The key requirement to become a successful medical coder and biller is to acquire medical coding and billing certification.
The medical coding and billing industry is a growing industry.
In fact, according to the United States Bureau of Labor Statistics, the medical records and health information technicians industry — where medical coding and billing belongs — is projected to increase by 8% (much faster than average) within 2019 to 2029.
Still from BLS, as of 2019, the number of employed individuals under the said industry or job category is 341,600. Again, as mentioned, this number is expected to grow even more in the coming years especially since the health industry is already transitioning to become more digitized.
Medical coding and billing, though it may sound challenging at first is actually a very rewarding job. Not only on the work itself but even financially, which is why it not surprising that more and more individuals are becoming interested in this line of job.
Needless to say, a lot of employers hiring medical coders and billers these days offer work from home setup, which is ideal for most people especially with the current situation when health and safety are at risk.
So, if you intend to join the medical coding and billing industry, it is imperative that you familiarize yourself with the whole process in order to succeed in finding a job.
As mentioned earlier, gaining a medical coding and billing certification is key to your success in this industry. That is why today, we are going to particularly focus on providing you essential information on how to become a certified medical coder and biller.
For your reference, though, here’s what we are going to tackle in the next sections:
- What is medical coding and billing?
- What are the requirements to become a medical coder and biller?
- How to become a certified medical coder and biller?
- How much does a medical coder and biller make?
- Where to find medical coding and billing jobs?
WHAT IS MEDICAL CODING AND BILLING?
Think about this — when you first meet someone, getting to know the person plays an important role in whether the supposed relationship will flourish or not, right?
The same goes when it comes to jumping into a job — especially when it is something that is totally strange to you. Getting to know about the job and the industry as a whole is key to gauge whether it is the right place for you to be or not.
So, with that said, let’s talk about what medical coding and billing is all about —
According to the Medical Billing and Coding Certification website, “Coding and billing are the invisible engines of the healthcare system. Without either field, the healthcare industry would be unable to efficiently transmit important data, and healthcare providers would have an incredibly hard time getting paid for their services.“
Furthermore, it states, “In a nutshell, it is the medical coder’s job to translate the healthcare provider’s report of a patient’s visit into numeric or alphanumeric code, which in turn is used by the medical biller to make a bill, or ‘claim,’ for the insurance company and determine the appropriate charge for the patient.”
Based on the above explanation, it is clear that medical billing and coding are two different processes in the healthcare system.
However, while an individual can work either as a medical coder or a medical biller only, he or she works as both as well. But, to be able to do so, the industry requires you to have proper training (and have the right certification).
Meanwhile, medical coding and billing jobs, although they’re usually prevalent in hospitals and clinics, you will also find on physician’s offices, insurance companies, as well as other healthcare institutions or offices.
WHAT ARE THE REQUIREMENTS TO BECOME A MEDICAL CODER AND BILLER?
Similar to any other jobs out there — regardless of industry — if you want to land a job and be successful in the medical coding and billing industry, you have to take into consideration the requirements set for the job.
Although employers have their respective set of qualifications or the things they’re looking for in an applicant, the list below are some of the most common requirements:
Certificate or Associate Degree Holder
Typically, for entry-level positions, employers prefer individuals who have acquired either a certificate or an associate degree program in medical billing and coding.
Medical Coding and Billing Certification
As mentioned earlier, getting certified is key if you want to pursue a medical coding and billing career because ultimately, employers prefer hiring certified medical coders and billers.
Another common requirement among employers who are hiring medical coders and billers is work experience. Although some prefer medical coding and billing work experience, other companies consider at least something that is related to it.
In addition to the above-mentioned requirements, employers also look into certain skills such as the following:
- Excellent Communication Skills
- Strong Organizational Skills
- Ability to Handle and Keep Confidential Information
- Computer Skills
Before moving on, to help you assess if medical coding and billing is the right industry for you to be in, check the video below by CareerStep. The video shows how being a medical coder and biller is like.
HOW TO BECOME A CERTIFIED MEDICAL CODER AND BILLER?
Earlier, we mentioned that having a medical coding and billing certification is important in this line of work especially since you will be dealing with medical terminologies, codes, etc. Needless to say, being certified greatly affects your employment status as well as your salary.
