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Medical Billing and Coding Certification and Requirements

Medical billing and coding professionals are tasked with ensuring that payment requests made to insurance companies are accurate and complete. Because they have the financial well-being of health care facilities in their hands, it's imperative for these workers to receive extensive, quality training. To help ensure that they are hiring knowledgeable workers, many organizations require that billing and coding employees receive a professional certification. There are a number of certifications available for these workers, some of which are offered by the American Health Information Management Association (AHIMA) and the American Academy of Procedural Coders (AAPC). The requirements for certifications generally include working in the field for a certain amount of time, completing continuing education courses, or passing an examination.

Although medical coding and billing can be done by the same person, they are actually two distinct functions, and professionals can obtain a certification for each one. Coding certifications -- such as the Certified Professional Coder (CPC) and Certified Professional Coder-Hospital Outpatient (CPC-H) offered by the AAPC -- test on knowledge of medical codes for diagnoses and procedures, reimbursement guidelines, medical terminology and what to do when a claim is denied.

Similarly, billing certifications like the Certified Professional Biller (CPB), allows professionals to demonstrate their knowledge about types of insurance plans, the life cycle of a medical bill, and how to follow up on a medical claim.

Educational requirements for medical billing and coding

To embark on a career in medical billing and coding, candidates are required to complete a high school diploma, or its equivalent, and are encouraged to take courses in health, math, biology, and computer science. After graduation, they may be required to obtain an associate degree or a postsecondary certificate that may take about one year to complete. According to the Bureau of Labor Statistics (BLS.gov), some employers also require that employees earn a professional certification in addition to a billing and coding degree.

Benefits of billing and coding certification

Certification may be a condition to gain employment in some cases, but it may also help some workers advance in their careers and gain the potential to boost their salaries. According to a survey conducted by AAPC, medical coders and billers who earn a professional certification generally make 20 percent more than those who do not.

Sources:

Medical Billing and Coding Certification, Ultimate Medical Academy, Accessed June 23, 2014, http://www.ultimatemedical.edu/education/medical-billing-and-coding-certification

Medical Certification Overview, AAPC, Accessed June 23, 2014, http://www.aapc.com/certification/

Medical Records and Health Information Technicians, Bureau of Labor Statistics, Occupational Employment Statistics, January 8, 2014, http://www.bls.gov/ooh/healthcare/medical-records-and-health-information-technicians.htm

Six Steps to Becoming a Certified Medical Coder, Find A Code, Accessed June 23, 2014, https://www.findacode.com/articles/six-steps-to-becoming-a-certified-medical-coder.html

What is Medical Coding?, AAPC, Accessed June 23, 2014, http://www.aapc.com/medical-coding/medical-coding.aspx

Medical Billing & Coding Schools

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            Medical Billing and Coding
            • At American Career College, we provide hands-on training for students who are ready for change.
            • The diploma and associate programs offered at ACC can change the direction of your healthcare career.
            • 5 campus locations in Southern California and 13 programs in healthcare fields.
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            Medical Billing and Coding Certificate
            • Ranked among the Best Online Bachelor’s Programs in 2015 by U.S. News and World Report.
            • Lets undergrad students try classes before paying any tuition.
            • Has an average class sizes of 18 for undergraduate and 13 for graduate-level courses.
            • Offers numerous scholarship opportunities that can help students save up to $750 per term on their tuition.
            • Tends to educate degree-seeking online and campus-based students who are adult learners with families and students who work while pursuing higher education.
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            Medical Billing & Insurance Coding (10-Month Diploma Program)
            UEI College , Riverside
            • Medical Office Specialist program covers medical office procedures, physiology, pathology, medical terminology, and more.
            • Helps students prepare for opportunities to work as Medical Secretaries, Electronic Health Record Specialists, Medical Administrative Specialists, and more.
            • Day, evening, and weekend programs are available to help students fit classes around their schedule.
            • More than 25 years of experience providing career-focused programs.
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            Medical Billing and Coding

            • Originally founded in 1916 as the Swedish Institute of Physiotherapy, it is one of the oldest continuously operating massage therapy institutions in the country.
            • Features a public massage clinic where students can get real-world experience.
            • Nationally accredited by the Accrediting Commission of Career Schools and Colleges (ACCSC).
            • Programmatic accreditation from the Accreditation Commission for Education in Nursing (ACEN) and the Commission on Accreditation of Allied Health Education Programs (CAAHEP).

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            Diploma - Medical Insurance Billing and Coding
            Everest College , Fort Worth
            • Has 100 campuses— many of which are on or near public transportation routes.
            • Provides trained student finance planners to assist students seeking financial aid.
            • Offers classes built around small teams, so students get personal, one-on-one skills training.
            • Incorporates hands-on training into all programs to provide students with important experience.
            • Provides day, evening, and weekend classes. (Classes offered may vary by location.)
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