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What Does a Career in Medical Billing and Coding Entail?
A medical billing and coding specialist is a healthcare professional that processes patient data like insurance information and treatment records. The primary responsibility of a coding professional is to review clinical statements and assign them standard codes using ICD-10-CM, HCPCS Level II, and CPT classification systems. What medical coding refers to is the process of transferring medical reports into the healthcare common procedure coding system used within the healthcare industry, which helps summarize medical services and document patient conditions and care so that medical records and health information can be stored.
Medical billing, on the other hand, is the process of a coding associate submitting and following up on health insurance benefits claims to receive payments and reimbursement for services supplied by a medical provider. Billers must understand how to read codes within medical documents - the reports put together by medical coders, and from there, ensure that medical providers get paid for the services they perform. Medical billers typically perform a variety of duties on the job: charge entry, payment posting, insurance follow-up, patient follow-up, and claims transmission. They must understand current procedural terminology, general medical terminology, basic anatomy and physiology, and medical billing and coding training in order to code medical records and health information correctly and assure the hospital or medical office gets paid.
As you might expect, a medical billing and coding professional will usually work full-time in healthcare settings: emergency rooms, hospitals, ambulatory centers, insurance companies, medical office, and clinics. However, there are some options for remote or online work. Most employers prefer to hire professionals with coding certification and receiving certification can help workers earn more than they would without the designation. Professional certification for a medical billing and coding specialist can include training and certification exams in order to earn coding certification as a Certified Professional Coder (CPC) or a Certified Coding Associate (CCA). In medical billing and coding programs you'll learn things such as the international classification of diseases, the ins and outs of the healthcare common procedure coding system, current procedural terminology, anatomy and physiology, and more general education that will support you in your billing and coding career.
Below, we’ll look at some of the educational pathways you can take to become a medical billing and coding professional. Here’s a little more about the field, the prospects, and your education options.
Typical Online Medical Billing and Coding Degree Requirements
An online diploma in medical coding and billing can help students prepare for a career as a medical records technician. Students can learn about managing health records through standardized billing and coding practices. Medical billing and coding programs are generally offered through for-profit vocational schools or community colleges and typically take about a year to complete whether they are provided online or in the classroom. On top of the training courses, students usually complete on the job training under the supervision of a working professional.
While you do not need a degree to work in this field, many employers give preference to applicants with an associate or certification, students who wish to create more opportunities for themselves may opt to earn a full online bachelor’s degree in healthcare administration or health information management. Both options will provide students with a background in medical coding and billing and will offer a broader view of healthcare administration as a profession.
We recommend pursuing this path if you’d like to set the tone for a career that allows you to move up.
Typical Medical Billing and Coding Certifications Needed
While not a legal requirement, coders with certifications will be more employable than those without the credential. The American Academy of Professional coders offers several levels of certification. At the entry level, trained billers and coders can sit for the Certified Professional Coder (CDC). The AAPC certification exams span anatomy, physiology, medical terminology, and coding systems—and the association provides 22 specialty certifications for experienced coders, diving deeper into fields like cardiology, pediatrics, and surgery.
The Bureau of Labor Statistics (BLS) reports that the average salary for a certified coder is $51,454, though those with a bachelor’s degree can earn slightly more.
Academic Standards for Medical Billing and Coding Degrees
Online and on-campus associate medical billing and coding programs give students a general education and overview of the healthcare industry, medical procedures, current procedural terminology, anatomy and physiology, and terminology, as well as an in-depth look at the shorthand code used for keeping records within the American healthcare system. In some cases, associate or vocational programs offer credits for internships at a hospital or clinic, so students can gain some experience as they complete their coding degree program. These programs are available from a community college or university and there may be a medical billing and coding online program available as well.
On the bachelor’s degree side, students will be expected to complete 120-130 credit hours of work focused on similar areas as the associate, as well as elective courses and general education requirements. A bachelor’s coding degree program also won’t focus exclusively on billing and coding; they will include more general healthcare learning.
Exam/Experience Needed for Medical Billing and Coding Degrees
Medical billing and coding professionals will need to obtain training before they are eligible to work in the field. That said, most training takes place in the form of a vocational program, throughout a year or so. While this is an entry-level job, candidates need to have a firm grasp of the coding standards used across the US healthcare system.
