The world of medical billing and coding is a fast-paced one within which billers and coders process the exchange of data between patients and the companies that provide them with their health care benefits.

Medical billing and coding specialists are responsible for reading patient charts, medical history, the diagnosis of each patient, and the care prescriptions if any, they receive after diagnosis. Based on this information, they then begin a process of transcribing the specifics into a medical code (ICD-10) that is understood and applied by both the patients’ doctors and their insurance companies. All of this is done so that patients receive the care they need, and insurance companies are charged the correct amount of money for that care.

What is medical billing & coding?

Billers and coders are the technicians that keep the cogs of the medical machine turning. Without them, data would not be properly recorded, patients might not receive the care they need, and insurance companies would have no way of knowing how much and when to pay for services.

They get to see hundreds of patient’s healthcare journeys, from start to finish, and aid in making sure that they are getting the care they need. They also ensure that their insurance companies are paying what they need to.

What are the Responsibilities of a Billing and Coding Specialist?

As with all careers, the particular set of responsibilities you are required to handle will depend on the facility in which you work. Thankfully, regardless of where a medical biller or a medical coder is employed, the core of their work remains the same. Here are a few of the most important aspects of billing and coding;

  • Examine patient charts/records
  • Interact with doctors, healthcare providers, or PAs in order to make sure information is recorded correctly
  • Track patient information with each visit and upload that data into the system
  • Understand the code needed to communicate properly with insurance companies for services rendered, then accurately enter that code into the system
  • Maintain the ability to manage a high volume of detailed information, while keeping it organized
  • Ensure that the correct codes are being used for each specific situation
  • Maintain patient confidentiality throughout the process

What is the process to become a billing and coding specialist?

The process to becoming a medical billing and coding specialist consists of four steps.

  1. Decide if you want to become certified
  2. Graduate from a medical billing and coding program
  3. Complete an internship or get work experience
  4. Take the certification exam and become certified

Step 1: Decide if you want to become certified

Making the choice to embark on a new career can be scary. It requires work, dedication, and, for most people, stepping outside of their comfort zones. However, if the challenges and responsibilities of working in the billing and coding world sound fulfilling to you, then your next step is to decide whether or not you want to become certified.

It is possible to work as a medical biller or coder without certifications, but both options have their pros and cons. Let’s discuss these further.

Pros and cons of choosing not to become certified

Pros
  • You will not have to go through the one year course it takes to obtain a certification.
  • You will not have to deal with student loans, fees, and the cost of textbooks.
Cons
  • The main con to this choice is less job security
  • You will be competing with people who have been certified. Certified individuals usually get the job over those who aren’t
  • Pay for non-certified specialists is usually lower than their certified peers

Pros and cons of choosing to earn your certification

Pros
  • More job security.
  • An edge on the competition
  • A certification tells potential employers that you are dedicated and goal-oriented
  • You can demand more pay due to your certification
  • Employers hire people they can trust to do the job right. Your certification tells them you know what you are doing.
Cons
  • The typical billing and coding certification course will take about a year
  • Like all formal education, there is a financial cost involved. You may have to be prepared to take out a loan and learn what programs you might qualify for help from.

Step 2: Graduate from a medical billing and coding program

The second step in becoming a medical billing and coding specialist is to complete a formal training program that is accredited by either the American Academy of Professional Coders (AAPC) or the Commission of Accreditation for Health Informatics and Information Management (CAHIIM). In order to become eligible to sit for one of the five nationally-recognized certification exams, you must earn a credential from a program recognized by one of these two national accrediting bodies.

Credentials awarded to medical billing and coding program graduates typically fall into three categories. A brief overview of each of these categories appears below.

Certificate & Diploma programs

Certificate and diploma programs are the most-common type of medical billing and coding training courses offered. These types of programs are offered by a variety of institutions, including: trade schools, community colleges and other vocational training centers.

The typical medical billing or coding certification course can usually be completed in 12 months or less, and awards a credential that qualifies the recipient for most entry-level positions in the industry.

See our guide for online medical billing and coding training.

Associate’s degree programs

Associate’s degree programs are also popular with students who wish to pursue a career in the billing and coding industry. These two-year courses differ from certificate and diploma programs in three important ways:

  • Duration (associate’s degree programs last twice as long)
  • Material covered (associate’s degree programs are more comprehensive)
  • Cost (associate’s degree programs usually have higher tuition and associated costs)

While the financial and time commitments required to complete an associate’s degree program are substantially higher than those for a certificate or diploma course, the rewards are usually higher as well. For example, many employers prefer to hire candidates with more education and also tend to compensate these individuals with higher pay.

