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Medical billing and coding are two closely related aspects of the modern health care industry. Both practices are involved in the immensely important reimbursement cycle, which ensures that health care providers are paid for the services they perform.
For the sake of simplicity, let’s divide the two at the moment and look at them as separate pieces of a larger process.
MEDICAL CODING
Medical coding, at it’s most basic, is a little like translation. It’s the coder’s job to take something that’s written one way (a doctor’s diagnosis, for example, or a prescription for a certain medication) and translate it as accurately as possible into a numeric or alphanumeric code. For every injury, diagnosis, and medical procedure, there is a corresponding code.
There are thousands and thousands of codes for medical procedures, outpatient procedures, and diagnoses. Let’s start with a quick example of medical coding in action.
A patient walks into a doctor’s office with a hacking cough, high production of mucus or sputum, and a fever. A nurse asks the patient their symptoms and performs some initial tests, and then the doctor examines the patient and diagnoses bronchitis. The doctor then prescribes medication to the patient.
Every part of this visit is recorded by the doctor or someone in the healthcare provider’s office. It’s the medical coder’s job to translate every bit of relevant information in that patient’s visit into numeric and alphanumeric codes, which can then be used in the billing process.
There are a number of sets and subsets of code that a medical coder must be familiar with, but for this example we’ll focus on two: the International Classification of Diseases, or ICD, codes, which correspond to a patient’s injury or sickness, and Current Procedure Terminology, or CPT, codes, which relate to what functions and services the healthcare provider performed on or for the patient. These codes act as the universal language between doctors, hospitals, insurance companies, insurance clearinghouses, government agencies, and other health-specific organizations.
The coder reads the healthcare provider’s report of the patient’s visit and then translates each bit of information into a code. There’s a specific code for what kind of visit this is, the symptoms that patient is showing, what tests the doctor does, and what the doctor diagnoses the patient with.
Every code set has its own set of guidelines and rules. Certain codes, like ones that signify a pre-existing condition, need to be placed in a very particular order. Coding accurately and within the specific guidelines for each code will affect the status of a claim.
The coding process ends when the medical coder enters the appropriate codes into a form or software program. Once the report is coded, it’s passed on to the medical biller.
FEATURED ONLINE MEDICAL CODING PROGRAMS
MEDICAL BILLING
On one level, medical billing is as simple as it sounds: medical billers take the information from the medical coder and make a bill for the insurance company, called a claim.
Of course, as with everything related to the health care system, this process isn’t as simple as it seems.
To get a better look at medical billing, let’s rewind the example we used earlier. Our same patient has a cough, a fever, and is producing lots of mucus. This patient calls the doctor and schedules an appointment. It’s here that the medical billing process begins.
The medical biller takes the codes, which show what kind of visit this is, what symptoms the patient shows, what the doctor’s diagnosis is, and what the doctor prescribes, and creates a claim out of these using a form or a type of software. The biller then sends this claim to the insurance company, which evaluates and returns it. The biller then evaluates this returned claim and figures out how much of the bill the patient owes, after the insurance is taken out.
If our bronchitis-afflicted patient has an insurance plan that covers this type of visit and the treatment for this condition, their bill will be relatively low. The patient may have a co-pay, or have some other form of arrangement with their insurance company. The biller takes all of this into account and creates an accurate bill, which is then passed on to the patient.
In the case of a patient being delinquent or unwilling to pay the bill, the medical biller may have to hire a collections agency in order to ensure that the healthcare provider is properly compensated.
The medical biller, therefore, acts as a sort of waypoint between patients, healthcare providers, and insurance companies. You can think of the biller, like the coder, as a sort of translator—where the coder translates medical procedures into code, the biller translates codes into a financial report. The biller has a number of other responsibilities, but for now you should simply know that the biller is in charge of making sure the healthcare provider is properly reimbursed for their services.
Certificate In Medical Billing And Coding Program Guide
Medical billers and coders play a crucial role within the healthcare system. Between 2019 and 2029, the Bureau of Labor Statistics (BLS) projects jobs for medical records and health information technicians to grow 8%. Considering this positive job outlook, now is a great time to consider a certificate in the healthcare industry.
Featured Online Medical Coding Programs
Learn about start dates, transferring credits, availability of financial aid, and more by contacting the universities below.
Should I Get A Certificate In Medical Billing And Coding?
These programs teach learners the skills needed to excel in the job, and a certificate demonstrates to employers that students have mastered the field’s fundamentals.
Although professionals can pursue a career in medical billing and coding without a certificate, earning a certificate offers several key advantages. These programs teach learners the skills needed to excel in the job, and a certificate demonstrates to employers that students have mastered the field’s fundamentals.
As the BLS projects8% job growth for medical records and health information technicians between 2019 and 2029, graduates can look forward to ample opportunities. Medical billing and coding remains a competitive field, making certificate-holders the most desirable candidates.
Although program lengths vary, students typically spend 4-15 months earning their medical billing and coding certificates. Learners can also pursue an online certificate in medical billing and coding, which is an especially convenient and flexible option for working professionals
What Will I Learn In A Medical Billing And Coding Certificate Program?
While pursuing a medical billing and coding certificate, learners gain insight into the systems and processes needed to smoothly run a healthcare front office. Students learn about health insurance and reimbursement, how to properly code medical and patient data, and how to use the Current Procedural Terminology system for reporting healthcare services and procedures.
Additional topics include record transcribing, medical terminology, and the history of the U.S. healthcare delivery system.
Graduates of medical billing and coding certificate programs can apply for entry-level positions in medical and healthcare offices. Program coursework can help students transition seamlessly from the classroom to the workforce with some additional on-the-job training.
How To Get Into A Medical Billing And Coding Certificate Program
Students who want to pursue a medical billing and coding certificate typically need a high school or GED diploma. Most certificate programs do not post stringent admission requirements. However, applicants should check all requirements for each specific certificate program.
What Can I Do With A Certificate In Medical Billing And Coding?
A medical billing and coding certificate can lead to several careers. Generally, these certificates prepare professionals to work in the front and back offices of healthcare clinics or medical facilities. See below for some potential careers with a medical billing and coding certificate.
Popular Career Paths
- Medical Biller and Coder
- Medical Coding Specialist
- Medical Billing Specialist
- Medical Records Technician
- Medical Records Coordinator
How Much Money Can I Make With A Certificate In Medical Billing And Coding?
According to the BLS, medical records and health information technicians earned a median annual salary of $44,090 in 2020. Professionals with certificates may earn more than those who enter the field without any formal education.
What is medical billing and coding?
Medical billing and coding involves documenting and transcribing different medical procedures, exams, tests, and treatments into standardized codes for billing through insurance or other reimbursement methods. The billing and coding processes are technically different but heavily interconnected.
How much does a medical billing and coding certificate cost?
The cost of a medical billing and coding certificate varies depending on the specific certificate and the organization that offers it. Certificates can range from several hundred to several thousand dollars.