But how does one become a certified medical coder and biller?
Well, in this section we are going to provide you with some of the most important details when it comes to the acquisition of a medical coding and billing certification.
MEDICAL CODING AND BILLING ADVANCEMENT OPTIONS
There are several options available for you to be able to eventually get a certification. The choices include:
- Certificate or Diploma Program
- Associate Degree Program
- Bachelor’s Degree Program
- Training Courses
Certificate or Diploma Program
The first direction you can take if you really want to land a medical coding and billing job is through a certificate or a diploma program.
These programs are usually offered in the postsecondary education years.
Take note, though, that these programs are totally different from each other.
Certificate programs typically require less time to complete. As compared to diploma programs, certificate programs have slightly more restrictive curricula.
Additionally, certificate programs are beneficial for career-focused individuals who want to get into the workplace as quickly as possible.
Meanwhile, if you opt for a better-rounded curriculum, and do not mind finishing the program for a longer period, a diploma program is more appropriate for you.
Both certificate and diploma programs also differ in terms of cost. Obviously, based on the length of time and the curriculum, diploma programs are more costly as compared to certificate programs.
Associate Degree Program
The second path you may take to become a certified medical coder and biller is by taking an associate degree program.
In comparison to certificate or diploma programs, taking an associate degree is definitely more expensive. Needless to say, it also takes more time to finish.
However, pursuing an associate degree program may bring about more career options for you. Also, it makes you become more competitive as more employers prefer job candidates with an associate degree in medical billing and coving over those who completed a certificate or diploma program.
Additionally, there are professional certifications that require an associate degree. Some of these certifications include the Registered Health Information Technician exam as well as the certified professional biller certification.
As mentioned, earlier, associate degree programs usually take a while to complete. Normally, it takes one to two years and costs roughly between $6,000 and $13,000 depending on the institution where you’ll get your associate degree.
Bachelor’s Degree Program
The third option you have to be able to get a medical coding and billing certification is by pursuing a bachelor’s degree program.
Typically, individuals who wish to pursue a career in medical coding and billing take their bachelor’s degrees in health information management or healthcare administration.
As compared to the previous options, taking up a bachelor’s degree program means studying for four years. However, it also means earning a comprehensive education and training that will certainly add up to your value.
As a bachelor’s degree holder, you become qualified for more lucrative levels of employment like managerial positions.
Of course, pursuing a degree program also means spending more. Typically, a four-year course costs around $36,000 to $120,000 depending on your preferred school.
Last, but certainly not the least option is taking training courses.
There are certain credentialing organizations like the American Academy of Professional Coders™ (AAPC) that offer preparation courses for various medical coding and billing exams.
AAPC, in particular, offers training courses to individuals who aim to become certified professional coder (CPC), certified inpatient coder (CIC), or certified outpatient coder (COC).
What’s nice about taking training courses like those provided by AAPC is that you can take it entirely online. Furthermore, you have the option to complete the course either in four months or less.
These training courses, however, are ideal for individuals who have strong knowledge of the topics that will be discussed like medical terminology as well as anatomy.
Certainly, taking up training courses are less expensive. Needless to say, it’s quicker to finish. But then again, you have to have the knowledge on the topics already. Otherwise, it would not work for you.
ACCREDITED MEDICAL CODING AND BILLING ONLINE PROGRAMS
Thanks to technological advancements and the internet, studying medical coding and billing online was made possible.
There are many medical coding and billing online programs out there.
However, when choosing a medical coding and billing online program, make sure that it is accredited by various accrediting bodies. Otherwise, your effort, time, and money will be put to waste.
Accredited programs ensure a high-quality education as well as greater employability after graduation.
For your reference, below is a list of the primary accrediting bodies for medical billing and coding programs:
- American Health Information Management Association
- Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM)
- American Academy of Professional Coders (AAPC)
MEDICAL BILLING AND CODING CERTIFICATION
The credential you need in the medical coding and billing field will depend on the type of work you want to pursue.
For example, a certified professional coder is ideal if you want to perform medical coding, while certified professional billers handle billing operations like submitting and following insurance claims through.
To help you understand better the difference between each credential, here’s a quick explanation of each medical billing and coding certification:
Certified Professional Coder (CPC)
Of all the medical billing and coding certification choices available, CPC certification is the most recognized, and the most common of all.
