OVERVIEW
What is a Medical Billing & Coding Specialist?
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.
RESPONSIBILITIES
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.
EDUCATION & BEST DEGREES
How Do I 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 & Nursing
Health Information Management – B.S.
A program designed for future leaders in HIM....
A program designed for future leaders in HIM.
- Time: 61% of grads earned this degree in 36 months or less.
- Tuition: $4,085 per 6-month term.
- Courses: 36 total courses in this program.
Skills for your résumé that you will learn in this program:
- Medical Terminology
- Healthcare System Applications
- Health Information Law and Regulations
- Healthcare Project Management
- Data Analytics and Information Governance
This CAHIIM-accredited program makes you eligible for the RHIA exam.
Health & Nursing
Nursing – Nursing Informatics (RN-to-MSN) – M.S.
A nursing program that empowers data-driven nurses with a BSN and MSN...
A nursing program that empowers data-driven nurses with a BSN and MSN component, allowing them to go from RN to MSN.
- Time: 63% of RN-to-MSN grads finish within 36 months.
- Tuition: $4,685 per 6-month term during undergraduate portion and $4,795 per 6-month term during graduate portion.
- Courses: 31 total courses in this program.
This program is ideal for currently licensed RNs who are looking to earn a bachelor's degree and a master's degree at an accelerated pace.
Skills for your résumé that you will learn in this program:
- Informatics System Analysis and Design
- Data Science and Analytics
- Advanced Pathopharmacological Foundations
- Leadership and Management
The trajectory of data and informatics in healthcare will continually open opportunities for registered nurses who take this path.
Health & Nursing
Nursing – Nursing Informatics (BSN-to-MSN) – M.S.
A nursing degree program that empowers data-driven nurses who already have...
A nursing degree program that empowers data-driven nurses who already have a BSN but seek the success a master's can bring:
- Time: 64% of grads finish within 24 months.
- Tuition: $4,795 per 6-month term.
- Courses: 14 total courses in this program.
Skills for your résumé that you will learn in this program:
- Informatics System Analysis and Design
- Data Science and Analytics
- Advanced Pathopharmacological Foundations
- Leadership and Management
The trajectory of data and informatics in healthcare will continually open opportunities for nurses who take this path.
How Much Does a Medical Biller and Coder Make?
$47,180
The salary of a medical biller and coder depends on previous education and certifications. The BLS reported that the 2022 median annual wage is $47,180 for medical records specialists. A survey from the AAPC showed that those with a higher degree earn a significantly higher salary.
What Is the Projected Job Growth?
8%
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 2032. As for Health Information Technologists and Medical Registrars, career growth is expected to increase by 16%.
SKILLS
What Skills Does a Medical Biller and Coder Need?
- 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.
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