How long does it take to get a certificate in medical billing and coding?
A medical billing and coding certificate often takes 4-15 months to complete. However, completion times vary by program and whether learners enroll full time or part time.
Is medical billing and coding a good career?
Medical billing and coding can be a solid career choice. Because of the faster-than-average growth rate, the competitive starting salary, and the relatively low barrier to entry, medical billing and coding is an ideal career choice for those who want to enter the healthcare field quickly.
Can you get a medical billing and coding job without experience?
Medical billers and coders do need job experience to apply for positions. Certificates can replace work experience in most cases, but those without formal experience may need to complete on-the-job training.
How To Become A Medical Coder
You don’t need a bachelor’s degree to become a medical coder and break into a growing industry on track to add 29,000 new jobs over the next decade. The Bureau of Labor Statistics (BLS) projects that employment in medical records and health information will increase by 8% from 2019-2029.
Medical coders have the complicated task of deciphering laboratory results, procedures, and diagnoses and translating this information into universal medical codes during the billing process.
Standardized medical codes help payers understand the specific treatments and services that patients receive for medical conditions. The data ensures that healthcare providers receive reimbursement from insurance carriers. Researchers and healthcare administrators also use the data to monitor health trends and better understand patient services.
As healthcare providers move to digitize records and increasingly use mobile health applications, there will likely be a greater demand for medical coders, according to the U.S. Medical Coding Market Outlook 2028.
Medical coders do not need an associate degree, although employers may prefer it. Keep reading this guide to find out how to become a medical coder, the training you need, and the expected salary.
What Are The Requirements To Become A Medical Coder?
Becoming a medical coder typically requires training through a certificate program or associate degree. Prospective medical coders can find medical coding programs at community colleges and technical schools. Earning a postsecondary certificate takes 1-2 years or less.
Specific requirements for medical coders depend on employers. Employers often hire individuals with only a high school degree and medical coding training. Some jobs may require a two-year associate degree in medical coding and billing or a four-year bachelor’s degree.
After medical coding training, students can opt to earn certification, which can boost their marketability and pay. Professional associations such as the American Academy of Professional Coders offer credentials to become a certified professional coder, certified inpatient coder, or certified outpatient coder. Certification requires passing an exam.
What Does Medical Coding Training Look Like?
Future medical coders all learn the same core skills, regardless of whether they earn a college degree or certificate, but it’s important for the program to be accredited. The training prepares students to work in various healthcare institutions. The BLS reports that 37% of medical records and health information specialists work in hospitals. They also find jobs in physician offices, surgery centers, and administrative and support services.
Students learn coding and classification systems by taking courses such as ICD-CM coding, ICD-PCS coding, and revenue cycle and billing. Courses also focus on maintaining patient files and protecting confidentiality.
Training programs and degrees provide a comprehensive understanding of medical codes and reimbursement. Courses teach students medical terminology; pharmacology; pathophysiology; and the appropriate coding for diagnoses, procedures, and equipment. These programs prepare students to take exams from the American Health Information Management Association or the American Academy of Professional Coders.
To earn an associate degree, students complete general education credits in addition to medical coding courses. Students enrolled in an associate program must complete an average of 60-65 credits, whereas certificate programs require about 30-35 credits. However, associate programs better prepare learners for a bachelor’s degree, making an associate a strong choice for learners interested in further education later on.
How Long Does It Take To Become A Medical Coder?
The educational pathway you choose dictates how long it takes to become a medical coder. A certificate program takes as few as nine months or up to 20 months. The average associate degree takes a full-time student about two years to complete.
Factors such as the number of required credits and the program format (online or in person) can also influence how long it takes to become a medical coder. Students who have completed previous college work can also earn an associate or bachelor’s degree quicker, depending on the number of transfer credits their school accepts.
Your Career Guide To Medical Coding And Billing Salaries
Health information technician, a profession that encompasses medical billing and all types of medical coding, ranks high in job opportunities, career advancement potential, and work-life balance. The salary range is competitive and far exceeds the financial and time investment required to become a medical billing and coding specialist. What’s more, working with healthcare providers in the medical field offers a career path rich in personal rewards.
If you’re considering a career in medical coding and billing, or currently employed as a health information technician, AAPC’s 2020 Healthcare Salary Survey isolates factors influencing compensation and will help you:
- Assess your salary potential
- Prepare for your job interview or salary negotiations
- Plan your medical coding career path for greater financial reward
CERTIFIED PROFESSIONAL CODER SALARY: REGIONAL AVERAGES
What Is The Average Medical Coder Salary?
On average, medical coders (certified and non-certified) make $53,051 annually. Medical billers and coders without certification earn approximately $41,543 per year while certified coding and billing specialists make an average yearly salary of $57,646 — 39% more than their non-certified colleagues.
The 2020 Healthcare Salary Survey again demonstrates that medical coding certification pays. Salaries for health information technicians with two credentials rise to an average of $63,085. Billing and coding specialists with three or more credentials earn approximately $68,589 per year.
AVERAGE MEDICAL CODING SALARY BY CREDENTIAL
| Credential | MedianSalary |
|---|---|
| Certified Professional Biller (CPB)® | $53,903 |
| Certified Professional Coder (CPC®) | $56,164 |
| Certified Outpatient Coder (COC®) | $61,435 |
| Certified Professional Coder-Payer (CPC-P™) | $60,544 |
| Certified Inpatient Coder (CIC®) | $53,811 |
| Certified Risk Adjustment Coder (CRC®) | $62,916 |
| Certified Professional Medical Auditor (CPMA®) | $68,172 |
| Certified Documentation Expert-Outpatient (CDEO®) | $70,535 |
| Certified Professional Coder-Instructor (CPC-I™) | $73,623 |
| Certified Professional Practice Manager (CPPM®) | $68,744 |
| Certified Professional Compliance Officer (CPCO®) | $77,186 |
| AVERAGE | $64,276 |
In addition to competitive salaries, health information technicians, unless freelance or contracted, typically receive standard employment benefits — health, disability, and life insurance, paid time off (holiday, sick leave, vacation), and defined-contribution retirement plans. Many employers also offer paid professional association dues and paid continuing education.
Paid continuing education is a particularly valuable employee benefit, given the correlation between medical coding salaries and the credentials a coding specialist has attained. Other variables that weigh into the salary equation include experience, specialty, employer type, and location.
How Much Do Medical Coders Make?
Medical coding salaries vary throughout the U.S. based on the employment cost index and consumer price index of the state in which the employing organization is located. The percent difference between the price index of 50 states — with the highest average wages received in California and the lowest wages in Alabama — is 37%.
On average, a health information technician employed in California makes $8.35 per hour more than a medical biller or certified coder working in Alabama. Again, the disparity in average state salaries mostly accounts for the costs of living in the state. A similar disparity is seen between urban and rural areas within the states.
From the table below, you can select your state to see an overview of salary information for your area. Each state page details average annual salaries by credential, education level, and healthcare work experience.
