The modern healthcare field relies on many types of highly trained professionals to keep operations running smoothly. Elite skills are just as important in administrative duties as they are within clinical settings. That’s why there is a need for hardworking medical coders and billers to improve revenue and serve as a link between patients, providers, and insurance companies.
Medical coding and billing is unique among healthcare positions because it doesn't require a two- or four-year degree. This career path is straightforward - earn a certificate, complete necessary exams, and enter the field. This makes medical coding and billing a compelling option for aspiring administrative professionals who are analytical thinkers and pay attention to details.
In this medical coding and billing career guide, we cover everything you need to know about this important part of the healthcare system. You'll discover what it takes to achieve success as a medical biller or coder — and what you can expect for job outlook and pay once you get your certificate.
What Is Medical Coding and Billing?
Medical coding and billing are core components of healthcare administration. They allow clinics, hospitals, and other facilities to improve the revenue cycle while providing seamless service for their patients.
Professional coders and billers work hard to ensure that their facilities consistently receive patient payments and insurance reimbursements.
Technically speaking, medical coding and billing are separate procedures. Coding involves gathering data from medical documents and determining which language or codes apply. They can be classified based on the types of codes used or by where the procedures take place. With billing, those codes are then used to form claims, which are first paid through insurance and then by the patient.
While coding and billing are clearly different and may be handled by separate professionals, these processes must function seamlessly to optimize administrative procedures. Many professionals seek training in both areas. From there, they can specialize according to their unique talents and interests.
The Need for Medical Coding and Billing
Medical coding and billing play a key role in every aspect of the healthcare industry. Proper coding and billing procedures are essential for making sure that medical practices are correctly paid for all services made.
As medical claims are covered by both insurance and individual patients, it is important for facilities to maintain a reliable payment process. This can limit the chances of patients being overcharged.
Demand for Medical Coding and Billing
Demand is incredibly high for qualified administrative professionals and throughout healthcare, but especially for medical coding and billing.
According to the Bureau of Labor Statistics (BLS) (categorized as "medical records and health information specialists), the job outlook between 2021 and 2031 is a 7 percent growth. In the next 10 years, the field is expected to gain an additional 14,900 positions.
Medical Coding and Billing School Requirements
The typical path to becoming a medical coder or biller begins with taking classes and earning a certificate through an academic program, followed by passing a certification exam. From there, professionals can find entry-level medical coding or billing positions with a variety of employers.
Medical coders and billers must develop targeted skills so that they can navigate tens of thousands of codes, plus complex insurance claims. After receiving their certificates, they must also have a clear understanding of healthcare privacy laws.
Key concepts covered while seeking a medical coding and billing certificate include:
Health Information Portability and Privacy Act (HIPAA)
Basic medical terminology, including symbols and abbreviations
Digital records management and electronic billing
Insurance programs, including private insurance, workers' compensation, disability benefits, and more
ICD code systems and procedural coding guidelines
Training may involve a combination of lecture-oriented learning and lab experience with students completing multiple research projects along the way. These programs should also prepare students for certification exams.
Once students have completed online or classroom-based coursework, they are ready to apply their new skills and knowledge in a variety of practical settings. Hands-on learning is vital to success, so students can benefit from completing externships.
How Long Does It Take to Become a Medical Coder and Biller?
A specialized coding and billing certificate can take less than a year. The College of Health Care Profession’s (CHCP) Medical Billing and Coding Program lasts around 38 weeks for the on-campus program and 48 weeks for the online program. Programs are divided into modules, which include lectures, labs, and externship experience.
Some medical coders and billers may choose to take an extra step in their education and get an Associate of Applied Science in Coding and Revenue Cycle Management. This degree prepares administrative professionals for success in a wider range of positions. In general, these managers make sure that processes involving coding and billing are run smoothly by streamlining interactions between patients, providers, and insurance companies. The CHCP AAS program takes around 22 months to complete.
Medical Coding and Billing Job Description
Medical coding and billing jobs can be diverse. Sometimes, employees are exclusively a medical coder or medical biller, while others are responsible for both tasks. A lot depends on where they work, as well as their day-to-day tasks.
Common responsibilities include:
Assign clinical codes using official classification systems
Compile and organize patient information through digital registries or databases
Review patient information to determine preexisting conditions or other relevant concerns
Verify the accuracy of insurance payments
Follow-up on denied or unpaid claims
Answer inquiries from patients or insurance providers
Opportunities for advancement exist in medical coding and billing, with some taking on roles to supervise medical coding or billing departments, or making sure that employees and their work is efficient and accurate.
Where Do Medical Coders and Billers Work?
Medical coders and billers can be found in a variety of healthcare facilities. These range from physician's offices and specialty clinics to outpatient surgery centers and hospitals. Some work with government agencies, often focusing on Medicare or Medicaid reimbursements.
Schedules vary from one place of employment to the next, but medical coders and billers are often able to work 9-to-5 hours. Hospitals or other 24-hour settings may call for evening or overnight shifts.
Increasingly, medical coders and billers can complete most or all of their work from the comfort of home. Remote coding and billing jobs have grown quite popular over the years and the pandemic caused a dramatic increase.
Many remote positions are full-time, although part-time jobs are also available. Some remote employees work on a contract basis or serve as freelancers for added flexibility.
Medical Coding and Billing Salary
Earnings can vary a lot based on work environment, state, and region. Coding and billing specialists in cities tend to earn more than those serving in rural locations.
Pursue Your Dream Career in Medical Coding and Billing
CHCP offers a Medical Coding and Billing Certificate Program that will thoroughly prepare you for the many opportunities and challenges that this role presents. Our on-campus program is offered through blended learning and meets in-person just two days a week. Our online programs offer hands-on labs on the weekends. Contact us today to learn more about our Medical Billing and Coding Programs or to get started with your application.