Introduction
In today’s healthcare industry, the importance of medical coding cannot be overstated. Medical coders play a crucial role in the healthcare system by translating medical data into standardized codes.
These codes are essential for insurance reimbursement, medical research, and maintaining accurate patient records.
As of the critical nature of their work, it is important for individuals to become certified as a medical coder in order to ensure accuracy and compliance with healthcare regulations.
Many medical coders pursue a degree in medical coding to gain the necessary knowledge and skills for this profession.
The job as a medical coder is in high demand, and the path to becoming a medical coder is a promising one for those interested in working in the healthcare field.
In addition to accurate coding, medical coders also need to have a strong understanding of medical terminology, anatomy, and physiology.
With the increasing importance of electronic health records and the need for accurate coding, the role of medical coders is only expected to grow in the coming years.
Therefore, getting a career in medical coding is not only important for the individual, but it also serves a critical function in the healthcare industry.Â
So, let’s get started!
Become a Medical Biller
Medical billers are important figures in the healthcare industry, but they are distinct from coders. Billers play a key role in communicating with patients, providers, and insurance companies to ensure proper payment for medical services.
They must have high-level communication abilities to handle these tasks. Unlike coders, they are more likely to interact directly with patients when discussing medical bills.
Medical billers are responsible for using software to file claims with insurance companies and government agencies like Medicare. They also notify patients of any amount due that is not covered by insurance.
Other tasks of medical billers may include verifying insurance coverage and pre-authorizations, correcting statements and payments, setting up payment plans, collecting past due accounts, and appealing denied insurance claims.
Billers must stay knowledgeable in HMO/PPO, Medicare, and Medicaid coverage.
A Certified Medical Coder
Medical coders are tasked with assigning codes to medical terms. This could relate to treatments, procedures, equipment and services. All of these codes must be entered into a billing system correctly.
By doing this, healthcare providers can get the right payment for the services they provide, either through insurance or through direct payments from the patient.
Medical coders ensure that billing and payments are correct and comply with all regulations. They generally work alone but need to stay in good communication with medical billers, doctors, nurses, and office personnel. They need to understand the different roles in the health care setting.
Medical coders have varied day-to-day tasks depending on where they work. Common responsibilities include:
- analyzing patient records and clinical reports
- researching payment info
- translating medical info into codes for billing
- keeping up with federal and state compliance
- doing audits for accuracy
Average Earnings of Medical Biller and Coder
The medical secretary job has a median yearly pay of $37,450. This figure can vary depending on where the job is located, which kind of office it’s in, and how much experience the person has.
People with more experience can get a higher salary, while those with less experience will get a lower one. Location can also be a factor – for instance, medical secretaries in larger cities usually make more than those in smaller towns.
The U.S. Bureau of Labor Statistics data shows that medical secretaries in the professional, scientific and technical services field earned a median salary of $47,150 in May 2021.
Medical billing and coding specialists in state government roles also earned a slightly higher median wage of $46,950 in the same month. The 10% highest earners in the field made more than $63,100, while the lowest 10% earned no more than $29,040.
According to UMA’s 2020-2021 graduates of its Medical Billing & Coding diploma and associate degree program, they reported an hourly median wage that is approximately equal to or just below the lowest 10% wage for the industry.
Earning your CPC can increase your income when combined with work experience. The AAPC offers this certification in the field of professional coding. Get your certification and get ahead!
Job Outlook for Medical Billing and Coding Certification
If you’re looking for a career in healthcare, medical billing and coding could be a good option.
The Bureau of Labor Statistics predicts an 8% increase in employment of medical secretaries, including medical billing and coding specialists, by 2031.
That means around 53,600 new job openings in the coming years. More people are getting medical care as the population ages, so more medical records have to be updated and more insurance claims processed.
If you work in medical billing and coding, you can be sure that your career will continue to be in demand.
More healthcare claims mean rising demand for this skill set. Qualified people are needed to organize and code the data involved with these claims.
Electronic systems are increasingly used in healthcare, and those trained in using this technology have better job prospects. Certified medical billing and coding specialists will benefit most from the faster-than-average growth in employment opportunities.
How to Become a Medical Coder?
1. Requirements
Becoming a medical coder starts with meeting certain requirements.
- A high school diploma or equivalent is necessary.
- Drug abusers or those convicted of sex crimes are not eligible.
- The job requires good social skills, as coders work with a diverse range of people like doctors, nurses, insurance agents and coding experts.
2. Complete Medical Coding Training Course
To become a medical coder, no formal qualifications are needed, but employers usually prefer applicants who have a certificate that proves they know the basics of medical coding.
Gaining this certification is relatively fast and the skills acquired will make you an attractive candidate. Medical billing and coding training courses offer this knowledge and prepare you to confidently enter the healthcare field.
An introduction to medical coding includes learning about Coding Foundations, ICD-CM Coding, ICD-PCS Coding, Ambulatory Care Coding, and Revenue Cycle and Billing.
Doctors and other health professionals rely on coders to accurately document medical records. With the right training, you can build a career transforming healthcare.
Healthcare organizations across the US and around the world use different medical coding classification systems.
In the US, healthcare professionals primarily use ICD-10-CM for their work. This system includes 7-digit codes that cover anything that can lead to sickness, injury, or death.
It has over 69,000 classification codes that list out conditions and diseases, toxins, cancers, injuries, causes of injuries, and activities being performed when the injuries happened.
Healthcare professionals use ICD-10-CM to document if medical treatment was necessary and for tracking purposes.
Medical professionals use codes to describe the services they provide, such as the Current Procedure Terminology (CPT) codes. Drugs are identified with National Drug Codes (NDC). Dental offices use the Code on Dental Procedures and Nomenclature (CDT).
Hospitals practice the International Classification of Diseases, Procedural Coding (ICD-10-PC). These codes help doctors and other healthcare workers to accurately report, track, and identify their services.
3. Pass the Medical Coding Certification Exams
After finishing your medical coding training, you may want to get certified to show that you have the skills required. Having a medical coding certification can help you get a job in the exact setting you want.
The Certified Professional Coder (CPC) is seen as the top standard for medical coding in the physician’s office. If you have it, it proves that you know how to review medical records and organize them into the right codes.
The CPC certification exam tests a person’s knowledge of how to appropriately use medical codes to document services that physicians provide. It assesses a person’s understanding of anatomy, physiology, medical terminology, coding regulations and guidelines.
To get the most out of the exam, make sure to study, practice and get some rest before the day arrives. That should help you feel more confident and do your best.
4. Gain a Coding Job
If you’re looking for a new job, medical coding could be just the opportunity you’re after. Many doctor’s offices, hospitals, clinics and other healthcare facilities need coders to manage their medical information.
In fact, the Bureau of Labor Statistics expects the demand for medical coders will keep increasing. So why not give it a go? This could be your chance to break into an exciting and growing industry.
With the American Association of Professional Coders (AAPC) network, coders stay up-to-date on changes in their field. Plus, it’s a great way to make connections and learn from experienced people.
You never know when a networking opportunity will lead to a new job. With AAPC your network is aware when a coding-related job comes up, maybe even one perfect for you – so they can recommend you for the job.
5. Get Advanced Certification in Medical Coding Program
Coding experience can give you a big advantage in the job market. A Certified Coding Associate (CCA) certification will show potential employers that you know coding in any healthcare setting, from hospitals to doctor’s offices.
Or, if you have work experience, getting a more advanced certification can help you get better jobs and make more money. A Certified Coding Specialist (CCS) certificate demonstrates expert coding skills.
Start climbing the ladder and widen your job options today – get training and certifications in coding.
American Academy of Professional Coders
The American Academy of Professional Coders helps medical coders take their careers to the next level. They offer different certifications, so coders can demonstrate their proficiency and advance in their field.
The AAPC also provides resources and networking opportunities for coders to build their career.
1. Certified Professional Coder
People who become Certified Professional Coders have special skill sets. They are trained to review documents, analyze medical encounters, and code for physician offices and advanced health providers. CPCs have the knowledge needed to correctly do this important work.
2. Certified Outpatient Coding
For medical coders looking to work in an outpatient hospital or ambulatory surgical center, the Certified Outpatient Coding exam is the perfect way to prove your skills. It tests your ability to accurately code for outpatient and emergency care work. If you are looking to start a career in medical coding, this certification is essential.
3. Certified Inpatient Coding
Hospital and facility coders can obtain CIC certification. The CIC exam assesses these professionals’ skills in ICD-10-CM and ICD-10-PCS coding. Becoming certified in this specialty will help you stay up to date with the latest coding practices.
4. Certified Risk Adjustment Coder
Becoming a Certified Risk Adjustment Coder (CRC) is an important step towards being able to determine accurate risk scores for patients. By doing this, providers are able to get the funding they need to take care of and support high-risk patients.
Advanced Certifications
1. Certified Professional Medical Auditor
People who hold the CPMA certification have special expertise when it comes to medical documentation, scope of analysis and statistical sampling, as well as risk analysis for coding and quality assurance.
This advanced certification ensures that professionals in the medical insurance field can make accurate decisions and provide trustworthy services.
2. Certified Documentation Expert Outpatient
Coders with extensive experience in outpatient services documentation and quality measure reporting can look into getting the Certified Documentation Expert Outpatient (CDEO) certification. This could allow them to build upon their skills and take their career to the next level.
3. Certified Physician Practice Manager
Certified Physician Practice Managers (CPPMs) specialize in managing physician practices. With this credential, you can move up the healthcare ladder and take charge of multiple different fields.