Medical Coding Salary Ranges By Employer Type
The average medical coding salary varies by employer, with larger healthcare organizations typically able to offer a higher salary. This trend, similar to salary variations by state economies, has proved consistent throughout 10 years of surveying salary by workplace.
Most health systems comprise 3 to 10 hospitals, as well as physician groups, urgent care clinics, and rehabilitation centers. As the largest employer type, health systems pay approximately 19.86% higher salaries than solo physician or small group practices.
Health information technicians employed by hospital inpatient earn the second highest salary, followed by coders and billers employed by large physician group practices.
BILLING AND MEDICAL CODING SALARIES BY WORKPLACE
| Healthcare Employer Type | Average Salary |
|---|---|
| Health System | $56,246 |
| Hospital inpatient | $54,458 |
| Large group practice (50 or more physicians) | $53,615 |
| Hospital inpatient & outpatient | $52,973 |
| Hospital outpatient | $48,828 |
| Medium group practice (11-49 physicians) | $48,360 |
| Solo practice/small group practice (1-10 physicians) | $46,928 |
The direct relationship between company size and salary range also remains consistent in year-over-year medical coder salary increases. We see the least movement among smaller employer types, which likely reflects financial constraints. Medical coders and billers, though, have many workplaces to choose from.
Where Can a Certified Coder Find a Medical Coding Job?
The emergence of remote monitoring and telehealth companies has recently added an employer type to the list of organizations with medical coding job opportunities. In addition to health systems, hospitals, and physician offices, specialists in coding and billing are needed by ambulatory surgery centers, walk-in clinics, accountable care organizations, assisted living and long-term care facilities, home health agencies, hospices, billing companies, healthcare consulting firms, software and durable medical equipment vendors, labs, imaging centers, insurance companies, government agencies, educational institutions, and some law offices.
What Are The Salary Trends For Medical Coding?
Medical coding salaries have maintained an upward trajectory throughout the last decade. In 2019, we saw a 5.8% pay increase over the previous year — almost double the 3.1% increase seen across all industries, according to the 2019 General Industry Salary Budget Survey.
But to understand 2020 salary trends for medical billers and coders requires looking at the pandemic economy.
COVID-19 & U.S. Job Loss
The quarantine economy disrupted employment and salary trends throughout the U.S. labor market. This disruption impacted the Health Care and Social Assistance sector, which saw a 16.5% decline in employment through April, as reported by University of Chicago’s Becker Friedman Institute.
The Becker Friedman Institute measured changes in the U.S. labor market during the early months of the pandemic using weekly data pulled from the largest payroll processing company in the U.S. The overall trends observed reflected the expected fallout:
- Industries requiring direct employee interaction with customers and colleagues saw the biggest employment declines.
- Industries comprising small businesses were the hardest hit by the pandemic.
By April 25, 2020, when the U.S. economy bottomed, employment across all sectors had fallen by 21% (relative to early February).
For these weeks and a second, extended period, the Becker Friedman Institute calculated the pandemic impact on employment for each 2-digit NAICS industry, as seen in the following table.
Pandemic Effects on Employment by Industry
| Industry | Feb. 15 – April 25, 2020 | Feb. 15 – June 20, 2020 |
|---|---|---|
| Arts, Entertainment and Recreation | -50.70% | -31.70% |
| Accommodation and Food Services | -45.40% | -26.80% |
| Retail Trade | -28.90% | -17.50% |
| Other Services | -25.10% | -14.60% |
| Transportation and Warehousing | -21.80% | -20.50% |
| Real Estate, Rental and Leasing | -21.00% | -16.90% |
| Information Services | -17.70% | -11.30% |
| Wholesale Trade | -17.50% | -12.80% |
| Administrative and Support | -16.80% | -15.50% |
| Health Care and Social Assistance | -16.50% | -10.30% |
| Educational Services | -16.20% | -18.90% |
| Construction | -13.80% | -4.00% |
| Manufacturing | -12.60% | -10.40% |
| Professional, Scientific, and Tech Services | -12.10% | -8.30% |
| Finance and Insurance | -1.20% | -4.9% |
In the second period of the study, all industries but Education Services saw partial recovery.
The Health Care and Social Assistance sector hadn’t been immune to the effects of COVID-19, but it was among the first industries to reopen, experiencing a 40% recovery of lost jobs by June 20.
Still, a 40% recovery leaves 10.3% of healthcare staff who had lost their jobs in February unemployed in June. This number supports the AAPC salary survey in which 10.5% of respondents reported being unemployed.
The 2020 unemployment rate among health information technicians is a departure from an otherwise healthy trend that averages 5.9% — or conversely, 94.1% employment of medical billers and coders, including newly certified apprentice coders (CPC-As). Employment for fully credentialled coders has held at 98% for ten years.
Salary Trends Routed by Economic Shutdown
During the worst economic crisis since the Depression, many business leaders opted to save jobs by cutting pay. Amid wage freezes and wage cuts ranging from 5 and 50%, the Becker Friedman Institute reported a 10% median wage reduction across industries.
In comparison, salaries for health information technicians dropped by just 2.9%, according to the AAPC Healthcare Salary Survey. Because the AAPC survey did not isolate wage cuts, the 2.9% drop also factors in annual earnings reduced by furlough, job loss, and cut hours. All the more, this statistic highlights the resiliency and stability of medical billing and coding as a career path.
Variability by State in Medical Coding Salary Trends
The quarantine economy impacted some states more than others, contributing to regional variability in 2020 medical coding and billing salary changes.
The District of Columbia, for example, confirmed its first cases of COVID-19 as early as March 7. Businesses and institutions began to curtail operations — including public transportation, which cut Metro ridership by 85%. Weeks later, shelter-in-place orders were issued.
With the nation’s capital still shut down in June, political unrest prompted business owners to board up storefronts. The daytime population of the Downtown D.C. Business Improvement District had dropped 90% from February. By July, economic activity was 12% what it had been in 2019.
Not surprisingly, medical billing and coding salaries in Washington D.C. fell sharply — 17.24% to be exact. This represents the steepest decline in the 50 states and U.S. territories.
In addition to D.C., five states saw coding salary reductions in disproportionate excess of the 2.9% mean. Utah, North Dakota, Idaho, California, and Kansas experienced salary decline at least twice as great. The pattern observed across the nation, however, was milder:
- 16 states incurred salary decline greater than 2.9%
- 20 states incurred salary decline less than 2.9%
- 16 states/regions experienced salary increase
Roughly 30% of U.S. coding and billing staff sustained salary loss above the 2020 average of 2.9%. But 70% of medical coders and billers fared better. This insight is key to understanding the year-over-year trend in medical coding salaries.
In keeping with all U.S. industries, the pandemic altered the growth trajectory for coding incomes. But the altered course was minimal and somewhat contained, which underscores the reliability of the long-term trend. In fact, roughly 30% of coding and billing staff received salary increases in 2020.
