Medical Billing and Coding

What They Do:

Medical billing and coding is the field in which the billing professional submits a patient's claims to health insurance companies. Once processed, this allows a health care provider to receive payment for services rendered. The same happens for insurance companies, including both private and government-sponsored programs.

There are literally thousands of codes that must be entered - each for multiple symptoms, medications and diagnoses. For this reason, it is necessary for these professionals to receive training and preparation they need to be successful on the job.

Qualifications:

To start working in this industry, you need to receive proper coding training from an accredited school. Most training programs will provide you the education you need to work as a professional billing clerk or specialist. Students should complete coursework that includes coding principles, medical terminology, HIPAA privacy laws and regulatory management. These professionals must be able to interpret insurance plans and calculate precise payments.

Most school offer training in the following areas: Health insurance claim forms, billing management, government programs, health care documentation, electronic data interchange and modifiers, health insurance and managed care.

Medical Coding Certification:

In order to become certified, you must pass the exam given by an accepted professional billing and coding association. Organizations like the AAPC or AHIMA can administer the certification exams for you. Certifications may require an associate degree or formal training at an accredited institution.

Once certified, you can remain so by taking courses, sometimes called continuing education units (CEUs). Professional organizations encourage billers and coders to become certified, but the law does not require it. A biller or coder can take such certification exams as the CMRS, RHIA and others. Certification schools can provide theoretical knowledge for students entering this field.

What They Make:

The annual salary of certified medical coders in the US is between $34,000 and $57,000 a year. Certain specialties like neuropsychiatry coding pay up to $62,000 a year. The hourly pay for coders and billers is between $16-29 per hour based on location, experience and certification.

Professionals with a bachelors’ degree earned, on average, $10,000.00 more per year than coders and billers without a degree. The national average was $51,825.00 for degree-holding professional coders and billers versus $41,802.00 per year for non-degreed coders and billers.

Where They Work:

• physicians' offices

• ambulatory centers

• emergency rooms

• insurance companies.

Career Outlook:

It is estimated that there will be a 13% job increase by 2029. 

Sources:

http://www.medicalbillingandcoding.org/medical-billing-coding/

Updated February 2021