Joining the healthcare explosion can be the ticket to a long-term, rewarding career in a growing industry. For people who want to avoid frontline medical work, medical billing and coding can be an excellent career option.
What Medical Billers and Coders Do
Billing and coding professionals have three main duties:
- First, the coder translates each medical condition, surgical procedure and diagnostic test into a numeric code known as the ICD or the CPT. This person acts as a liaison between the doctor providing the service and the entity that will pay for it.
- Next the medical coder or biller transmits these codes to the insurance company along with a request for payment. The biller may work with a government agency in the case of Medicare and Medicaid patients. He or she must stay aware of various insurance plans, negotiated agreements and regulatory requirements.
- Finally, the biller tracks how much the medical attention cost, how much was paid by the patient and how much was paid by the insurance company or government subsidy program. The medical billing assistant also calculates the amount that must be written off as a contractual adjustment above the maximum allowable amount.
In small offices a single employee may perform all coding and billing, whereas in a large institution these functions are more specialized.
Medical Billing and Coding Salary and Job Prospects
Full-time coding and billing work is plentiful in hospitals, physician offices and nursing care facilities. Common job titles include medical biller, billing assistant, medical office assistant, records assistant or receptionist. The U.S. Bureau of Labor Statistics reports that medical billers, coders and health information technicians typically earn $21,000 to $32,000 annually. Top performers and tenured professionals can make over $53,000. The nation's aging population equates to more medical treatments and a greater need for qualified billing and coding technicians. An estimated 37,000 jobs will be added to the field by 2020.
Medical Billing and Coding Training and Education
Because healthcare jobs are competitive, having the right education is crucial. At a minimum, applicants must possess a high school diploma. Most employers require a relevant degree or certification. Since the majority of today's medical claims are electronic instead of paper-based, computer familiarity is also essential.
Within medical coding and billing training programs, students explore multiple topics. They learn about medical terminology, coding systems, billing practices, reimbursement processes, claims processing, collections, record maintenance and computer applications. Advanced programs may also feature courses in anatomy and physiology, healthcare statistics and health data standards.
Medical Billing and Coding Certification
These classes often prepare graduates to pass a national exam and obtain a certification. The American Academy of Professional Coders, the American Association of Medical Assistants, the American Medical Billing Association and the American Health Information Management Association are just a few of the organizations that offer certificates. Popular choices include the Certified Professional Coder designation, CPC, the Registered Health Information Technician designation, RHIT, and the Certified Medical Reimbursement Specialist designation, CMRS. Regardless of education, the most successful job candidates are attentive to detail, reliable and eager to enter or advance in the medical field.