U.S. territories reported the greatest salary increase at 6.48%. Given their isolation from continental U.S., we can infer that healthcare organizations abroad conducted business as usual.
A similar image was projected by Vermont, which averaged a 6.17% salary increase for health information technicians, the second highest of the country. Having averaged double-digit daily COVID-19 cases until late November 2020, Vermont was among the states least affected by the pandemic.
Variability in Salary Trends by Medical Coding Credentials
In past years, salaries for certified billing and coding specialists have consistently increased in a trend reflecting the value placed on certification as a measure of proficiency. Certified professionals have established a reputation of excellence within the healthcare industry, one that is attributed to quality training and on-the-job experience.
2019 stayed the course, with salaries increasing above the general industries average of 3.1% for all AAPC coding credentials. But such was not the case in 2020, as seen in the table below.
AVERAGE ANNUAL SALARY CHANGE BY CREDENTIAL
| Credential | 2020 | 2019 | % Pay Change |
|---|---|---|---|
| Certified Professional Biller (CPB) | $53,903 | $55,078 | -2.13% |
| Certified Professional Coder (CPC) | $57,201 | $56,164 | -1.81% |
| Certified Outpatient Coder (COC) | $65,028 | $61,435 | -5.53% |
| Certified Professional Coder-Payer (CPC-P) | $62,612 | $60,544 | -3.30% |
| Certified Inpatient Coder (CIC) | $63,191 | $53,811 | -14.84% |
| Certified Risk Adjustment Coder (CRC) | $64,882 | $62,916 | -3.03% |
| Certified Professional Medical Auditor (CPMA) | $69,172 | $68,172 | -1.45% |
| Certified Documentation Expert-Outpatient (CDEO) | $69,987 | $70,535 | 0.78% |
| Certified Professional Coder-Instructor (CPC-I) | $75,403 | $73,623 | -2.36% |
| Certified Professional Practice Manager (CPPM) | $71,004 | $68,744 | -3.18% |
| Certified Professional Compliance Officer (CPCO) | $77,333 | $77,186 | -0.19% |
The percent pay changes listed above show the commonality in the 2020 experience. Although the AAPC survey did not ask COVID-specific questions, we can speculate that many health information technicians encountered a disruption in the typical work week that affected their compensation.
A closer look to compare average salary by professional certification suggests additional details resulting from the shutdown.
CICs, the hardest hit by the pandemic, incurred a 14.84% decline in 2020 earnings. In view of the ban on elective and non-urgent procedures, it’s reasonable to assume that the average acute healthcare facility was forced to furlough a significant portion of CIC staff — possibly for the duration of the ban in their state.
While COCs weren’t affected as greatly as certified inpatient coders, a 5.53% cut in annual income is consequential. Delaying elective procedures likely had a similar effect on outpatient departments and ambulatory surgery centers, requiring them to cut hours or furlough their COC staff for a period of weeks or months.
Medical Coding and Billing Salaries Based on Trends in Employer Types
Heightened reimbursement pressure on independent physicians has given rise to a trend of consolidation between hospitals and physician practices. Nationwide, physicians are leaving private practice and entering into employment arrangements with health systems.
In less than a decade, the percentage of hospital-employed physicians increased by more than 70%. During the same period, all U.S. regions saw an increase from 91% to 303% in hospital-owned practices, according to data compiled by the Physicians Advocacy Institute.
Employed physicians now outnumber self-employed physicians. And this trend is observed in the AAPC Healthcare Salary Survey.
Only 11.2% of respondents reported working for small physician practices in 2020. This number represents a tremendous shift from 37.2% in 2015. Of the most predominant employer types listed below, more than 50% of medical coders and billers now work for the largest employer types.
As seen in the chart above, salary decline occurred among all employer types, but the medical coding professional employed by a health system, the largest of healthcare organizations, continued to receive the highest pay in 2020.
Medical Coding Salary Trends Based on Educational Background
Although certification carries the most weight with employers, and does not require higher education to obtain, our survey shows an influence of education on medical billing and coding salaries.
Health information technicians with no college education average $24.22 per hour, while a certified coding specialist with some college or an associate degree averages $25.57 per hour — 3.5% more money annually. The hourly wage rises to $26.58 for professionals with a bachelor’s degree and $30.70 for coding specialists with a master’s degree.
Medical Coder Salary – How Much, Expectations And Duties
As the population of the United States continues to age, the healthcare field is experiencing a growing demand for qualified workers. According to the U.S. Bureau of Labor Statistics (BLS), employment across the healthcare industry could increase 18% by 2026, which is much faster than the average for other occupational groups. This translates to an additional 2.4 million jobs over a 10-year period.
More patients need more care, which in turn means more health records. Managing this data is a critical administrative function that requires trained workers such as medical coders, who apply standard codes to each diagnosis, procedure, and treatment.
What To Expect From A Medical Coder Salary
While the BLS does not currently feature medical coders among the detailed career listings in its Occupational Outlook Handbook, it does include the broader category of medical secretaries. The BLS outlines median and average medical secretary salaries, as well as breakdowns by industry and location, in its Occupational Employment and Wages overview.
Though coders who attain industry certification are capable of earning higher salaries (more on that later), the BLS data provides a general overview of what medical coders and other types of medical secretaries typically earn.
As of May 2017, the mean (average) medical secretary/medical coder salary was $35,870 per year. The median annual wage was $34,610, which means half of these workers earned less than that and half earned more. The top 10% earned over $50,340.
How Much Does A Medical Coder Make Per Month Or Per Hour?
If you work as a medical coder and earn the average $35,870 salary, you would make about $2,989 per month before taxes. That translates to $17.25 per hour.
Your take-home pay depends on your:
- Salary
- Federal income tax bracket
- State tax rate
- Benefits and deductions
Your base salary can vary depending on where you live and the industry in which you work.
States That Pay The Highest Medical Coder Wages
Medical secretaries living in the nation’s capital have the highest average salaries; three northeastern states and Alaska round out the top five in the BLS list of top-paying states in this field:
- District of Columbia – $46,420
- Massachusetts – $43,030
- Connecticut – $42,630
- Alaska – $42,240
- New Jersey – $41,830
Cities Where Medical Coders Make The Most Money
The top metropolitan areas for medical secretary salaries aren’t necessarily in the best-paying states. Only two of the top 10 metro areas are in the highest-paying states, while the remaining eight are all in California. Based on BLS annual mean wage data, medical secretaries earn the highest average salaries in:
- San Francisco/Redwood City, CA – $50,580
- San Jose/Sunnyvale/Santa Clara, CA – $50,020
- New Haven, CT – $47,390
- Vallejo/Fairfield, CA – $47,340
- Salinas, CA – $46,930
- San Luis Obispo/Paso Robles/Arroyo Grande, CA – $46,210
- Fairbanks, AK – $45,910
- San Rafael, CA – $45,830
- Napa, CA – $45,760
- Santa Rosa, CA – $45,630
Impact Of Certification On The Average Medical Coder Salary
The BLS occupational employment statistics are helpful for getting idea of what all types of medical secretaries earn. However, if you attain certification from a major industry organization, such as the AAPC (previously known as the American Academy of Professional Coders), you could potentially earn even more.
