Health Information Management vs Medical Billing and Coding | CHCP

Health Information Management vs Medical Billing and Coding | How to Choose

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July 12 2024

For aspiring healthcare professionals with a passion for data management and information processing, healthcare administration can be a rewarding career that empowers you to help others. Among the most flexible healthcare roles, administrative healthcare positions come in a variety of specializations and are more likely to offer remote work options — meaning that you can choose your ideal path based on personal strengths and interests.

With the multitude of different titles and roles available in administrative healthcare, it can be difficult to understand which route may be the best fit for you. To help you navigate your options, we’ve put together a comprehensive comparison guide on two of the most common administrative healthcare roles: health information management vs. medical billing and coding. Below, we’re outlining the commonalities and differences between the two, as well as overall responsibilities and career path options for each.

In This Article:

Defining Health Information Management vs Medical Coding and Billing

What Is Medical Billing and Coding?

Medical billing and coding involves the translation of clinical data into standardized, universal codes that can be recognized by insurance providers, government payers, and private payers alike. Medical billing and coding specialists will also record a patient’s insurance information alongside codes to correctly file, charge, and refund claims. They work with insurance companies and other payers to collect payment for services after developing and filing accurate claims. Billers and coders are also in charge of the resubmission procedure if claims are rejected and the appeals process if claims are refused.

For more detailed information, including medical billing and coding salary, career outlook, and job descriptions, explore our Medical Billing and Coding Career Guide.

What Is Health Information Management?

Professionals in the field of health information management (HIM) organize, categorize, and assess the massive amount of medical data created by the healthcare industry. Health information encompasses health data at all levels, including personal privacy and patient rights, staff and facility planning, research, financial rights and information, and technical roles in information administration, such as statistics and data analysis.

Accurately documenting health information is crucial to patient safety. These data experts seek to ensure health information is established correctly, promptly, and securely. To ensure patient information is accurate and enhance patient safety through documentation, they collaborate with all healthcare providers and departments, including physicians, nurses, and lab, radiology, and pharmacy personnel.

Health Information Management vs Billing and Coding | Overview

There are obvious similarities between these two fields, both of which handle and record important healthcare data. The primary distinction between the two roles lies in the extent of their responsibilities: medical billers and coders work within the field of health information management to handle data explicitly related to the healthcare payment process. 

Conversely, health information management professionals work with data in a broader sense. While this can include the same information that medical billers and coders use, it also includes a wider range of data related to the patient and facility. More than this, roles that fall under the umbrella of health information management can sometimes require a secondary step beyond recording, translating, or filing data. Often, higher-level professionals like coding and revenue cycle management specialists will analyze and organize data to create efficiencies within the facility’s processes and systems.

Differences in Roles & Responsibilities

Both medical billing and coding specialists and professionals in health information management will need to demonstrate soft skills such as attention to detail, critical thinking, and organization. Where these two professions diverge is largely dependent on the specific role held by an individual. For example, a medical coding specialist may have a more limited range of responsibilities but a deeper specialized knowledge of coding, while a health information manager may have a working knowledge of many systems and processes with a specialized focus on leading, implementing, and improving those processes. The work environment between the two might be different, as well. Medical billers and coders typically work in insurance environments or medical care environments such as doctors’ offices, clinics, hospitals, and other facilities necessary for treatment or diagnostic services. Someone with a degree in health information management may work for these facilities, or in other sectors such as public health or for government agencies like a department of health or education.

Medical Billing & Coding Responsibilities

The day-to-day responsibilities of a medical biller and coder can vary based on the demands of their work environment, but generally, medical billing and coding specialists are responsible for the following:

  • Clinical Coding. The primary responsibility of medical billing and coding specialists is to assign appropriate clinical codes to various medical services and diagnoses using official classification systems such as the International Classification of Diseases (ICD) and Current Procedural Terminology (CPT). This coding ensures that healthcare providers are reimbursed correctly and efficiently for the services they provide.
  • Verifying Insurance Payments and Claims. Medical billing and coding specialists are also responsible for ensuring the accuracy and completeness of insurance payments and claims. They review claims to confirm that all charges are coded correctly and reconcile payments received from insurance providers to prevent billing errors and facilitate timely reimbursements.
  • Effective Communication. Specialists communicate regularly with patients, insurance providers, and healthcare facilities to address inquiries and resolve discrepancies in billing and insurance claims. 
  • Maintaining Patient Records. Medical billing and coding specialists maintain comprehensive and up-to-date patient information within digital databases to reflect the latest medical treatments and services received.
  • Maintaining Data Privacy and Security Practices. Medical billers and coders must adhere to strict data privacy and security protocols to protect patient information. This includes implementing and following policies that safeguard against unauthorized access and data breaches.
  • Audit and Compliance. Specialists often participate in audits and compliance reviews to ensure that all coding and billing practices meet legal and ethical standards. They assist in the preparation of documentation and reports required for regulatory compliance and internal audits.
  • Training and Development. Medical billing and coding specialists frequently engage in professional development opportunities to enhance their skills and stay informed about the latest trends and changes in the industry.

