Medical Billing and Coding Education, Schools and Career Overview
Medical billing and coding professionals are an integral, though largely unseen, part of the health care industry. As patients go to their doctors for the treatments they need, medical billers and coders work in the background -- generally employed at hospitals, nursing homes, doctors' offices and government agencies -- to ensure that the financial part of the system runs smoothly. In order to do this important job, some employers require medical billers and coders to receive extensive industry training.
How to Become a Medical Coder and Biller
According to the Bureau of Labor Statistics (BLS.gov), medical coders and billers -- also known as medical records and health information technicians -- generally receive an associate degree or a professional certificate in order to enter the field.
When earning a high school diploma or its equivalent, students interested in entering this field are encouraged to take courses in math, computer science, biology and health. After graduating high school, students can enter the field after studying medical billing and coding for one or two years, but some may choose to continue their education past that point.
Medical billing and coding degree programs
Some of the degree programs that are available to medical coders and billers include:
- Certificate programs. Medical billing and coding certificate programs generally take one year to complete. Students enrolled in these programs can expect to learn the basic principles of the field and gain the practical experience they need to work based on the industry's HCPCS, CPT, and ICD-9-CM coding manuals.
- Associate degrees. Medical coding and billing professionals who complete associate degrees generally finish these programs within two years. These programs give students a more in depth look at the field, increasing their understanding of the standards that guide the field and the ethical principles that these professionals are expected to adhere to.
- Bachelor's degrees. Students enrolled in undergraduate billing and coding degree programs may be able to finish their degrees within four years. These programs teach students more advanced information about medical terminology, how to code different procedures and diagnoses, and the computer databases that coding and billing professionals are expected to master to be successful in the field.
- Master's degrees. Medical billing and coding professionals who want to advance in their careers and pursue managerial positions in the field may consider enrolling in a two-year master's degree program in health information management. These degree programs teach students the business behind health care and information technology so they have the tools to manage other professionals.
Medical billing and coding training
Each school that offers a medical coding and billing degree program has its own unique curriculum, but there are subjects generally taught no matter which school students enroll in. The following topics are examples of what students may study:
- Medical terminology
- Medical billing
- Medical coding
- Health care reimbursement methods
- Health care law and ethics
- Health care statistics
- Computer systems
Medical billing and coding certification
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.
The field of medical coding is as vast as the field of medicine itself. Much like physicians who specialize in specific disease pathologies and ailments, medical coders too can specialize. Medical billing and coding certification for medical specialties is available through a number of national organizations: The Board of Medical Specialty Coding (BMSC), The Professional Association of Healthcare Coding Specialists (PAHCS), and The American Academy of Professional Coders (AAPC). Earning these specialty certificates would add a credentialed title that would follow the earner’s name much like those who’ve earned doctorates have PhD behind their names.
Skills and Qualities for Medical Coders and Billers
Medical coders and billers are required to deal with the minutia associated with providing quality care, because if services are not coded properly, it can become a logistical nightmare for a health facility. In order to ensure that the payments flow the way they should, these workers should be detail oriented and have strong analytical skills. In addition, medical coders and billers should have good communication skills because they need to be able to discuss billing concerns with medical professionals; technical skills that allow them to use specialized industry software; and integrity, as they are responsible for handling sensitive, confidential patient information.
Career Outlook for Medical Billers and Coders
In general, health care careers trend upward due to factors like increasingly healthy living and improved technology leading to longer lives, in addition to an aging population. Medical billers and coders might expect to see figures around these job growth and salary estimates:
- AAS Medical Reimbursement & Coding, Bryant & Stratton College, Accessed June 23, 2014, http://www.bryantstratton.edu/degrees/associate-degrees/aas-medical-reimbursement-and-coding
- Certificate in Medical Billing and Coding, Drexel University, Accessed June 23, 2014, http://www.drexel.com/online-degrees/nursing-degrees/medical-billing-coding/index.aspx
- Medical Billing and Coding Classes Online, Penn Foster Career School, Accessed June 23, 2014, http://www.pennfoster.edu/programs-and-degrees/medical-billing-and-coding/medical-billing-and-coding-career-diploma
- Medical Billing & Coding Professional, San Francisco State University, Accessed June 23, 2014, http://www.cel.sfsu.edu/medical-billing/
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- Medical Records and Health Information Technicians, Bureau of Labor Statistics, Occupational Employment and Wages, May 2013, http://www.bls.gov/oes/current/oes292071.htm
- 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