According to the 2017 AAPC Salary Survey, specialists who have achieved the Certified Professional Coder (CPC®) designation earn an average annual salary of $54,051. However, even for a certified medical coder, salary can vary greatly depending on experience. If you’re just starting out, it can take years before you reach the CPC average.
Across all AAPC credentials (including CPC as well as expert-, manager-, and officer-level certifications), the average earnings range from $38,011 for zero to one year of experience and progressively increase up to $71,506 for those with 31 or more years of experience.
How Do Medical Coder Salaries Compare To Other Administrative Jobs?
Returning to the BLS data, which includes both certified and non-certified workers, you’ll find that the median medical secretary/coder salary is basically in line with other healthcare administrative positions.
Medical records and health information technicians, or simply health information technicians, use various classification and computer systems to make sure health data is organized, accurate, and secure. This position has a national median salary of $39,180 per year.
Medical transcriptionists listen to voice recordings made by healthcare providers and transcribe that information into written form using a computer. They then use their typed notes to create written reports. These workers may also review transcripts created with speech-recognition technologies and manually apply any necessary corrections. A medical transcriptionist earns a median annual salary of $35,250.
Other medical administrative assistants, including receptionists and schedulers, would be included in the medical secretaries category.
Now that you have an idea of the average medical coder salary, you may be interested in learning more about what the job entails.
What Is Medical Coding?
Medical coding is an administrative process that involves converting medical information into universal medical alphanumeric codes.
These codes are applied to multiple types of data, including:
- Diagnoses
- Procedures and treatments
- Medical equipment
The coder gets this data from physicians’ notes, test results, and other medical record documentation.
Medical coders typically use three basic classification systems: Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and ICD-10, which stands for the International Classification of Diseases, 10th Revision.
The code systems are a form of communication that allows healthcare providers to accurately bill patients and their insurance companies for services provided. Medical billers then take the information provided by coders and use it to create invoices and send them on to the correct payer.
Some organizations combine the role of medical coder and biller, with one person performing both tasks. If the functions remain separate, the two positions will work together to ensure billing is accurate and to avoid rejected claims.
What Do Medical Coders Do?
Medical coders spend most of their time reading, writing, and reviewing healthcare documentation with three primary tools: patient notes and files, code books, and medical record and/or billing software.
The type of notes and records they work with may depend on the setting in which they are employed, such as a hospital, clinic, or outpatient facility. Medical coders might be assigned to work with a specific department. For example, a large university hospital might use a team of coders to work exclusively with the cardiology unit. Smaller offices and private practices often have one team—or sometimes one individual—responsible for coding every patient interaction, from annual exams to injuries and illnesses.
Every morning, medical coders will usually have a stack of records to work through. While reviewing the patient’s documents, they can find pertinent information to assist in their coding and data entry:
- Medical diagnoses
- Procedures
- Treatments
- Physician name
- Date of visit or procedure
- Other relevant information
They then use all that information to assign applicable codes, which help translate the patient’s unique medical file into something universal and sharable.
Once they complete a chart, they will move on to the next one.
Is Medical Coding Difficult?
In most cases, coders are able to quickly identify the relevant codes because they encounter many common diagnoses and procedures in the course of their daily work, whether it’s an annual checkup or a case of the flu. Their knowledge of medical terminology and understanding of how to use the codebooks make the process a straightforward one.
However, not all cases are simple, so coders also need to have the research skills required to deal with the gray areas that exist in medicine. Unusual or complicated cases may not fit neatly into the existing coding guidelines.
Medical coders also typically work according to a production schedule. They are often expected to complete a specific number of files within a set timeframe to make sure they meet organizational and insurance requirements. Typically, healthcare facilities want to have the records coded and claims submitted within two to five days after a patient’s visit.
Although coders often work independently, they may also interact with other staff including fellow coders, billing specialists, administrative staff, and medical personnel. They are also likely to have their work audited on a regular basis to ensure their records are accurate, complete, and compliant with standards.
How To Become A Medical Coder
Medical coders typically have relevant training and certification to help them excel at their work. There’s little room for mistakes in coding: the wrong code followed by an incorrect bill can result in unpaid insurance claims.
While some workers may enter the field with just a high-school diploma and on-the-job training, most complete some type of formal education, such as a medical billing and coding diploma or associate degree program. A diploma usually takes less than a year to complete, while an associate degree may run closer to two years. Students can also choose between on-campus classes or online courses.
Some employers prefer to hire candidates who have industry certification, such as the CPC credential. Accordingly, many diploma and degree programs include courses that are designed to help students prepare for their certification exam.
Full CPC status requires two years of on-the-job-experience or 80 contact hours of a coding preparation course and one year of experience. New graduates who pass the exam will be designated as a CPC Apprentice (CPC-A) until they have completed the requisite experience.
Once you graduate and pursue a position, you can leverage your training and certification to hopefully land a position as a medical coder.
Is A Career As A Medical Coder Right For You?
Medical coders and billers are an essential part of a healthcare facility’s administrative team. As the healthcare industry continues to grow, the job outlook suggests demand for medical coders will increase along with it. And based on past BLS occupation profiles, the average medical secretary/medical coder salary is also likely to rise.
With a diploma or associate degree and certification in hand, you can be well positioned to pursue entry-level positions in this dynamic field.
How To Teach Yourself Medical Coding
The American Academy of Professional Coding, or AAPC, which certifies medical coders, also recommends, but does not require, that you have an associate degree prior to sitting for the certification exam. However, it is knowledge and experience that is most important in this field. If you are not interested in pursuing a degree, it is possible to teach yourself medical coding.
Online Courses
Free or very low cost medical coding books and classes can be found online. These valuable resources offer self-paced instruction that can help you prepare for a career in the healthcare field. The World Scholarship Forum website has information on medical coding organizations such as MedicalBillingAndCoding.org that offer medical coding books online for free along with medical coding training videos and career tips.
Medical Terminology
It is not important to learn every term in a medical dictionary, but you should familiarize yourself with the medical terminology used in the medical coding profession in conjunction with training in medical billing and coding for beginners. Important terms to learn include disease names, pathology terms, insurance industry terms and procedural terminology. Three books that coders refer to for this information are CPT (Current Procedural Terminology), HCPS (Healthcare Common Procedure Coding System), and ICD (International Statistical Classification of Diseases).
Human Anatomy
Knowledge of human anatomy is essential if you hope to accurately interpret and code medical reports. You need an understanding of gross anatomy, the anatomical structures that can be seen by the naked eye, and microscopic anatomy, the minute anatomical structures that must be viewed with a microscope.
Examples of gross anatomy include limbs, organs and bones. Examples of microscopic anatomy include tissues and cells. The best way to quickly learn anatomy is with a good reference book or website. Some schools like Carnegie Mellon offer free, open online courses to help students learn anatomy and physiology. Many students also find it helpful to study with a partner or flashcards.
Coding Procedures
The Center for Disease Control and Prevention developed a diagnosis classification code that is used by medical coders in the United States and other countries around the world. The code is published in the International Statistical Classification of Diseases and Related Health Problems Clinical Modification/Coding Procedural Systems, now in its 10th edition. The ICD-10-CM/CPS consists of two parts. The first section is the ICD-10-CM, which includes the 3-7 alpha and numeric digits and full code titles that coders refer to while doing their job.
Second is the ICD-10-CPS, which contains the classification system used in in-patient hospital settings. You should familiarize yourself with both parts of the book and learn how to navigate the sections so that you can quickly look up codes. Take note that an 11th edition is scheduled for release on January 1, 2022 and wil replace the medical billing and coding books of 2020.
Gain Practical Experience
Sometimes, the best way to learn something is through practical experience. You can get real coding experience through a formal internship. Contact physicians’ offices, hospitals and other medical facilities in your area to request an internship opportunity. If an opportunity is not available, ask if you can volunteer your time in a health information management department. This will provide a chance to learn from experienced professionals. If this fails, ask if it would be possible to review and re-code previously coded records. This will allow you to practice with real records on your own.
Is A Medical Billing And Coding Certificate Worth It?
Answer:
As most certifications, medical billing and coding certifications are definitely worth it. They provide better job opportunities and higher salaries since they prove that you have gone through accredited training and the necessary examination. It is important to keep in mind that there are multiple medical billing and coding certifications. The most widely known certifications are the Certified Professional Coder (CPC), the Certified Coding Specialist (CCS), and the Certified Medical Coder (CMC). These certifications have the highest quality standards in the medical billing and coding field. Therefore, most professionals work to get them. These certifications are offered by different agencies that have different certification requirements. Most of them require candidates to take and pass a certification examination that ensures that candidates are properly prepared to get a credential. They can also require candidates to have completed an accredited training program or to have a certain amount of work experience. In conclusion, if you want to further your career as a medical biller and coder, you should get a certification.
Medical billing and coding are two of the fastest-growing careers in the medical field that don’t require a medical degree. While both can be great jobs to have, you might be wondering if becoming a medical biller and coder is right for you. Check out what a medical biller and coder does, and if it feels like a good fit.
While both medical billing and medical coding are careers that are in healthcare administration, the roles of each are vastly different. Medical coders translate patient care from physicians into CPT (current procedural terminology) codes. Their main focus is to make sure that the medical services that are provided to a patient are recorded and accurately coded.
A medical biller, on the other hand, is responsible for working with the codes a medical coder provides and creating a claim for billing and insurance purposes. They make sure that the hospital, physician’s office, or medical establishment gets the highest reimbursement possible for an insurance claim. They have to understand how insurance companies work and determine claims.
In some offices, they choose to hire one person to cover both positions, but in some locations, the medical biller and medical coder are different positions.
Benefits of Working as a Medical Biller or Medical Coder
There is a high demand in the medical field for qualified and experienced medical billers and medical coders. That means that once you go through a quick certification and training course, you can quickly find a job that works for you. These jobs are also great because, with very little training, you can earn a high hourly salary.
ALL ABOUT MEDICAL BILLING
Medical billing is a job in high demand. Across the country, everything from private practices to large hospitals all need certified medical billers. There is a nationwide shortage of medical billers and the medical billing might be too difficult to learn. Becoming trained in medical billing takes anywhere from a few months to as long as two years to complete. A large part of your success in medical billing depends on your own investment in the courses and training that you are receiving
Medical billing deals with regulations and money, so if numbers and figures are not your thing, it might not be a good fit for you.
What is required for education and certification?
Training and certification are required to work in medical billing. There are various programs online and at universities that can give you the training that you need to become a medical biller. CareerStep provides an online certification program that allows you to take courses at your own pace.
A minimum education of a high school diploma or GED equivalency is required before additional training. Other than the educational requirements, there are no age restrictions to work as a medical biller.
The standards of insurance companies, as well as the legal requirements for patient information and security, are constantly evolving. With those changes, you are required to keep up to speed with those advancements.
How much is the average pay for a medical biller?
The average pay for a medical biller is around $16 hourly. This rate can change depending on the location that you are working in and the company that you are working for, as well as your experience and education.
What is the competition like with this job choice?
Depending on the location that you live in, the competition in this field can be very fierce, or not exist at all. In general, for most markets, there is not an extreme amount of competition for a job opening. The biggest thing a medical office is looking for is that you have the education that is needed to do the job, and that your personality fits with their office environment.
Is medical billing a stressful job?
Medical billing can be a stressful job for some. The deadlines and pacing of the work does require some getting used to, but it is not overwhelming or excessive.
ALL ABOUT MEDICAL CODING
Medical coding is in high demand in a growing medical field. Trained professionals are needed in offices, practices, and hospitals across the country. A medical coder is an important connection between the doctor that a patient worked with, and the billing and insurance process of healthcare.
What is it like to be a medical coder?
A medical coder reviews a patient’s medical records from the physician or doctor and then assigns codes to diagnoses and procedures performed. This requires knowledge of medical procedures and practices and puts a medical coder in direct contact with doctors and physicians.
Is learning medical coding difficult?
Depending on your own investment and skills, becoming a medical coder does not have to be difficult. Medical coders convert complex medical information into a set of codes. To do this, a medical coder has to be able to remember the codes as well as the meaning and use of each code.
Being a medical coder requires you to be accurate in everything that you do, while still paying attention to the small details. For some people, it is not difficult to achieve that high level of attention to detail and becoming a medical coder is easy.
What are the requirements to become a medical coder?
A medical degree is not required as part of this career, but a training certificate is required or preferred by almost all employers.
There are a variety of schools and programs that provide ways for you to become certified as a medical coder, each with a different set of requirements for both time and money. CareerStep’s online medical coding and billing program is designed to be completed in only four months of full-time study. But, we know that you might not be able to dedicate a full-time schedule to study, so we allow you to finish the program at your own pace, up to 12 months.
To get into a certification program, you will need a high school diploma or a GED equivalency. Because the insurance and medical fields are constantly growing and adapting to new research, treatments, and legal requirements, there is a constant need to keep updated in the field of medical coding. There are on-going training and education requirements to make sure that you stay trained and up to date.
Where do most medical coders work?
Most medical coders work as part of the administrative face of clinics, hospitals, billing offices, or occasionally at home. Depending on the standards of the office that they work for, medical coders might be required to wear scrubs or business professional outfits.
How much is the average pay for a medical coder?
Pay scales of medical coders vary by employer, geographic location, and experience. On average, a medical coder will make around $21 an hour.
What is the competition like with this job choice?
It is estimated that medical coding is going to grow and will need 6,000 additional jobs annually. The problem is that there are only 2,000 graduates of various coding programs to fill those jobs. While there might be some competition for the highest paying jobs in populated areas, there is a very high demand for this job, with not enough qualified applicants.
SIMILARITIES AND DIFFERENCES IN MEDICAL BILLING AND MEDICAL CODING
What are the similarities between medical billing and medical coding?
Both medical billing and medical coding are a great way to be involved with the medical field without needing an advanced medical degree. You do not have to go to medical school for either medical billing or medical coding.
Another great similarity between the two careers is that they are in high demand. With the growing medical field and the increase of retirement and health issues common to an aging population from the baby boomer generation, there is a nationwide need for both billers and coders
Both medical coders and billers are an essential part of a patient’s experience. They both deal with the safety of personal medical information while making sure that billing and payment for services and diagnoses are done correctly. In many offices, there is only one person who handles both the medical coding and billing as a single job.
Even in training and certification, some programs, like CareerStep’s online training program, allow you to get training for both medical coding and billing at the same time.
What are the differences between medical billing and medical coding?
Medical billing deals more with the money and finances of a patient visit with the insurance company, and clinic, office, or hospital, while medical coding focuses on translating the patient’s records from a physician’s or nurse’s notes to accepted code. While they deal with different aspects of the billing and administrative jobs, medical billers and coders have very similar skills and responsibilities.
Can you work remotely with either field option?
Both jobs do offer options to work remotely or from home. Typically, these opportunities are only given after a medical biller or coder has worked in the office and established themselves as an expert in their field.
There are occasionally some options to start work at home, but generally, you will first need to start at an office before you are offered a remote position.
Is the job outlook better for either job?
Both medical billing and medical coding will continue to grow and be in high demand and have a very good job outlook for the next decade. There will be 81.7 million Americans that will enroll in Medicare by 2030, which will continue to create a need in the healthcare market for both jobs. With a growing population that will need medical care and assistance, there is a direct need for medical staff and administration to serve them.
What is the ease of finding opportunities if you relocate to another city or state?
There are no specific state standards for either medical coding or billing. Your certificate and education qualify you to work in any city, in any state. With the growing need for medical coding and billing specialists, you will likely be able to find a job no matter where you move.
WHAT SKILLS AND TRAITS WOULD MAKE A GREAT MEDICAL BILLER?
A medical billing specialist takes the medical code provided by a medical coder and then bills insurance and other third-party payers, like Medicare or Medicaid.
What traits make a great medical biller?
Attention to detail and accuracy with those details is essential. An error in medical billing can cost a patient thousands of dollars. Errors due to inaccurate billing can cause an increase in insurance denials, write-offs, and overpayments. A medical biller needs to make sure that the correct information is shared with the correct parties in a timely manner so that errors can be avoided.
What kind of people are usually interested in this field?
People who have great analytical, critical thinking, and organization skills do great in medical billing. It is important to have a good foundation in math, including consumer math and algebra, as these skills will be used frequently.
Medical billing is also a perfect option for those who want to be part of the medical field but do not want to invest in a long-term, expensive medical degree.
WHAT SKILLS AND TRAITS WOULD MAKE A GREAT MEDICAL CODER?
A medical coder is a health information professional who assigns codes that stand for medical diagnoses and procedures. They analyze patient records and then translate the personal medical information into universal codes, which are then passed to medical billing specialists.
What traits make a great medical coder?
Due to the growing and evolving field, some important traits for a medical coder to have include organization, attention to detail, great communication skills (must be able to communicate with both doctors and nurses), analytical skills, integrity, and the ability to be a lifelong learner.
What kind of people are usually interested in this field?
People who are academically inclined and like the science of medicine are a great fit to become successful medical coders. Those who enjoy a good puzzle and strive to find the solution to problems are also great candidates because a medical coder needs to be able to research through both hard copy books of medical coding references as well as online sources. Without complete and accurate details, they are unable to do their job correctly.
FAQS
What is medical billing?
Medical billing is an essential part of the healthcare industry. It is taking medical coding from a patient’s records and then submitting claims with health insurance companies in order to receive payment for services provided. Medical billing takes a healthcare service and translates it into a billing claim. This ensures that the healthcare facility the biller works for is able to receive reimbursement for the work they performed.
What is medical coding?
Medical coding is the responsibility of reviewing clinical notes and assigning standard codes using a variety of classification systems. Those codes are then transferred to a medical biller who will submit a claim for services rendered.
How do you become a medical biller?
To get into the programs that provide the education and training needed to become a medical biller, you have to have your high school diploma or a GED equivalency. Once you have that, the fastest way to become a medical biller is by taking a medical billing certification training course. While this is not required, many employers prefer applicants with certifications. These trainings can run anywhere from four months to a year in length and can be online or in person. Once you have finished your training, you can start applying for jobs in the career field wherever you want to live and work.
How do you become a medical coder?
Training and certification to become a medical coder are essential to the job. To get the training required for the job, you are going to first need to have a high school diploma or GED equivalency. Certification training will take anywhere from four months up to two years depending on which program you choose to take as well as the workload that you are able to handle.
How much does a medical biller make in a year?
The average salary for a medical biller is around $16 per hour, or $32,000 a year. Depending on your training, experience, and location, this amount can change.
How much does a medical coder make in a year?
The average salary for a medical coder is $21 per hour, or $43,000 a year. Depending on your training, experience, and location, this amount can change.
What exactly does a medical biller do?
A medical biller takes code from a patient’s records and then submits a claim with a health insurance company. That claim becomes a billing claim for the insurance company. The medical biller is responsible for following up on and collecting the reimbursement from the insurance provider.
What exactly does a medical coder do?
A medical coder takes the clinical notes from the physicians, doctors, and nurses in a patient’s records, and translates the notes into a series of standard codes using a variety of classification systems. A medical coder is responsible for making sure that a patient’s interaction and history with the clinic, office, or hospital is recorded correctly because, if it is not, there is a risk of the patient being billed too much, an insurance claim being denied, or even potential legal actions.
Are medical billing and medical coding careers in high demand?
Yes. The medical field is rapidly expanding and has more job openings every year. The average annual job growth rate is 5%. In the field of medical billing and coding, the growth rate is estimated by the Bureau of Labor Statistics to be 11%. This means that these careers have a very high growth rate and are estimated to still be in demand for the next decade.
How hard is it to learn medical coding or medical billing?
Depending on your background and personality type, learning medical coding or medical billing can be difficult or easy to learn. For those who are dedicated to their certification education and willing to invest the required time and energy into their training, it may seem easier to complete certification and be ready to enter the work field. If you have a head for numbers and accounting, medical billing might be easier for you as well. If you are interested in the science of medicine and medical procedures, then medical coding might be a better choice for you.
What Is A Medical Coding And Billing Specialist?
A medical coding and billing specialist acts as a liaison between the medical office and insurance companies.
What does this mean?