Bachelor’s degree programs

The bachelor’s degree program is probably the least-common approach taken by aspiring billers and coders due to the amount of time and cost required to earn a degree. These four-year programs cover a wide range of academic material beyond simply billing and coding, and are offered by fewer institutions as well.

Nonetheless, this option can be appealing if your long-term career goal is to hold a management position in the health information or healthcare administration fields. Many employers require a four-year degree in a related discipline from any management candidate.

What to Look for in Billing and Coding Programs

There are several things you might want to consider before enrolling in a program. Taking the time to research the programs available to you can greatly enhance your chances of not only finding success in school, but also in your career.

The following is a list of the major factors you should consider when comparing programs.

1. Program Accreditation

There are two very important organizations that you should be aware of when looking for program accreditation: The CAHIIM and AAPC.

The Commission of Accreditation for Health Informatics and Information Management Education (CAHIIM) and American Academy of Professional Coders (AAPC) evaluate the curriculum, facilities and faculty at all medical billing and coding programs across the country. Their endorsement, given in the form of accreditation, indicates that a program satisfies the current industry and governmental standards for excellence in training.

Furthermore, only students who graduate from a program accredited by one of these two bodies are eligible to sit for one of the major national certification exams.

2. Course Availability

Everyone’s personal life and responsibilities are different. Some people looking into starting a program might be young, have no children, and few financial obligations. These students can afford the time it takes to enroll in a program that might be on campus, and require that students take on a full-time class load.

There are people who are deciding to start a program as a change of career in a life they have already started. These people might have children, mortgages to pay, or other responsibilities that would prohibit them from showing up to a campus every single day or taking a full-time class schedule load.

Thankfully there are many options. As stated before, there are online options that can be taken to cater to your schedule needs, and there are of course on campus options that require you be in class at certain times on certain days – no excuses.

Whatever your life’s current schedule looks like, make sure to examine it carefully before choosing a program. Pick the one that will aid you in excelling, not make your life even more hectic.

3. Cost

This factor is very similar to course availability. Some programs will be more expensive than others. Regardless of your financial situation when looking into enrolling in a program, it is important that you speak with a financial advisor who is affiliated with the program to discuss what payment options are available to you and if you can afford them.

Step 3: Complete an internship or get work experience

Completing an internship while studying billing and coding is an important part of the training process. Internships are usually unpaid, but allow students to gain actual working knowledge of the environment they are studying.

Despite the fact that these internships will take time, and offer no money in return, they look great on resumes. Internships are essentially a financial investment that allows possible employers to test a student’s abilities to make informed and important decisions on the job. For this reason, many programs state that an internship or some form of on the job work experience is a prerequisite before you can receive your certification.

Step 4: Take the certification exam and become certified

When all is said and done, and you have chosen a program, completed an internship or work experience, you will be required to take an exam. This exam, if passed, will award you the honor of being officially certified.

The Certified Professional Coder’s exam (CPC) is quite the undertaking, but also an amazing achievement to have on your resume as it shows an intense dedication to the field and is looked very highly upon by employers. There are 24 sections that this extensive exam covers, all pertaining to specific aspects of the medical industry. You will be expected to study and know all of them. The CPC can take over six hours to complete. It’s serious business, and it shows you mean serious business, too.

Finding a Job as a Biller or Coder

You’ve taken the courses, completed the internship, have some work experience under your belt, and have your medical billing and coding certification. You’re now one of the elites in your line of work, who are considered professionally prepared to take on the responsibilities that billing and coding entails.

So, what’s your next step? Well, you have to inch your way into the field now. Just like many other career fields, there are thousands of people doing the same thing as you right this very second. Due to this, your job is to do as much as you can at this point to make sure you stand out from the sea of applicants.

At this stage, some people consider undergoing secondary training or gaining more work experience in the field you are interested in working under as a biller or coder. For instance working at the front desk of a doctor’s office for a little while is not a bad idea. This, in itself, is a form medical records work and adds experience to your resume. A few other options to help you gain more experience and weight behind your resume are

  • Asking an already working professional biller or coder if you can shadow them for a day or two. Take notes and examine the process they go through on a day to day basis. This is a firsthand experience you can’t get in a classroom or online.
  • Calling local doctor’s offices or healthcare clinics, explain to them that you are looking for volunteering opportunities to gain some secondary work experience. Reaching out and making connections, as well as making yourself available is an important part of this field. Volunteering entails free work, meaning you gave your time willingly, which demonstrated dedication on resumes.

