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Not all medical professions involve direct patient care. Plenty of healthcare jobs still allow you to make an impact in the field while working behind the scenes.
Medical billing and coding is one of these professions. It involves analyzing healthcare data and translating it into a standardized code to bill insurance companies and patients. This profession is detail-oriented and technical, but is medical billing and coding hard?
Medical billing and coding might be complex, but it’s certainly not impossible to master. Let’s take a look at what medical billers and coders do.
What Do Medical Billers and Coders Do?
What is medical billing and coding, and what do these professionals do on the job? Let’s dive in.
Role and Responsibilities
Medical billers and coders are the backbone of the healthcare reimbursement cycle. Sometimes, one professional takes on both billing and coding duties. Other times, these duties are handled by separate people.
Medical billers and coders are responsible for ensuring healthcare providers receive payment for their services. When a patient sees a doctor at a clinic, hospital or physician’s office, medical staff records data about the visit. That data, also known as clinical documentation, includes information like diagnoses, procedures and prescriptions.
Medical coders translate clinical documentation into standardized codes. They use specialized coding software and coding classification systems, like Current Procedural Terminology (CPT®), International Classification of Diseases (ICD-10-CM) and Healthcare Common Procedure Coding System (HCPCS) Level II.
Medical billers receive these codes and use them to create a bill, or claim. They then send these claims to the patient’s health insurance company or a federal agency, like Medicare, for reimbursement. If insurance doesn’t cover all of the costs, medical billers bill patients for the outstanding balance.
Succeeding as a medical biller and coder requires a strong knowledge of coding systems and the ability to learn quickly. You’ll need sharp memorization and communication chops.
While medical billers and coders do not provide direct patient care, answering patient questions regarding claims is a part of the role. Medical billers and coders also spend a lot of time in direct communication with insurance representatives.
Medical billers and coders commonly work in hospitals, physician’s offices, management positions, accounting services and nursing facilities.
Other industries need medical coding and billing professionals, too, including insurance carriers, scientific research centers and technical consulting services.
Salary and Job Growth
The median medical billing and coding salary is $46,660 per year, according to the U.S. Bureau of Labor Statistics. Employment in the field is projected to grow by 7% between 2021 and 2031, which is about as fast as other occupations. Over that same period, nearly 15,000 medical billing and coding jobs are expected to open each year.
Top Skills for Medical Billing and Coding
What skills are required for a successful medical billing and coding career? Alongside a thorough knowledge of medical and coding terms, excellent medical billers and coders should possess the following soft skills.
Medical billers and coders interact with other professionals daily, so they must be comfortable with written and verbal correspondence and practice clear, effective communication.
Of course, communication gaps do occur. It is just as important for medical billers and coders to have conflict resolution and problem-solving skills.
Attention to Detail
Medical codes are highly specific, so attention to detail is key. Entering a wrong character into the coding or billing software could throw a wrench in your work. You’ll also need to scan bills for inaccuracies and discrepancies, which requires a keen eye for detail.
Ability to Learn New Software
Medical coders use specialized software to generate medical codes from clinical documentation. Billers use software programs to automate billing tasks, such as verifying patients’ insurance plans, processing claims and submitting payments.
While you’re not expected to master every type of software, you should know how to familiarize yourself with new software as it’s introduced.
Medical billers and coders must regularly meet patient inquiries and requests. This is where great customer service skills come in. You might be asked to explain industry jargon or help a patient understand their medical bill, for example. No matter what patients ask, medical billers and coders should always respond with patience, respect and professionalism.
Medical Billing and Coding Courses
A higher education degree is not necessary to enter medical billing and coding. However, a degree in medical billing and coding, healthcare management or another related field could increase job prospects.
Here are a few courses you can expect to take while completing a billing and coding degree.
Pathopharmacology is the study of human diseases and how they’re treated. In this course, you’ll learn how drug therapy strategies are wielded against various diseases, as well as disease etiology (the causation of diseases), how to spot symptoms, diagnostic measures, dosages and drug administration.
Introduction to Health Services and Information Systems
This course provides an overview of the history and organization of the U.S. healthcare system. You’ll learn about the system’s current challenges and explore the relationships among healthcare network components, including patients, providers and other healthcare professionals.
Basic Medical Terminology
In this course, you’ll learn the fundamentals of medical terminology. Students review the terminology used to describe medical procedures, medications and the human body and its conditions.
Health Insurance and Reimbursement
In this class, you’ll explore common reimbursement and payment methodologies used in U.S. healthcare systems.
Is Medical Billing and Coding Hard?
Medical coding and billing is technical, requires great attention to detail and demands sharp communication and problem-solving skills. This may prove challenging for some, while others might find it fits right into their natural working style.
Education and Training
You don’t need a degree to become a medical biller and coder, but it’s recommended to bolster your resume and job opportunities. Completing an associate degree takes two years, while a bachelor’s degree typically takes four.
