to expedite their success in an impactful role.
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.
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:
- Certified Billing and Coding Specialist from the NHA
- Certified Coding Associate from AHIMA
- Certified Coding Specialist from AHIMA
- Specialty Coding Professional from the BMSC
- Certified Professional Biller from the AAPC
- Certified Outpatient and/or Inpatient Coder from the AAPC
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.
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 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.
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
What is the Work Environment Like?
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.
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.
Q&A with a Medical Biller & Coder
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.