A Certified Professional Coder knows and understands thoroughly all code sets. Also, a CPC has the ability to assign the right codes for healthcare services provided by doctors and other healthcare professionals.
Furthermore, a CPC fully understands everything about healthcare administration, as well as ethics and regulatory practices that are involved in both medical insurance claims and reimbursement.
Certified Outpatient Coder (COC)
Being a Certified Outpatient Coder means you fully understand anatomy, medical terminology, as well as coding guidelines.
Furthermore, a COC must demonstrate comprehension of payment methodologies, as well as regulatory compliance, and the use of several different code sets for outpatient settings.
Additionally, COCs are also considered proficient in evaluation and management, surgical services, medicine, anesthesia, radiology, and pathology.
Certified Professional Biller (CPB)
As a Certified Professional Biller, you are expected to master and understand all areas of the revenue cycle.
CPBs act as a liaison between physicians and insurance providers. Thus, your tasks involve submitting medical claims to insurance companies, as well as processing payments and necessary reimbursements. CPBs also handles resolving claim denials, as well as issuing appeals.
All CPBs are expected to comply with governmental regulations as well as private payer policies.
Certified Professional Medical Auditor (CPMA)
As a Certified Professional Medical Auditor, your job involves ensuring that professionals fully understand medical record standards and documentation guidelines, category risk analysis and communication, coding and reimbursement concepts, scope and statistical sampling methodologies, medical record auditing abstraction, as well as coding and documentation compliance guidelines.
With such extreme knowledge, CPMAs get to work in different healthcare settings, ensuring both compliance and profitability of doctor practices.
Certified Physician Practice Manager (CPPM)
The CPPPM certification is ideal if you have experience in other areas of healthcare and if you are interested in physician practice management.
As a Certified Physician Practice Manager, you have to fully understand all facets of medical office administration.
As a CPPM, you must be proficient in human resources, general business processes, health information, as well as compliance regulation, and revenue cycle.
Certified Professional Compliance Officer (CPCO)
Being a Certified Professional Compliance Officer, you must be capable of designing, implementing, as well as maintaining a healthcare compliance program, particularly for a physician’s practice.
The whole process involves various steps, which include staff training and education, audits, risk assessments, and of course, compliance review.
HOW MUCH DOES A MEDICAL CODER AND BILLER MAKE?
Now that we have already tackled the most important details you need to know about earning a medical coding and billing certification, this time around, let’s talk about how much a medical coder and biller makes.
As mentioned, medical coding and billing are two different processes. While you can be both a medical coder and biller (which is not always the case as it requires a more extensive credential), the more common is you are either a medical coder or a medical biller.
Now, with regards to how much you make as a medical coder or biller, it varies depending on your credential, which is why getting certified is a must.
Being a certified medical coder and biller means being more valuable, which leads to your ability to request a higher salary rate.
Apart from that, your location is also taken into consideration. How much a medical coder and biller makes also depends on where you are at.
According to Salary.com, the average salary of a medical coder in the United States as of November 2020, is $171,813.
Meanwhile, according to Glassdoor, medical billers in the country make an average base pay of $33,716 per year. It could range from $24,000 up to as much as $49,000 depending on the factors we mentioned earlier.
WHERE TO FIND MEDICAL CODING AND BILLING JOBS?
Once you have earned your medical coding and billing certification, it’s time to look for a job.
There are a lot of places or companies that offer medical billing and coding jobs.
Some of the companies that usually hires medical coding and billing professionals include:
- Change Healthcare
- Conifer Health Solutions
- GeBBS Healthcare Solutions
- Himagine Solutions
- Maxim Healthcare Services
- The Coding Network
- United Health Group
In addition, you can also find medical coding and billing job opportunities on major online job listing sites like:
FINAL THOUGHTS ON MEDICAL CODING AND BILLING CERTIFICATION
The medical coding and billing industry is a growing industry, and in the projections are right, it is going to grow even more in the years to come.
If you are someone who wants to work in the medical field but not as a medical practitioner, becoming a medical coder and biller might just be the perfect job for you.
Why do we say it night be the perfect job for you?
Well, as we’ve said, working as a medical coder and biller is both fulfilling, and financially rewards especially if your credentials are good.