Medical Billing & Coding Career Guide: Steps, Salary, Certifications
Reviewed by Maegan Baker, BSN RN CCM
If you're considering a career path in the health care industry but prefer a role that doesn't involve direct patient care, medical billing and coding is an important behind-the-scenes career.
The U.S. Bureau of Labor Statistics projects an 8% job outlook growth for medical records professionals from 2022-2032. This is due to an increase in an aging population accessing medical care and the need for coding and billing specialists to translate medical information into codes for insurance reimbursement.
What is The Job Description of a Medical Coder and Biller?
Medical coding and billing specialists work with health care providers, patients, and insurance companies to organize, manage, and code medical data. These codes are then used in billing processes to generate invoices for insurance and payment purposes.
While the same person may perform both roles, each has distinct functions and responsibilities.
Job Duties of Medical Coders
A code is assigned to ensure proper billing when a patient receives a diagnostic test or procedure. Medical coders commonly use Current Procedural Terminology (CPT) and ICD-10 coding classification systems to assign codes to medical procedures, examinations, and diseases. These codes are used as a universal language for health care providers, facilities, and payers to communicate and ensure accurate reimbursement and payment.
Job Duties of Billing Specialists
Medical billing specialists will take these codes to generate claims, invoices, and payments. The billing specialist may perform the following tasks:
- Review codes for accuracy
- Follow-up on claim approval or denial
- Request missing patient information
- Review patient insurance coverage and eligibility
- Communicate with providers and other staff
- Generate invoices for remaining balances
- Track outstanding balances and payments
These roles are closely related, as one can't occur without the other, which is why duties are often combined.
Skills Necessary For Coding and Billing Success
Coding and billing specialists will spend the majority of their time either on a computer or on a phone. You must be able to navigate software systems and electronic health records efficiently. The following skills make for excellent medical coders and billers:
Attention to detail. You will be tasked with spotting and correcting errors. Working frequently with numbers and codes increases the risk of mistakes, which can result in inaccuracies in billing and payments.
Strong communication. Professionalism on the phone is crucial as you may be communicating with physicians, patients, insurance companies, and administrative staff.
Remaining up to date on changes. There may be changes in Medicare guidelines, health care systems, coding technology, and more that will require smooth adaption.
The ability to work autonomously. Medical billers and coders frequently work alone and do not require much supervision to perform their roles.
How to Become a Medical Coder or Biller
Becoming a medical biller or coder is an entry-level position that requires no direct patient care and fewer educational requirements than many roles in the health care field. These are the steps one can take to enter the profession:
Step 1: Obtain a High School Diploma
This career requires foundational skills, including problem-solving, organization, multitasking, critical thinking, and a basic understanding of medical terminology. While a degree is not required, candidates must possess a GED or high school diploma.
Step 2: Apply to Medical Coding and Billing Education Programs
Some employers provide on-the-job training, though many prefer to hire candidates who have completed a certificate program. Medical coding and billing programs exist at technical or vocational schools. These programs often offer a go-at-your-pace option and may even be completed online or in a hybrid setting. Program completion can take as little as a few months to a year to complete.
Step 3: Obtain an Advanced Degree (Optional)
Employers will prefer job-seekers who possess associate's or bachelor's degrees, which take two to four years to complete. Advanced degrees often equate to higher pay.
Step 4: Pass a Certification Examination.
At the completion of your medical billing education, you will be prepared to take a certification examination to prove your knowledge and skills.
Typical Medical Billing & Coding Certifications
Several organizations grant medical billing and coding certifications, including:
The AAPC (American Academy of Professional Coders)
The AHIMA (American Health Information Management Association)
The NHA (National health career Association)
Certifications from these institutions include the following:
- Certified Coding Associate (CCA)
- Certified Professional Coder (CPC)
- Certified Professional Biller (CPB)
- Certified Coding Specialist (CCS)
- Certified Billing and Coding Specialist (CBCS)
The eligibility criteria for each certification differ. Some certifications require the completion of specific courses or programs, while others depend on an area of specialization, such as coding for services performed by physicians or in medical offices.
Specialty Coding and Billing Certifications
Coding and billing specialists who choose to obtain specialty certifications earn more than their peers in general settings. Here are some examples of specialist areas:
- Ambulatory Surgery Center Coder (CASCC)
- Certified Anesthesia and Pain Management Coder (CANPC)
- Certified Cardiology Coder (CCC)
- Certified Emergency Department Coder (CEDC)
Potential Careers & Salaries for Medical Billing & Coding Graduates
The salary of a medical billing and coding job varies, depending on the level of education, experience, certifications, medical setting, and location. However, the average annual salary is $47,180 or $22.69/hour.
According to Salary, medical billing supervisors earn over $66,000 annually, medical records coding managers earn over $86,600 per year, and billing managers earn over six figures, which means advancing in this career has lucrative advantages.
Work Environment of Medical Coders and Billers
Where a medical coder or biller works can impact their income. Most work in hospital settings, but a significant percentage work in physician offices, including dental clinics and optometry offices. Here are some additional settings that hire medical coders and billing specialists:
- Outpatient surgery centers
- Insurance companies
- Government agencies
- Universities
- Consulting firms
Can Medical Billers and Coders Work Remotely?
Yes. Remote medical and billing jobs are common as the work can be done easily from any office setting. Since you have access to patients' protected health information, you must adhere to HIPAA (Health Insurance Portability and Accountability Act) laws and use secure software with a dedicated phone and internet connection.
Career Options in Medical Coding and Billing
When you're ready to begin your job search, there are office career options and titles for medical billing and coding graduates.
- Medical biller — responsible for medical documentation and mastery of reimbursement methodologies.
- Certified professional coder (CPC) — oversees the health care facility's medical coding.
- Certified coding associate — works under the CPC and manages electronic health records.
- Medical billing and coding specialist — works as a biller and a coder using medical software for more efficient recording, storage, and other tasks.
- Medical insurance billing and coding (MIBC) — specializes in receiving, coding, analyzing, and processing insurance claims.
Other common job titles include health information technician, medical records specialist, or coding specialist.
Should I Get an Associate's Degree or a Medical Billing and Coding Certificate?
If your goal is to begin working in medical coding and billing quickly, the best option is a certificate program you can finish in less than one year. If you plan to become a supervisor or switch to another health care profession, an associate degree will likely be necessary.
Takeaway
Medical coding and billing is a respectable profession for people who desire to work in health care in a secure position but do not wish to be involved in the treatment or direct care of patients.
Getting started in a medical coding or billing career is as easy as obtaining a high school diploma, completing an educational program, and passing a certification exam. However, candidates seeking higher-paying positions with more opportunities may choose an associate's or bachelor's degree.
There are many specialty certifications that can be obtained to keep your career fresh and varied while earning more money. Medical coding and billing specialists may work in an array of health care settings or from the comfort of their homes.