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As the Medical Billing and Coding Certification (MBCC) website puts it, medical coding and billing is the ‘invisible engine’ of the healthcare system. Medical coding and billing turns the gears of the industry by enabling the transmission of important data as well as the exchange of funds and services.
Online medical coding and billing programs teach both technical skills and medical terminology. Being a medical biller or coder lets you work in healthcare but doesn't require direct patient care. Once employed as a coder or biller, you will be responsible for correlating illnesses and medical procedures to codes in a universal system that is designed to aid healthcare practitioners in billing third-party payment systems. Doctors' offices, hospitals, insurance companies and government agencies all use universal medical codes to track medical activities, interpret trends and bill for services. It helps to be detail-oriented in this field, as you'll be inputting much data. An eye for technicalities will help you succeed.
THE CAREER PATH
According to the MBCC website, the overall process of medical coding and billing is actually separated into two different functions. Both coding and billing each require unique knowledge and skills, although the two go hand-in-hand. The separate roles can be filled by independent professionals or they can be combined into a single professional’s scope of responsibility depending on the size of an agency. It is important for professionals to have an equally thorough understanding of both, and it is common for educational programs to include equal coverage.
Medical Coding focuses on translating medical assessments, procedures, diagnoses, and prescriptions into codes according to the International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS). Medical Billing involves turning medical codes into accurate, legal bills for healthcare providers and sending them to insurance companies and payers. There are separate certifications for the two aspects of this profession, to confirm an understanding of the many different variables that are involved. In general, professionals in this career will have responsibilities such as:
- Reviewing patient records for accuracy and completion
- Using classification software to assign clinical codes for reimbursement and data analysis
- Working as a liaison between health clinicians and billing offices
As a graduate in this field, you'll get to work in healthcare, but on an administrative level. You could work for a physician's office, hospital, dentist, medical insurance company or outpatient billing service. The median pay for a medical records and health information technician—a medical biller falls under that category—is healthy.
To find work, you may need professional certification, such as through the American Academy of Professional Coders (AAPC). This organization offers continued training to keep medical billing professionals updated as regulations change. You could also become a Certified Medical Reimbursement Specialist (CMRS) through the American Medical Billing Association (AMBA). Make sure any online education you pursue meets desired licensing standards.
The United States Department of Labor states that professionals who work with medical records and health information technology make around $38,000 each year. As the health system continues to modernize and digitize, incentives for professionals to advance their education and career will increase. In the next seven years, the demand for medical coding and billing professionals is expected to grow at a rate of 15%—which is more than double the national average for occupations.
WHO IS THE IDEAL CANDIDATE?
Professionals in the medical coding and billing field must be reliable and ethical for the work that they do. Like other healthcare professions, their ambitions must stem from a passion for service. In addition to good character, medical coding and billing requires professionals to be analytical and detail-oriented; there are no little mistakes when it comes to maneuvering finances in the medical industry. Tiny mishaps can cause major delays for patients trying to receive services, or professionals waiting to get reimbursed for the services they have provided.
WHAT SHOULD I LOOK FOR?
No matter what your lifestyle currently looks like, careers in medical billing and coding are easily accessible. A high school level education or its equivalent is most common among professionals in the field, according to O*NET. However, a certificate or associate's degree in medical billing will better prepare you for a position as a medical biller or coder. Much of your work coding and billing will be done on a computer, so a medical billing online degree will be highly focused on technology. You'll learn how to analyze patient records to input the correct information.
Expect to take several classes in medical billing and coding. Your program should also offer classes on medical software commonly used in the field. Other common courses include medical terminology and health-related legal studies. You could seek additional certificates, such as in medical compliance or physician practice management, if you'd like to specialize in a certain field. Billing certification programs will cover topics incluidng Medical Terminology, Medical Insurance Principles, and Medical Billing Terminology. Coding certification programs will place more emphasis on subjects like Pharmacology, Medical Office Procedures, and Medical Records. Both individual programs, as well as joint programs, will cover CPT, ICD, HCPCS, and Medical Ethics.
Expect to pay between $1,000 and $3,000 for certificates in medical coding and billing. Associate’s and bachelor’s degrees can vary depending on schools and program resources. Click on a degree name to view total tuition cost including all fees.