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Medical Billing and Coding

Medical billing and medical coding specialists carry out the communication between healthcare providers and insurance companies. They read patient records, translate physicians’ diagnoses into codes, and bill insurance providers.

Differences Between Medical Billing And Coding

Medical billing and medical coding are certainly related fields. At times you’ll do both, especially when you’re starting out in your career or working at an individual office. However, the specialties do have a few differences.

Roles and Duties

Medical billers gather patient and insurance details, and enter them into billing software. In the career, you will:

  • Collect confidential patient information
  • Generate invoices
  • Handle payments

Certified Coding Specialists (CCS) decipher the documents written by the doctors or nurses and apply the appropriate procedure codes. In the career, you will:

  • Translate patient diagnoses and services rendered into medical codes
  • Submit claims to insurance companies
  • Appeal denials

School & Career Requirements

Medical billing and coding can be learned on the job, but more commonly, those employed in the industry got their start in a local training program. These take as few as 10 months to 2 years to complete. At the end, you’ll have earned a certificate or an associate degree. To enroll, you must:

  • Be at least 18 years of age
  • Have a high school diploma or GED

In school, you’ll cover both medical billing and coding, and learn topics such as:

  • Medical office procedures
  • Electronic medical records
  • Body systems and terms
  • Pathology and pharmacology
  • Billing and insurance
  • Coding diagnoses and procedures

Medical billing or coding specialists must learn to be accurate, protect sensitive and confidential information, and communicate well by phone and email. A good school will help you develop in these areas. Find local medical billing and medical coding training.

Additionally, many employers require certifications. Preparation for these begins in school, and it’s smart to have at least one to your name, at minimum. The two most common certifications for medical billing are the:

  • Certified Professional Biller (CPB) from AAPC, formerly known as American Academy of Professional Coders
  • Certified Medical Reimbursement Specialist (CMRS) from American Medical Billing Association (AMBA)

For coding, the three most popular choices are the:

  • Certified Professional Coder (CPC) from AAPC
  • Certified Medical Coder (CMC) from Practice Management Institute (PMI)
  • Certified Coding Specialist (CCS) from American Health Information Management Association (AHIMA)

Past these, these major certifying bodies have created dozens of targeted, niche areas you can earn additional certifications in.

Benefits Of The Career

Many billers and coders will tell you they like the calm, organized nature of the industry. It’s a good field if you’re interested in medicine, but who prefer to work behind the scenes rather than directly with patients. Here are a few more benefits:

Engaging

Medicine is a serious practice, but if you like strategy and find catching/preventing errors fun, you’re going to enjoy this industry. Once hired, challenge yourself by studying the ICD-10, ICD-10-CM, and CPT manuals. You can progress quickly by learning new ways to bundle and bill—and these books tell you exactly how to do this.

Good Pay

According to the Bureau of Labor Statistics, medical billers in 2022 made an average of $44,800, with the top 10 percent earning closer to $60,480. Medical coders in 2022 averaged $51,090, with the top 10 percent earning $75,460. 

Work From Home

Finally, the perk many strive for is the ability to work from home. Being realistic, before you are hired for a remote job, you may need to start at a smaller doctor’s office to gain experience. Be ready to do front desk tasks like answering phones and setting up appointments. In time, it will become easier to get the jobs you want.

Job Outlook + Career Path

If you’re looking for a career that provides stability, you’ve found it. Medical billing and coding specialists are essential and in demand. Both medical billing and medical coding are expected to undergo growth rates consistent with the national average for all occupations by 2031. 

Medical billing and coding has a good career ladder, as well. Specialize by building your career around an area that interests you and earning its certifications. Those already in the industry say having multiple certifications in a niche brings the best pay and advancement.

Additionally, with training and experience, you can teach the trade or manage a medical office.

Find a medical trade school with local and online medical billing programs and CCS classes.

Reference:

Medical Records on BLS