If you have experience in healthcare, getting your CPPM is the next step in your career. It’s a great opportunity to enhance your knowledge and stand out from the crowd.
4. Certified Professional Compliance Officer
Coders looking to become certified in managing healthcare compliance programs can pursue certification as a Certified Professional Compliance Officer (CPCO).
This certification means they have proven expertise in this area and can help their organization create better compliance programs.
Qualifications Required for Medical Billing and Coding Program
Employers looking to hire medical billing and coding specialists often have different job requirements.
People might be able to work in the field without prior education, but some employers may require a diploma or associate degree. Additionally, some employers may require industry certification.
Medical billing and coding specialists need more than just education requirements to do their job. The U.S. Bureau of Labor Statistics (BLS) lists important qualities for medical secretaries. These include:
- People in the medical coding field need strong decision-making skills. These skills help them review medical records and diagnoses to figure out how to code the information in a patient’s medical record correctly.
- Good organization is essential for keeping accurate records and entering patient information. This includes the ability to carefully track data and code it correctly.
- Medical secretaries need to be good communicators and have excellent people skills. They must be able to handle stressful situations like billing conflicts and insurance rejections with ease.
- Medical secretaries should have good writing skills, including grammar, professionalism and accuracy. Good email communication is a must for this job; honing these skills is beneficial.
Technology Skills Needed to Work in Billing and Medical Coding Job
Working in medical billing and coding requires having a range of tech skills. Each employer may use different programs and apps, but they all need you to use the same program to get basic tasks done. You’ll need to be comfortable with a computer and the program they give you to do your job.
Medical billers and coders need to be familiar with different types of technology, such as accounting software, databases, medical coding tools, word processing programs and more.
They learn some of these technologies through their education, and others are picked up while on the job. It’s important for them to know the Healthcare Common Procedure Coding System (HCPCS) and Electronic Health Record (EHR) programs.
By having a strong knowledge of these technologies, they’ll be better prepared to handle medical billing and coding tasks.
How Much Time Does it Take to Become a Certified Professional Coder?
To become a medical coder, it typically takes two years to earn an associate degree. Alternatively, shorter certfication programs are also available, with some taking anywhere from nine to twenty months to complete.
Where do Medical Coders Work?
Medical coders can work in many different places like doctors’ offices or health care centers. Some coders work in-office, while others may be able to work remotely. Here’s where you can usually find them:
1. Consulting Services
The Medical coders help ensure accuracy of medical records. They may work in certain health care offices, travel for their job, or work from a distance. Professional consultants can also teach others how to code properly. Having someone to check the accuracy of these records is an essential part of the job.
2. Government agencies
Government agencies regularly hire medical coders. This includes the Army National Guard, US Air Force, and the Department of Veterans Affairs. Medical coders help the agencies run more efficiently and accurately.
3. Hospitals and Clinics
Medical coders often find work at hospitals and clinics. These facilities often require multiple coders to manage their billing processes. Coders help to ensure that claims for medical services are submitted correctly, helping to keep the costs of healthcare organized and manageable.
4. Insurance Companies
Insurance companies need skilled medical coders to check for accuracy and validate medical claims submitted by health care providers. To do this task, medical coders must have considerable expertise in medical coding.
5. Nursing Homes and Assisted Living Facilities
Nursing home medical coders help seniors in assisted living facilities, hospice care centers, residential nursing homes, and other places. They use special codes to bill for services related to elderly care. Their work is important and ensures that seniors get the assistance they need.
6. Remote work
Many healthcare providers outsource their medical coding to trained professionals. The great news is that some of these coders can do their work remotely. All they need is the right training, an internet connection and a reliable computer.Â
Employers may hire remote coders full-time, part-time or as freelancers. When dealing with people’s medical records, employers must uphold the requirements of HIPAA privacy and security.
Conclusion
Thus, there are numerous benefits to becoming a medical coder and medical biller. One of the main advantages is the opportunity to work in the healthcare industry without having to directly provide patient care.
Medical coders and billers play a crucial role in the management of patient medical records and health information, ensuring that all information is accurately documented and coded for billing purposes.
This career also offers the potential for professional growth and development, as medical coders may choose to specialize in certain areas of healthcare, such as outpatient or inpatient coding.
Additionally, the demand for skilled medical coders and billers continues to grow, providing a sense of job security and stability. Furthermore, a career as a medical coder can also be financially rewarding, with the potential for competitive salaries and benefits.
While medical coding requires specialized training and knowledge, the skills learned can be transferable to various work settings and provide individuals with the flexibility to work in different healthcare environments.
Overall, pursuing a career as a medical coder and biller offers numerous advantages and opportunities for individuals looking to work in the healthcare industry.Â
Good Luck!