Where to Start Your Job Search

According to medicalbillingandcoding.org, aside from bolstering your resume, two of the best places to look for work in the billing and coding industry are two organizations we’ve already discussed, and you should be familiar with by this point; the AAPC (American Association of Professional Coders) and the American Health Information Management Association (AHIMA)

It cannot be stressed enough that reaching out and making connections are an important part of your role at this point. Get your profile set up on LinkedIn, politely ask people already working in the industry for advice, and be persistent.

Sites like careerbuilder.com are also great resources for individuals starting their search for a job in a specified field. Upload your resume onto this site and check it every day for updates and new job listings in the billing and coding field. Careerbuilder.com will also email you if potential job opportunities are listed that match your resume well.

Here are a few more sites that can aid you in landing an interview for a job in billing and coding

  • Indeed – another site very similar to careerbuilder.com. It includes a large database of job listings that are added according to the field. You can search through them and apply to as many as you like.
  • Monster – yet another site similar in function and style to Indeed and careerbuilder.com.
  • Simply Hired – This site features job listings that are a little more in depth. Their front page alone boasts “One search, millions of jobs.” This website allows you to enter advanced criteria into your search, like years of experience and level of schooling attained.
  • Government Jobs – If you would like to work for a federal or state funded clinic or hospital, then this website can help you locate one that’s hiring.

There is quite a few other legitimate job listing websites out there, and we recommend familiarizing yourself with all of them. However, before you upload a resume or input any personal information – like an email address or phone number – make sure you do a little research on the site. See what the reviews about it are saying. Just to make sure you aren’t signing yourself up for a ton of spam in your inbox.

What Type of Job Setting is Right for You?

Believe it or not, billers and coders that work in the medical industry do not all operate under the same conditions. Some working environments will be very mellow – like an independent physician’s office in a small town. Other environments can be hectic and very stressful; hospitals and urgent care centers can maintain this type of environment to billers and coders. Generally, however, no matter what type of medical facility you work in, it will be on-site. Meaning you’ll be right smack dab in the middle of all the action there in the office.

Due to this, you have to decide which working environment is right for you. You will also have to be open to possibly working in an environment you might not particularly like for a short time, as many new employees do when they first enter a field.

Luckily there are plenty of resources online that can help you determine which type of environment you want to work in. For instance on healthjobsstarthere.com “Job seekers can use a unique questionnaire, which assesses personality and work environment preferences to match candidates with potential employers.”

The general consensus is that regardless of what environment you end up working in, be it a calmer one or a hectic one, your responsibilities will most likely be about the same. It’s the volume of work, and the level of stress you are prepared to deal with that you want to assess within yourself before deciding which coding and billing environment is best for you.

That being said, get out there, bolster that resume, send it out to as many places as you can, and get to work! Landing the perfect job is about persistence, drive, and proper preparation. If you do end up landing an interview, out last bit of parting advice for you is that you make sure to do a little homework before walking into it. Research the facility you are interviewing for, what it is that they do, and make sure you understand what your role will be as a member of their team.

The National Employment Outlook for Billing and Coding

All Allied Health Schools has stated in a recent article that “The U.S Bureau of Labor Statistics (BLS) Occupational Outlook Handbook, 2016-17, the median expected annual salary for medical billers and coders is $35,900.” However, these earning will vary, as with almost all professions, according to the level of education you have, your experience in the field, and if you have a specialty within the field.

Another piece of useful information is the fact that there has been a recent change in the billing and coding programs used by doctors and healthcare providers. This system is called The Internal Classification of Diseases (ICD) and it is used to identify and properly code all the information pertaining to patients, their health, diagnosis’, procedures performed, and all other data needed to track an individual in the medical industry.

Before this change, the ICD-9 was being used to track all data. However, the ICD-10 is the current form of software being used, and this has caused a leap in demand for more billing and coding specialists, which is great news!

On top of this, you can trust that the demand for billing and coding specialists will continue to rise, as with the demand for all types of employment in the medical field. The Bureau of Labor Statistics claims that job opportunities and demand for any form of medical technician are expected to make an exponential growth leap of 15 percent through 2024. This is much faster than average for nearly any other career outlook in the US.