A coding and billing specialist helps the healthcare facility manage insurance claims, invoices, and payments. The day-to-day work of a medical coding and billing specialist includes:
- Properly coding services, procedures, diagnoses, and treatments
- Preparing and sending invoices or claims for payment
- Correcting rejected claims
- Tracking payments
- Following up with patients and insurance companies about outstanding bills
While these workers often work in the same healthcare facility where patients go for treatment, this is primarily an office job as opposed to patient-facing clinical work. A medical coding and billing specialist will spend a large amount of time at the computer, reviewing, entering, and updating information.
The Difference Between Billing And Coding
Job descriptions often combine billing and coding within a single position. However, they are technically two different job functions, each with its own responsibilities and tasks. Many medical offices will hire the same person to do both jobs, though larger facilities may divide the work into two separate positions—so it’s important to understand the difference between the two roles.
The Medical Coder
Medical coding is the act of taking a provider’s diagnostic and procedural notes and converting them into the correct codes for record-tracking and billing purposes. The codes are industry-standard alphanumeric combinations used to identify the services being provided and billed. This will require knowledge of the different codes used:
- Current Procedural Terminology (CPT) – These codes are used to identify specific procedures and examinations performed.
- International Classification of Diseases (ICD-10) – These classification codes are used for medical diagnoses.
- Healthcare Common Procedure Coding System (HCPCS) – This system includes codes not covered in the previous two sets, such as codes for specific medical devices or supplies and non-physician services.
Each of these codes is used in insurance billing, and the coder must follow specific guidelines for proper use and placement in the billing software.
Codes may be entered as soon as the patient makes an appointment. There will be codes for the type of visit and the symptoms reported by the patient. Further codes will be applied for the symptoms observed by medical staff, tests and procedures performed, diagnoses, and treatments recommended.
The Medical Biller
After the coding is completed, medical billing specialists generate invoices and send the claims to patients’ insurance providers (or other payers). Based on these codes, insurance companies will approve or deny the requests for payment. Any remaining amount not covered by insurance will then be sent to the patient for payment.
The billing process often begins as soon as the patient makes an appointment with the medical office, as codes may be entered and submitted to an insurer for pre-approval. This helps determine what the patient’s out-of-pocket expenses will be, so the office can charge the patient for that amount at the time of the visit.
A medical biller needs to understand the industry codes even if someone else does the coding, since the billing specialist has to review the reasons behind any denied insurance claims and may be responsible for updating the codes before resubmitting the claims. They will also verify the codes are entered correctly before submitting the initial claim.
Once the insurance billing is settled, the remaining balance will be invoiced to the patient. This process also falls to the medical billing specialist. Medical billers also determine co-pay requirements, track the payments, and follow up on outstanding payments from insurance companies and patients.
If a bill goes unpaid, the billing specialist will need to contact the insurance companies and make sure all the paperwork is in order. If a patient does not submit payment for an outstanding bill within a specified timeframe and does not respond to further requests, the billing specialist may need to turn the debt over to a collection agency.
Combining Billing And Coding
Because the billing and coding processes are so intertwined, many medical offices hire coding and billing specialists with the training to perform both roles. While some larger facilities will hire separate teams to take care of the billing and coding, these individuals typically work very closely together to ensure the process is done correctly. The most important aspect is avoiding coding and billing errors so payments are collected in a timely manner.
Other Requirements
While job titles and descriptions may vary for medical coding and billing specialist careers, the basic requirements will often be the same. Familiarity with the necessary codes is the most important requirement, but there are other knowledge areas that can increase your ability to get hired.
- Medical Terminology
To code properly, a basic understanding of medical terminology is essential. This includes anatomy and physiology terms, diagnosis and procedural terminology, etc. Understanding the most commonly used terms in the medical profession will help with the billing and coding process.
- Basic Math Skills
You will need to be able to do basic arithmetic to determine the proper billing amounts. While the billing system may automatically populate forms with the proper amounts for insurance claims based on the codes entered, you may need to calculate the remaining amounts due from patients or set up payment plans where applicable.
- Computer Skills
The medical billing and coding process requires a working knowledge of computer systems and relevant medical software. The ability to learn new programs is also a plus.
- Communication Skills
Part of the medical billing process may involve contacting patients for payment. The ability to communicate effectively and professionally is necessary for this aspect of the job. Some patients may be stressed, upset, or angry when faced with medical problems and a large bill, so good communication skills can help make these conversations a little easier.
- Use of Basic Office Equipment
In addition to having a level of computer proficiency, a medical coding and billing specialist will need to be able to use other basic equipment, such as a 10-key calculator, printer, copier, scanner, phone system, and the like. If you have ever worked in an office setting, you have likely used these tools and should have no problem.
Medical Coding Certification
While certification is not required by every employer to get a job as a medical coding and billing specialist, having industry certification can make it easier to get a job. Medical coding certification may also increase your earning potential.
The BLS reports that the mean or average salary for a medical secretary, under which medical billers and coders fall, was $34,610 per year in 2017. If you earn industry certification, however, such as the Certified Professional Coder (CPC®) credential from the AAPC, and then gain years of experience, you could earn more. The 2017 AAPC Salary Survey states that coders with an average of 13 years of experience and the CPC certification earned an average annual salary of $54,106.
While work experience and other eligibility requirements are necessary for full CPC certification, those who pass the exam but lack the requisite experience may be awarded the CPC Apprentice (CPC-A) designation. Upon submitting proof of two years of on-the-job experience or 80 contact hours of a coding preparation course plus one year of experience, a CPC Apprentice may gain attain full CPC status.
With a combination of formal education, certification, and experience, your earning potential can increase, especially as you move into senior-level or supervisory roles.
A medical office will often require either experience or certification to hire a new billing and coding specialist, and some may require (or prefer) candidates to have both. Earning a diploma or degree in medical billing and coding can help you gain the required knowledge while getting you ready for the certification exam.
Who Is A Good Fit For A Medical Coding And Billing Career?
A medical coding and billing specialist requires good organizational skills. If you are a detail-oriented professional who is able to manage time well and adeptly handle multiple projects, a job in medical billing and coding might be a good fit for you.
Candidates should also be comfortable in an office setting, as the job requires a lot of time in front of a computer screen and working with patient files. It’s important to have a good grasp of medical terminology, or at least be willing to learn it. Workers in this field will also need to stay up to date with changes in procedures and coding guidelines, so an interest in continued learning is also a good quality for this role.
If this description sounds like you, then training for a medical coding and billing specialist position may be a good career choice.
Getting Started In Medical Billing And Coding
Would you like to take advantage of the growth potential in the medical billing and coding industry?
You can get started with an online diploma or degree in medical billing and coding from Ultimate Medical Academy.Not only will your UMA education lead to a credential, but it will also prepare you to take the CPC certification exam.
Once you pass the exam, you can earn the CPC-A designation, which can be updated to full CPC status upon meeting eligibility requirements.
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