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How to Become A Medical Biller and Coder

Submitted by Joseph Pineiro on Thu, 01/28/2021 - 15:29
medical coding

Medical billing and coding is one of those hot jobs you see on many career lists. It pays well, it's in demand, and it doesn't require a degree. It can even be done from home!

Those facts don't really tell you much about the reality of the job, however. You probably want to know whether medical coding is a good job, how hard it is, and how to get into medical coding or billing. What are the education requirements? What does the future look like?

Let's dive right in, so you can see whether becoming a medical biller or coder is for you.

Medical Billing, Medical Coding, or Medical Billing and Coding?

You may see billing and coding discussed as separate jobs, but they're also often bundled together. So which is it – are they the same or are they different?

Well, the answer is "yes," because it depends.

Medical billing and medical coding are two separate processes. Medical coding comes first. Medical coders' job is to translate the nuanced and complicated reality of patient records into relatively cut-and-dry standardized codes. These codes determine how an insurance company gets billed.

Medical billers then use these codes to file an insurance claim. They often have to follow up with patients, medical providers, and insurance companies to make sure claims are paid.

Larger employers split medical coding and medical billing into separate jobs. This often includes hospitals, health insurance companies, and other large healthcare organizations.

Smaller businesses like doctor's offices combine the roles to streamline the process.

How Hard is Medical Coding? Medical Billing?

Each job has its own challenges – but challenges are what keep these jobs interesting.

Becoming a medical coder is often likened to learning a new language. It's difficult at the beginning and then becomes second nature.

You'll need to become familiar with three different coding systems: the International Classification of Diseases (ICD), the Current Procedure Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS). The first encodes injuries and illnesses, while the other two are both used to encode procedures, services, and equipment.

The more long-term challenge of becoming a medical coder is the detective work it sometimes takes to accurately code a patient record. However, most coders find this to be the best part of the job.

Medical billing, on the other hand, requires excellent people skills and the ability to navigate bureaucracy. You may spend a lot of time interfacing with stressed-out patients and busy medical professionals. It's definitely a job that's better suited for people persons.

The challenge of being a medical biller and coder is to balance these roles. You need the attention to detail and problem-solving skills of a coder and the people skills and patience of a biller.

Is Medical Coding a Good Job? Is Medical Billing?

Yes! Medical coding is a good job no matter how you define the concept. So is medical billing.

The pay is solid for both positions. The average annual wage for medical coders is $42,604/yr (or $18.77/hr). The average wage for medical billers is just a tad lower, at $40,220/yr ($16.46/hr).

Job opportunities are also growing. The U.S. Bureau of Labor Statistics (BLS) projects 8% growth by 2029, which is much faster than average.

And since both careers can be kicked off with a post-secondary certificate program in less than a year, rather than a 2-year or 4-year degree, you can be well on your way to an experienced professional (with little to no student loans) by the time that boom slows down.

Plus, an increasing number of medical billing and coding jobs can be done partially or completely from home!

I've heard AI or Healthcare Reform Will Kill Medical Coding or Billing Jobs

Yup, we've heard that, too.

Although artificial intelligence (AI) is starting to play a role in medical coding, experts say it will never replace human coders entirely.

Think of transcription technology. It's very useful, but it gets a lot of things wrong, and it can miss a lot of the nuance. A human has to review the automated output before it's reliable.

Remember when we said that medical coding involves taking medical records full of gray areas and classifying them into black-and-white coding? That requires human analytical skills and judgment calls. Current AI isn't capable of that, and we're not sure if it ever will be.

The other boogeyman is healthcare reform, or more specifically, single-payer healthcare.

This is unlikely to affect the amount of medical coding that has to be done. But admittedly, medical billing would probably take a hit. One reason healthcare costs are so high in the U.S. is that billing is convoluted and complex. A single-payer system would eliminate a lot of the complications, which would mean fewer people would be necessary to get it done.

Given the current political gridlock, however, single-payer healthcare may not be a realistic outcome anytime soon. If this outcome concerns you, look for career paths that will be the least impacted. And in the meantime, you'll earn a steady income and pick up skills that are transferrable to any number of industries.

What Do You Need to Become a Medical Coder (and/or Biller)?

While medical coder education requirements sometimes extend to a 2-year Associates degree, a certificate program that takes less than a year is often enough to get your foot in the door. You can get into medical coding or billing right away and earn a degree later if you feel it will be beneficial.

Medical Coding Training, Medical Billing Training, or Both

Most schools (including us) offer programs that include both skill sets. This is advantageous even if you only want to specialize as a medical coder or medical biller.

As a medical coder, it can be helpful to understand how your decisions will affect the billing process. As a medical biller, you can benefit from a basic understanding of how coders do their jobs.

Cross-training also makes you more flexible on the job market. Having broader options never hurts.

Medical coder education requirements include medical terminology and abbreviations, classification and coding systems, and health data requirements. You'll spend time applying and practicing the coding process so you're ready to hit the ground running.

Medical billing education includes the fundamentals of medical billing, reimbursement methodologies, and legal or regulatory issues.

Medical Coding and Billing Certification

There are a few well-respected certification programs for medical billers and coders. The one we recommend is the Certified Billing and Coding Specialist (CBCS) designation from the National Healthcareer Association (NHA).

CBCS credentials qualify you for an entry-level billing and/or coding job. The certification is proof that you've mastered regulatory compliance, claims processing, front-end duties, payment adjudication, and coding knowledge.

Whatever credential you choose, certification will make it easier to get a job. You're also more likely to earn higher pay.

Learn Medical Billing and Coding with Us

Our Medical Billing and Coding course includes 390 hours of coursework, which you could complete in 6 months of part-time study.

Tuition includes a voucher for the CBCS exam, so you won't have to worry about the fee, and we'll also provide study guides, practice drills, and a 100-question practice test so you can walk into your certification exam feeling confident that you'll pass.

If you think you'd prefer to work for a smaller practice in a multi-faceted role, you might consider our course for Medical Administrative Assistant with Billing and Coding, instead.

Are you a military spouse? The DOD might be willing to pick up the check through their Military Spouse Career Advancement Account (MyCAA) scholarship funds. Please use the contact form on this page to learn more.