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How to Become a Medical Biller and Coder in Pennsylvania

To become a medical biller and coder in Pennsylvania, complete a certification prep course, obtain certification, find employment with health care providers, and maintain your credentials for career growth.
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How to Become a Medical Biller and Coder in Pennsylvania

Medical billing and coding are essential components of the health care industry, ensuring that medical services are accurately billed and coded for insurance claims and patient records. If you're considering a career in this field in Pennsylvania, understanding the steps to becoming a certified professional is crucial. This guide will walk you through the process of becoming a medical biller and coder in Pennsylvania.

What is Medical Billing and Coding?

Medical billing and coding are two distinct yet interrelated functions within the health care system. They involve the translation of health care services into standardized codes and the subsequent billing of these services to insurance companies.

Medical Coding

Medical coding involves converting diagnoses, procedures, and medical services into universal alphanumeric codes. These codes are derived from various coding systems, which are used to maintain uniformity and accuracy in the health care industry.

Medical Coding Systems Comparison

Coding System Description
ICD-10-CM International Classification of Diseases, Tenth Revision, Clinical Modification; used for diagnosis coding.
CPT Current Procedural Terminology; used for coding medical procedures and services.
HCPCS Healthcare Common Procedure Coding System; used for coding services, procedures, and equipment not covered by CPT.

Medical Billing

Medical billing is the process of submitting and following up on claims with health insurance companies to receive payment for services rendered by health care providers. It requires a detailed understanding of insurance policies and medical codes.

Do I Need a Medical Billing and Coding License in Pennsylvania?

In Pennsylvania, you do not need a specific license to work as a medical biller or coder. However, obtaining certification can significantly enhance your job prospects and validate your expertise in the field.

Becoming a Certified Medical Billing and Coding Professional in Pennsylvania

Step 1: Enroll in a Certification Prep Course

While not mandatory, enrolling in a certification prep course can be beneficial. These programs prepare you for certification exams such as the CPC (Certified Professional Coder), CPB (Certified Professional Biller), and CCS (Certified Coding Specialist).

Here are a few medical coding and billing programs in Pennsylvania:

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Step 2: Get Certified (CPC, CCS or Equivalent)

Certification is a mark of professionalism and expertise. Consider obtaining certifications like the CPC, CCS, or an equivalent to enhance your credibility and job opportunities.

Step 3: Find a Medical Billing Job in Pennsylvania (Or Remote)

Pennsylvania hosts several large health care providers where you can seek employment:

  1. UPMC (University of Pittsburgh Medical Center): A leading nonprofit health care provider and insurer based in Pittsburgh, operating 40 hospitals and covering over 4 million insurance members.
  2. Allegheny Health Network: Offers high-quality, cost-effective care across an eight-hospital network.
  3. Highmark Health: Provides integrated health care delivery and serves around 1.2 million health plan members.
  4. Main Line Health: Offers a wide range of medical services and operates multiple hospitals and outpatient facilities.

Step 4: Maintain Your Certification

Stay updated with the latest coding standards and renew your certification as required to maintain your professional standing.

Frequently Asked Questions

How Much Do Medical Billers and Coders Earn in Pennsylvania?

According to the Bureau of Labor Statistics (BLS), medical records specialists in Pennsylvania earn an average annual salary of $49,680, with an hourly mean wage of $23.88. The state employs approximately 9,120 professionals in this field.

The AAPC Salary Survey for Pennsylvania provides more nuanced information:

Certification Annual Salary
Certified OB/GYN Coder (COBGC) $59,642.86
Certified Inpatient Coder (CIC) $69,583.33
Certified Cardiology Coder (CCC) $61,785.71
Certified Outpatient Coder (COC) $77,115.38
Certified Pediatrics Coder (CPEDC) $75,000.00
Certified Professional Coder (CPC) $61,384.49
Certified Professional Biller (CPB) $55,434.78
Certified Rheumatology Coder (CRHC) $78,750.00
Certified Risk Adjustment Coder (CRC) $61,384.49
Certified Family Practice Coder (CFPC) $75,357.14
Certified General Surgery Coder (CGSC) $85,416.67
Certified Orthopedic Surgery Coder (COSC) $73,333.33
Certified Professional Coder-Payer (CPC-P) $57,500.00
Certified Emergency Department Coder (CEDC) $75,416.67
Certified Physician Practice Manager (CPPM) $78,055.56
Certified Outpatient Coder-Apprentice (COC-A) $37,500.00
Certified Professional Medical Auditor (CPMA) $79,848.48
Certified Hematology and Oncology Coder (CHONC) $59,166.67
Certified Professional Coder-Apprentice (CPC-A) $47,966.10
Certified Professional Coder-Instructor (CPC-I) $112,500.00
Certified Documentation Expert Outpatient (CDEO) $90,681.82
Certified Evaluation and Management Coder (CEMC) $70,666.67
Certified Professional Compliance Officer (CPCO) $91,666.67
Certified Anesthesia and Pain Management Coder (CANPC) $62,500.00
Certified Professional Coder-Payer Apprentice (CPC-P-A) $50,000.00
Certified Cardiovascular and Thoracic Surgery Coder (CCVTC) $57,500.00

Where Can Medical Billing and Coding Take You?

A career in medical billing and coding can lead to various opportunities within the health care sector, including roles in hospitals, clinics, insurance companies, and remote positions.

Bottom Line

Becoming a medical biller and coder in Pennsylvania is a promising career choice, offering stability and growth in the health care industry. By following the outlined steps and obtaining the necessary certifications, you can embark on a rewarding career path in this essential field.

Medical Coding Training Course
Midnight Medical Coding
Boothwyn, Pennsylvania
Learn More
Medical Coding Training Course
Midnight Medical Coding Medical Billing and Coding Certificate Online
Pennsylvania
Medical Coding Training Course
Midnight Medical Coding Medical Billing and Coding Certificate Online
Pennsylvania
Award Type
Program Cost
PRogram Length
Delivery Method
Certificate
$2,875
16 weeks
Award Type
Progam Cost
Certificate
$2,875
Program Length
Delivery Method
16 weeks
Online
Certified Professional Coding
Deborah Imig PMCC Imig
Los Angeles, Sacramento, Greencastle, Pennsylvania
Learn More
Certified Professional Coding
Deborah Imig PMCC Imig Medical Billing and Coding Certificate Online
California
Certified Professional Coding
Deborah Imig PMCC Imig Medical Billing and Coding Certificate Online
California
Award Type
Program Cost
PRogram Length
Delivery Method
Certificate
$2,600
14 weeks (about 3.5 months)
Award Type
Progam Cost
Certificate
$2,600
Program Length
Delivery Method
14 weeks (about 3.5 months)
Online
Program outcomes may vary depending on each institution's specific curriculum and employment opportunities are not guranteed.