Health Information Management Responsibilities

Health information management is a more comprehensive field in comparison to medical billing and coding. From medical records technicians to even health information management coding specialists, this facet of administrative healthcare is interwoven with a variety of specializations. Those pursuing leadership roles in health information management will need a foundational understanding of these nuances, as well as the ability to organize and analyze data, perform coding quality control, navigate storage and retrieval systems, and practice data protection processes. Here are a few examples of what the responsibilities of different health information management roles may entail:

  • Data Management and Integrity. Health information managers work to ensure that all patient data, including medical records, lab results, and treatment histories, are accurately captured, recorded, and maintained. They oversee the use of data management systems to uphold data integrity. 
  • Compliance and Privacy. HIM professionals are responsible for ensuring compliance with regulations governing the use and sharing of health information, such as HIPAA. They develop and implement policies and procedures that protect patient privacy and data security. 
  • Information Governance. Health information managers are key to developing strategies that improve the accessibility, usability, and quality of health data. They lead information governance initiatives to ensure that information is accurate, accessible, and secure. 
  • Technology Management. A health information manager may play a significant role in selecting, implementing, and maintaining electronic health record (EHR) systems and other health information technologies. 
  • Coding and Billing Oversight. While they may not code directly, health information managers ensure that the coding and billing processes are compliant, efficient, and accurate. 
  • Training and Education. Health information managers develop and coordinate educational programs for staff regarding new policies, systems, or regulations. 
  • Quality Assurance. HIM managers may conduct regular audits and continuous improvement processes to enhance the quality of healthcare services through better information management.
  • Strategic Planning. Senior health information managers often engage in strategic planning for the healthcare organization. They analyze data to assist in decision-making and planning processes, identifying trends that affect healthcare delivery and organizational performance.

Differences in Education Requirements

Health Information Management Certification & Education

The education necessary to excel in these roles is different, as well. An associate degree is typically the minimum required to work in the broader field of health information management. However, many employers will expect a bachelor’s degree or even a graduate degree from an accredited health information management program, especially when people management is part of the role.

Many of the education requirements and responsibilities related to health information management overlap with other broad roles, including healthcare management, healthcare administration, coding and revenue cycle management, and health and medical administrative services. Those working to become health information managers may choose to pursue degrees within these categories, honing skills that can apply to a number of different positions. 

In addition to degrees in healthcare administration, aspiring health information managers may choose from the following certifications offered through the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC) to demonstrate specialized skills:

Medical Billing and Coding Certification & Education

The path to employment as a medical biller and coder usually requires graduation from an accredited medical billing and coding certificate program. This is because medical billing and coding require different skills and knowledge specific to this segment of health information. For example, medical billers and coders must learn the proper coding languages, such as HCPCS and ICD, and many employers may require certifications such as:

For more information, you can explore our guide to the medical billing and coding certificate program at CHCP

Healthcare Administration & Medical Billing and Coding Programs in Texas | Find Your Program

Regardless of which specialization you may choose, building a foundation of knowledge and critical skills is the first step towards thriving in healthcare administration. As one of the leaders in healthcare education and training, the College of Health Care Professions is here to assist you in finding the career, and education, path that’s suited to you. We have campuses throughout major cities in Texas like Austin, Dallas, Fort Worth, San Antonio, McAllen, and Houston, as well as online program offerings.

Our Medical Billing and Coding Certificate Program at CHCP is available in both online and blended learning modalities and is designed to help you understand, explore, and use current CPT, HCPCS, and ICD code sets for medical billing and coding. Instruction includes fundamental medical billing and coding skills, how to use medical management software, how to read and submit medical documents and billing forms, and how to process insurance claims.

We also offer a variety of healthcare administration programs, ranging from certificates to bachelor’s degrees. If the idea of diving into the world of medical coding and billing, health information management, or healthcare administration excites you, we’re here to help you get started. Get in touch to speak with an academic advisor and get started on your healthcare career today.

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