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Medical Coding and Billing Career Guide

How to Become a Medical Billing and Coding Specialist

Medical Coding and Billing is a fulfilling career. Learn more about the responsibilities, education requirements and salaries for professionals in these roles.

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What Is a Medical Biller or Coder?

Medical billing and coding is a system that organizes and updates information in patient records and bills. This system documents medical issues and conditions as well as treatment options. Working in this field requires a driven individual with the skill set to handle many medical records and the attention to detail to accurately organize vital patient information for treatment. These professionals are also in charge of medical insurance claims and the overall billing process. This role supports healthcare providers while directly impacting patient care and privacy.

What Does a Medical Biller and Coder Do?

A medical biller and coder is responsible for reading and transcribing patient charts, turning that into the correct codes, and submitting the billing as an insurance claim. The job requires analyzing a patient's medical information following any visit with a healthcare professional and choosing the best route for billing the insurance company or the patient. They are also responsible for sifting through medical codes that are used to notify the insurance companies of the specific procedures performed and how much they need to be compensated for them. It is crucial that medical billers and coders are precise in their work to ensure that patients receive appropriate care and bill the correct party. Any errors made can result in over- or underbilling and not getting the medical professional properly reimbursed.

What Education Do You Need to Become a Medical Biller and Coder?

You’ll need to take a certification exam after completing a specialized course in medical billing and coding. Fortunately, there are several different certifications that you can choose to pursue. One of the most common routes of certification is through a professional organization, such as the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA). Along with the proper certification, the educational requirement for medical billers and coders is a high school diploma. Some employers require an associate degree. Additionally, any degree in healthcare or previous years of healthcare work experience are beneficial in developing a solid foundation of the skills and credentials needed to lead in this industry.

Certifications are facilitated by professional organizations and include:

  • Certified Coding Specialist (CCS) 
  • Certified Medical Coder (CMC) from the Practice Management Institute (PMI)
  • Certified Professional Biller (CPB) 
  • Certified Coding Associate (CCA) from the American Health Information Management Association (AHIMA)
  • Certified Billing and Coding Specialist (CBCS) from the National Healthcareer Association 
  • Certified Outpatient Coding (COC)
  • Certified Professional Coder (CPC) 

Best Degrees for a Medical Billing and Coding Specialist

Health Information Management – B.S.

A program designed for future leaders in HIM:...

A program designed for future leaders in HIM:...

A program designed for future leaders in HIM:

  • Time: 60% of grads earned this degree in 36 months or less.
  • Tuition and fees: $3,795 per 6-month term, plus a Health Professions Student Fee of $350.

Some careers and jobs this degree will prepare you for:

  • Director of informatics
  • HIMS chief
  • Information systems auditor
  • Outpatient coder
  • Health records manager

This CAHIIM-accredited program makes you eligible for the RHIA exam. 

Compare with B.S. Business – Healthcare Management

Nursing – Nursing Informatics (BSN-to-MSN) – M.S.

A nursing degree program that empowers data-driven nurses who...

A nursing degree program that empowers...

A nursing degree program that empowers data-driven nurses who already have a BSN but seek the success only a master's can bring:

  • Time:  72% of grads finish within 18 months.
  • Tuition and fees: $4,385 per 6-month term, plus a Health Professions Student Fee of $350.

Some careers and jobs this degree will prepare you for:

  • Chief Nursing Informatics Officer
  • Informatics Director
  • Nursing Informatics Specialist
  • Informatics Analyst

The trajectory of data and informatics in healthcare will continually open opportunities for nurses who take this path.

Nursing – Nursing Informatics (RN–to–MSN) – M.S.

A nursing program that empowers data-driven nurses to go from RN...

A nursing program that empowers data-driven...

A nursing program that empowers data-driven nurses to go from RN to MSN, earning their BSN along the way:

  • Time:  90% of RN-to-MSN grads finish within 36 months.
  • Tuition and fees: $3,795 per 6-month term during undergraduate portion, $4,385 per 6-month term during graduate portion, plus a Health Professions Student Fee of $350.

Some careers and jobs this degree will prepare you for:

  • Chief Nursing Informatics Officer
  • Informatics Director
  • Nursing Informatics Specialist
  • Informatics Analyst

The trajectory of data and informatics in healthcare will continually open opportunities for registered nurses who take this path.


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What Skills Do Medical Billing and Coding Jobs Require?

  • Medical Terminology: Medical billers and coders often work with various code types that come with unique abbreviations. The ability to understand various applications of healthcare delivery systems, regulations, and compliance is important for transcribing a physician's diagnosis into the correct alphanumeric codes. It’s important for these professionals to become well versed with these codes as well as standard medical terminology in order to accurately communicate data to the required party.
  • Technological Proficiency: Medical billers and coders must also be proficient in technological terminology and problem-solving. This includes understanding and using classification systems, such as CPT, ICD-10-CM, and HCPS Level II.
  • Attention to Detail: All jobs in medical coding and billing require strong organizational skills and the ability to recognize and correct errors.
  • Strong Communication Skills: A medical biller and coder is often a crucial link of communication between patients, insurance companies, and healthcare professionals. It’s important that they have the communication skills to relay information between all three parties.
  • Ability to Work Independently: This job is often remote and, therefore, requires the individual to be able to solve problems and work independently.
  • Accounting and bookkeeping: It’s ideal to understand basic accounting and bookkeeping since the professional will be responsible for sending out billing statements and will need to reconcile them as payments.
  • Ability to Maintain Patient Confidentiality: In any healthcare field, maintaining the patient’s privacy is absolutely necessary. Any breach in HIPPA compliance or patient confidentiality will result in immediate termination.

Salary for Medical Billing and Coding Jobs

$42,015

The salary of a medical biller and coder depends on previous education and certifications. Those who are not yet certified can make an average salary of $42,015 per year, while certified professionals can make an average salary of $55,923 per year.

If the individual chooses to pursue education and a career in this field, they have the option to choose a health manager track, which has an average salary of $104,280 per year. A survey from the AAPC showed that those with a higher degree earn a significantly higher salary.

Job Outlook for Medical Billing and Coding

8% Growth

There will be a significant increase in demand for medical billers and coders within the next 10 years.

The U.S. Bureau of Labor Statistics anticipates an 8% growth rate by the year 2029.

As for health information manager professions, career growth is expected to increase by 32%.

Where Do Medical Billers and Coders Work?

Varies

Many medical billers and coders can work from home thanks to the job’s emphasis on technology and coding that can be done simply from a computer. Other potential locations are:

-Hospitals
-Physician's offices
-Nursing homes
-Home health-care
-Outpatient facilities

Learn more about how you can pursue a health degree and a career in medical coding or billing at WGU.

Interested in Becoming a Medical Billing and Coding Specialist?

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