The most common coding certification is a Certified Coding Associate (CCA), a designation administered through the American Health Information Management Association (AHIMA). Candidates are eligible to take the certification exam after they complete a training program. After a few years in the field, technicians are eligible to sit for the Certified Coding Specialist Exam, which includes either a hospital-based or physician option.
Important Questions to Ask (FAQ)
How long does it take to earn a Medical Billing and Coding bachelor's degree online?
Online medical billing and coding programs are usually called health information management or healthcare administration degrees. These degrees take four years, on average, to complete and students may choose to sit for the Registered Health Administrator exam after graduation. Associate degrees typically take about two years to complete, while vocational training programs are usually about a year.
Those enrolled in an online bachelor’s program may be able to participate in an accelerated track, though keep in mind that accelerated programs may put a lot on your plate at once. Many people choose to enroll in online courses due to a busy schedule or a full-time job, which are both factors that can affect how long it takes to complete your degree. Thus, many students attending online actually take longer to complete their degrees.
How much does a Medical Billing and Coding bachelor’s degree cost?
An online bachelor’s degree in health administration can cost anywhere between $160 per credit hour to $900 for private colleges or out-of-state programs. As such, students will need to look at factors like the school's location, the reputation, whether its public or private, and what fees you'll need to pay on top of the costs of tuition.
Does the online school have the major(s) you’re considering?
You don’t actually need to go to college to work as a medical coder or biller, so finding a training program is a matter of researching schools according to keywords.
Students may take courses from a vocational training program or get an associate in this discipline. Those pursuing a bachelor’s degree may choose to earn their associate degree first and gain some work experience. From there, students may choose to build on their foundation by studying health administration, healthcare management, business, or public health.
With that in mind, you’ll want to look at schools that offer a strong curriculum when it comes to healthcare administration. Courses that cover customer service, medical terminology, medical coding, billing, and communications will all serve you well in a healthcare administration setting.
If you’re only interested in pursuing a career path in medical billing and coding, we recommend looking for an accredited program nearby.
How many students graduate “on time,” in four years?
One thing you might not think to consider is how many students graduate on time—or within that standard four-year time frame. If the school has a low graduation rate, it might be a sign that the faculty and administration have not provided the resources and support students need to succeed. A high graduation rate, on the other hand, is a good sign that a program offers quality education, that required courses are available, and that students have access to help if they get stuck or need guidance.
What kind of accreditation does the online program hold? How is it regarded in the field?
If you’re looking to pursue a bachelor’s degree, you’ll want to find a program offered through an accredited institution, whether you are looking to attend online or not. Accreditation is typically provided through regional organizations, which work to ensure that students receive a consistent experience wherever they earn their degree.
Within the healthcare space, you’ll also want to look out for schools with a Commission on Accreditation of Healthcare Management Education (CAHME). This organization is responsible for setting measurable criteria for healthcare education — and earning the seal of approval from CAHME ensures that you will learn the proper methods for coding, billing, and other US healthcare processes.
Professional Medical Billing and Coding Organizations
AAPC
American Academy of Professional Coders
The AAPC is the world’s largest credentialing body for health information professionals. The organization offers membership, education, certification opportunities, and networking opportunities. AAPC also provides the CPC certification that entry-level coders and billers typically obtain after completing their training. Additionally, they offer several certifications to those who want to specialize in healthcare compliance, medical auditing, document management, or a whole range of coding for different areas of medicine.
AHIMA
American Health Information Management Association
The AHIMA is a professional organization that aims to provide knowledge, tools, and resources to advance health information as an industry. This organization offers several students with merit-based scholarships and offers several resources ranging from white papers to certifications for members. AHIMA also provides coding workshops and provides a code check service that functions as a resource for those with questions about any of the four classification systems used by the industry.
HBMA
Healthcare Billing and Management Association
The HBMA is a nonprofit organization that serves as a resource to billing, coding, and medical information professionals. The site states that the organization is a critical voice in the revenue cycle management industry and provides job boards, advice, and certifications to members.