After graduating, most medical records specialists take various medical billing and coding certification online courses to enhance their training. Being certified may help you pursue more competitive positions, as certifications demonstrate your expertise in medical billing and coding. Requirements for medical billing and coding certification vary, so check with your prospective provider for details.
Common medical billing and coding certifications include:
- Certified Professional Coder (CPC®)
- Certified Coding Specialist (CCS)®
- Certified Coding Associate (CCA)®
To pass the CPC exam, you’ll need to understand anatomy, the business of medicine, and how to code a variety of patient services. The CPC is recommended for medical coding careers in physician offices.
How long it takes to obtain this expertise varies, but it could take several months—or years—of job experience. It’s recommended to have a minimum of one year of coding experience to become CCS certified, or at least six months of coding experience to become CCA certified.
Beyond medical billing and coding certification training and exams, this profession involves constantly learning on the job. This profession is a good fit for those who enjoy memorization and career-long learning.
Ultimately, becoming a medical biller and coder requires a certain level of rigor and tenacity. But if you’re up for the challenge, it can be a great career fit.
Frequently Asked Questions (FAQs) About Medical Billing and Coding
How do I start a career in medical coding?
If you have experience in a related field like healthcare information management, you can start by searching for billing and coding jobs in your area. Higher education isn’t required for medical billing and coding, so it’s possible to find the right job match without a degree.
If you don’t have previous experience in a related field, you may start with a medical billing and coding training course. This prepares you to take certification exams to advance your career.
How many months is a medical coding course?
How long it takes to complete a medical coding course depends on the program and the student’s enrollment pace. Generally speaking, it takes about one to three years to become a medical biller and coder.
However, you can find courses that fast-track the process. San Francisco State University’s online course can take up to nine months to complete, for example, while DeVry University’s online program takes about a year, depending on qualifying transfer credits.
What is the cost of medical coding training?
The cost of medical coding training depends on the program. Some programs cost a couple thousand, while others cost more than $10,000. You can find online programs, like the medical billing and coding course at the U.S. Career Institute®, for under $2,000.
Some programs offered by public universities are less expensive for in-state students. Santa Barbara City College, for example, charges a $1,748 in-state tuition fee for its medical billing and coding program. Out-of-state tuition costs $12,578.
How much do medical coding certifications cost?
The cost of a medical coding certification depends on which you pursue. The CPC certification exam costs $399 for one attempt or $499 for two attempts, whereas the CCS exam ranges from $299 to $399. The CCA exam fee ranges from $199 to $299.
I'm an industry expert in medical billing and coding, with extensive knowledge and hands-on experience in the field. Over the years, I've delved deep into the intricacies of healthcare reimbursement, coding systems, and the day-to-day responsibilities of medical billers and coders.
Now, let's break down the key concepts mentioned in the article:
Role and Responsibilities:
- Medical billers and coders ensure healthcare providers receive payment for services.
- They work with clinical documentation, including diagnoses, procedures, and prescriptions.
- Sometimes, one professional handles both billing and coding, while other times these duties are split.
- Medical coders use specialized coding software and systems like CPT®, ICD-10-CM, and HCPCS Level II.
- Medical billers create bills using these codes, sending them to insurance for reimbursement.
- If insurance doesn't cover all costs, billers send bills to patients for outstanding balances.
- Medical billers and coders work in hospitals, physician's offices, management positions, accounting services, and nursing facilities.
- Other industries such as insurance carriers, scientific research centers, and technical consulting services also require their expertise.
Salary and Job Growth:
- Median salary is $46,660 per year, with a 7% job growth projected from 2021 to 2031.
- Nearly 15,000 new jobs expected to open each year.
- Strong communication skills for interaction with professionals and patients.
- Attention to detail is crucial due to the specificity of medical codes.
- Ability to learn new software quickly.
- Excellent customer service skills for addressing patient inquiries.
Education and Training:
- A degree is not necessary, but it's recommended for better job prospects.
- Associate degree takes two years, while a bachelor's degree takes four.
- Certification is essential; common certifications include CPC®, CCS, and CCA.
- Constant learning on the job is crucial for staying updated in this dynamic field.
Courses in Medical Billing and Coding:
- Pathopharmacology, Introduction to Health Services and Information Systems, Basic Medical Terminology, Health Insurance and Reimbursement.
Is Medical Billing and Coding Hard?
- Technical and detailed, requiring sharp communication and problem-solving skills.
- Education and training are recommended, involving certification courses.
- Rigor and tenacity are essential for success in this career.
- Starting a career: Experience in a related field or through medical billing and coding training courses.
- Duration of a coding course: Typically one to three years, with options for faster completion.
- Cost of training: Varies, with programs ranging from a couple of thousand to over $10,000.
- Cost of certifications: Depends on the certification pursued, ranging from $199 to $499.
If you have any specific questions or need further clarification on certain aspects, feel free to ask.