How to Become a Medical Biller and Coder in Tennessee
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If you’ve been to the doctor, you’ve probably benefited from the work of medical coders and billers without even realizing it. In this guide, we’ll explore everything you need to know about becoming a medical biller and coder in Tennessee, from selecting a program to obtaining certification and landing your first job.
Quick Overview:
- Medical billing and coding is a crucial component of health care in Tennessee.
- While Tennessee doesn't require a specific license, most employers value professional certification.
- Training programs can often be completed in a matter of months.
What Do Medical Coders Do?
Medical coders act as translators, converting complex medical information into standardized codes essential for accurate billing and maintaining comprehensive patient records.
Key Responsibilities of Medical Coders:
- Analyzing patient charts and clinical documentation with precision
- Applying appropriate ICD-10, CPT and HCPCS codes to reflect diagnoses and procedures
- Collaborating with healthcare providers to clarify documentation when needed
- Processing and submitting coded information to insurance companies and government programs
- Monitoring claim statuses and addressing any rejections or denials
- Staying up-to-date with health care regulations and coding guidelines
By bridging the gap between clinical care and financial processes, medical coders are indispensable to the efficient operation of Tennessee's health care institutions, from major medical centers to small family practices.
Common Coding Systems Explained
What Does Medical Billing Involve?
Medical billers handle the financial aspects of healthcare, working with patients, providers, and insurance companies. Here are the main responsibilities of a medical biller:
- Claim submission: Convert medical codes into insurance claims, ensuring accuracy and completeness.
- Payment follow-up: Track unpaid claims and follow up with insurance companies or patients as needed.
- Quality control: Review claims for errors before submission to prevent delays or denials.
- Denial management: Address rejected claims by troubleshooting issues and resubmitting corrected claims.
- Patient billing: Bill patients directly for costs not covered by insurance, explaining charges clearly.
- Insurance policy knowledge: Stay informed about different insurance company rules and requirements to ensure smooth claim processing.
In summary, medical billing requires attention to detail, strong communication skills, and the ability to understand both medical procedures and insurance policies. It's a role that combines financial tasks with healthcare knowledge.
Do I Need a Medical Billing and Coding Certification in Tennessee?
While Tennessee doesn't legally require certification for medical billers and coders, getting certified can greatly improve your job prospects and potential earnings.
Here's why certification matters in Tennessee:
- Employer Preferences: Many health care providers in Tennessee prefer or require certified candidates. Certification shows you have the necessary skills for the job.
- Industry Standard: Large hospitals and small clinics alike often look for certified professionals to ensure quality coding and billing.
- Job Requirements: Many job listings in Tennessee mention certifications like RHIT from AHIMA or CPC from AAPC as preferred or required qualifications.
- Career Growth: Certification can open doors to better positions and higher salaries in Tennessee's healthcare sector.
In short, while you can work in medical billing and coding in Tennessee without certification, getting certified is highly recommended for better job opportunities and career advancement.
Becoming a Certified Medical Biller or Coder in Tennessee
Step 1: Enroll in a Certification Prep Course
To start your journey, you'll need to hit the books. Tennessee offers various medical billing and coding programs at local community colleges, vocational schools and online institutions.
Pro tip: Compare costs and program length. Some certificates can be completed in just a few months, while others might take longer. Look for programs that align with Tennessee's health care landscape and prepare you for nationally recognized certifications.
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Step 2: Ace That Certification Exam
After completing your certification prep course, it's time to put your knowledge to the test. In Tennessee, as in other states, two major organizations dominate the certification landscape for medical coding and billing:
- AAPC's Certified Professional Coder (CPC)
- AHIMA's Certified Coding Specialist (CCS)
When choosing between these certifications, consider the following factors:
- Which exam does your training program prepare you for?
- Check job listings in Tennessee to see which certifications are in demand by local employers.
- Consider your career goals: CPC is popular for outpatient settings, while CCS might be more suitable for hospital coding positions in Tennessee's major medical centers.
Step 3: Find a Medical Billing Job in Tennessee (Or Remote)
Finding a medical coding and billing job in Tennessee is similar to job hunting in any field. You can apply directly to employers, search job boards, or tap into your professional network. Tennessee offers many opportunities for medical billing and coding professionals, with several major health care systems as key employers.
Some of Tennessee's largest health care employers include:
- HCA Healthcare: Headquartered in Nashville, HCA operates numerous hospitals and medical facilities across the state.
- Vanderbilt University Medical Center: A major academic medical center in Nashville, known for its research and clinical care.
- BlueCross BlueShield of Tennessee: While primarily an insurer, they also employ medical coders and billers.
- Community Health Systems: Based in Franklin, this company operates hospitals throughout Tennessee and other states.
- Ballad Health: A major healthcare provider in Northeast Tennessee and Southwest Virginia.
- Methodist Le Bonheur Healthcare: A large healthcare system serving the Memphis area.
Health systems and smaller hospitals, clinics, and private practices in Tennessee regularly employ medical billing and coding professionals. The diversity of healthcare providers, from urban centers like Nashville and Memphis to rural hospitals in East and West Tennessee, offers a range of opportunities in this field.
Besides applying directly to these healthcare providers, you can also keep an eye on medical billing and coding job boards, such as:
Besides applying directly to these healthcare providers, you can also keep an eye on medical billing and coding job boards, such as:
Step 4: Maintain Your Certification
Earning your certification is just the beginning. To keep your credentials current and demonstrate ongoing expertise, you'll need to fulfill regular maintenance requirements. Here's what you need to know for maintaining an AAPC certificate (AHIMA and other certifying bodies have different requirements).
- Complete continuing education units (CEUs) every two years.
- The required CEUs vary based on your certifications.
- Earn CEUs through webinars, workshops, and other approved events.
- Report completed CEUs through your online account.
Frequently Asked Questions
What Do Medical Billing and Coding Professionals Earn in Tennessee?
According to the Bureau of Labor Statistics (BLS), medical records specialists—including medical coders and billers—earn $55,950 per year or $26.90 per hour in Tennessee. However, the BLS’s figure doesn’t reflect the salary variation for medical billing and coding. For that, we turn to AAPC’s salary survey in Tennessee.
Average Salary in Tennessee by AAPC Certification
Career Growth: Where Can Medical Billing and Coding Take You in Tennessee?
Starting in medical billing and coding can open doors to various career paths within Tennessee's thriving health care sector. As you gain experience in the Volunteer State's medical facilities, you'll find opportunities to grow your career and increase your earning potential.
One way to advance is by focusing on a particular area of medical coding and obtaining specialized certificates. Another route for career growth is pursuing higher education at one of Tennessee's many excellent institutions, such as:
- Earning a degree in Health Information Management (HIM)
- Studying Healthcare Administration
Medical billing and coding gives you a peek into the inner workings of hospitals and other health care providers. When combined with an advanced degree, a grounding in billing and coding could give you an advantage in health care administration or nonclinical health care positions.
Bottom Line
Starting a medical billing and coding career is ideal for those who prefer behind-the-scenes roles in Tennessee's hospitals or health care providers. Many training programs can be completed in a few months, providing quick entry into Tennessee's robust health care industry.
If you're considering this career path in Tennessee, explore:
