What is a Medical Biller and Coder?
For many years, people have assumed that medical billing and coding are the same things.
Well, we are here today to tell you that they are not.
However, you can get a job doing both!
Let’s talk about what exactly medical billing and coding are:
Medical billing involves the billing process in a health care facility.
Medical codes (given to the biller by the coder) are used to put together claims for insurance companies and patients.
Medical coders are responsible for translating medical services into codes.
All of these codes are documented in the patients’ reports and transcriptions.
In order for this job to be effective, there must be constant communication between medical billers and coders, which is why many people do both jobs simultaneously.
Duties
Now that you understand the difference between billing and coding, let’s discuss some of the duties that may be required of a medical biller and coder:
- Read and analyze patient records
- Determine codes for specific treatments in patient records
- Use codes to bill insurance providers
- Interact with physicians and assistants to ensure accuracy
- Keep records of patient data
- Maintain patient confidentiality
These are just a few of the things that you can plan on doing each day, though many jobs will vary on the number of reports and coding needed to be done.
Salary
On average, a medical biller and coder in the United States can make around $40,000 a year.
Those that are just starting out in the career will likely make less, around $38,000 a year.
Once you gain more experience, certifications, and knowledge about the career, a person can make up to $44,000 a year as a medical biller and coder.
Some other factors that may weigh into a person’s salary include the location of where they work, as well as their education level.
Those that have more education and work in higher populations tend to make more money than people who work in rural populations.
Annually National Average Salary: $42,060
Average Annual Salary by State
State | Avg. Annual Salary |
---|---|
California | $39,280 |
Colorado | $39,250 |
Connecticut | $51,830 |
District of Columbia | $51,180 |
Florida | $56,880 |
Georgia | $34,750 |
Illinois | $69,670 |
Indiana | $36,510 |
Louisiana | $28,770 |
Maryland | $31,430 |
Massachusetts | $41,290 |
Michigan | $32,590 |
Mississippi | $41,820 |
Missouri | $54,390 |
Nebraska | $37,920 |
New Mexico | $57,580 |
New York | $49,750 |
North Carolina | $62,030 |
Ohio | $35,150 |
Oklahoma | $31,660 |
Oregon | $42,510 |
Pennsylvania | $45,950 |
South Carolina | $34,780 |
Tennessee | $38,690 |
Texas | $35,120 |
Utah | $35,520 |
Virginia | $40,390 |
Washington | $66,440 |
Wisconsin | $43,800 |
Annual Average Salary: Top 5 States
The top earning state in the field is Illinois, where the average salary is $69,670.
These are the top 5 earning states in the field:
Conducted by: Bureau of Labor Statistics, Department of Labor.
* Employment conditions in your area may vary.
How to Become a Medical Biller and Coder
Step 1Cover the Basics
You don’t want to go into this career without making sure that all of your prerequisites for education are settled first.
This includes having your high school diploma and any other transcripts you may need.
Typically, you’ll have to go through a background check in order to be a medical biller and coder.
This is also a good time to start thinking about getting your Associates’s degree.
Some people who go through medical billing and coding programs even have Bachelor’s degrees.
Step 2Enroll in a Program
Even though you don’t have to have a formal education to become a medical biller and coder, it will help to begin with some education so that you understand the concepts and ideas of the career.
A usual billing and coding program can take from eighteen months to two years to complete.
When looking for programs, you also want to ensure that the one you choose is accredited and that your certification will be valid when you graduate from the program.
Programs that give you qualifications for the Certified Billing and Coding Specialist Exam through the National Healthcare Association are what you want to look for.
Step 3Become Certified
After you complete the program, the next step is to become certified.
Although certification isn’t necessary to work in medical billing and coding, it’s highly unlikely that a prospective employer will hire you without one.
Having a certification shows employers that you understand the material and that your competency in that area is greater than an average person.
There are several different types of certifications you can achieve as a medical biller and coder.
These include:
- Certified Professional Coder
- Certified Outpatient Coder
- Certified Inpatient Coder
- Certified Risk Adjustment Coder
- Medical Auditing Certification
The list goes on.
In order to become certified, you must take an exam and pass it.
You will then be certified for three years, in which you’ll need to renew your certification.
Check online for places to take the exam, it may vary by state.
Step 4Complete an Internship
It’s possible that your program requires you to work in an office for credit.
Other programs do not require any type of experience.
If your program doesn’t allow you to do an internship, you should think about doing one on your own.
This way you’ll be able to get the proficiency you need without all of the pressure.
You’ll likely be working under someone’s wing to learn the ropes.
An internship may also open doors for future careers as well.
Step 5Get Hired
Of course, the final goal in all of this is to get hired!
If you did an internship, you may be lucky enough to land a paying job with the company that you interned with.
However, there are some people who don’t get that opportunity.
Check your local doctor’s offices, hospitals, and clinics to see if they need any help.
The internet has several job search websites that can also help in your quest.
You may even want to think about volunteering some of your time in order to get as much experience as possible.
Medical billing and coding is a difficult job, but if you have the right mindset, you will do fantastic.
Education
It is not a requirement to gain any formal college education to become a medical biller and coder.
However, most people who work in this field state that it is wise to have some formal education, possibly even a Bachelor’s degree, before enrolling in a billing and coding program.
If you decide to get your degree is up to you, but the next step is to enroll in an accredited program that will also lead you toward a certification.
Medical billing and medical coding are two separate things, and so you can take programs focusing on one or both.
You may also be able to find a program online but be wary of these as some of them are scams.
When looking for schools, try and find one that is either certified by the Commission of Accreditation for Health Informatics and Information Management Education or American Academy of Professional Coders, both of these will be great choices.
The standard medical billing and coding program can last anywhere from eighteen months to two years.
Some of the classes that you can expect to take in this type of program include:
- Anatomy and physiology
- Insurance claim procedures
- Insurance law
- Internal classifications of disease
- Medical terminology
- Coding workshops
Among others.
These classes will prepare you for the world of billing and coding.
It is a good idea to take some accounting classes as well so that you understand money and digital transactions.
There are several online programs that you can do from home, but it’s also wise to check out your local community college to see if they offer the program as well.
Many people decide to also do an internship while going to school.
This can help with experience and getting your foot in the door when it comes time to find a job.
Video About The Career
Certification
One of the great things about the medical billing and coding career path is that there are so many different certifications you can obtain.
You can gain certifications in billing, coding, and a variety of specialties within both.
Some of the billing credentials that you may be able to receive from an accredited school include:
- The Certified Professional Biller, by the American Academy of Professional Coders
- The Certified Medical Reimbursement Specialist, by the American Medical Billing Certification
- The Certified Medical Billing Specialist, by the Medical Association of Billers
- The Certified Coding Assistant, by the American Health Information Management Association
- The Certified Coding Specialist, by the AHIMA
- The Certified Professional Coder, by the AAPC
These are just a few of the different certifications you can gain, as well as different places you can receive these certifications.
The Certified Professional Coder is the umbrella certification, this exam has 150 questions primarily as multiple choice.
You will have five hours to complete this test, but you will have opportunities to take a practice exam before the big day.
You must pass the exam with at least 70 percent.
It is not required by law to have a certification in medical billing and coding; however, most employers won’t even look at an applicant if they don’t have one.
A certification shows employers that you are serious about a job and that you are knowledgeable in the field that you will be working in.
Certification exams for other certifications will likely be different than the exam explained here, although they will be around the same length of time.
Another certification, the Certified Medical Reimbursement Specialist gets 45 days to complete their exam, and it is done online.
You must pass this exam to earn certification as well.
If you would like more information about where to go for a certification, check out the American Medical Billing Association’s website.
Certification Example:
Average Training Program Duration: 1-2 Years
The average program to become a certified medical biller and coder can take anywhere from eighteen months to two years.
Many people choose to do their programs online so that they can be in their own home for classes and taking tests.
Both on-campus and online classes will vary in time, but if you want to become certified you’ll need to pass the program.
Once you pass the program, you can become certified.
A certification takes around five hours, and you can get your results back immediately in some cases.
Other certifications may take up to six weeks to get results.
Popular Programs
Job Outlook
Employment for medical billers and coders is expected to rise around 11 percent within the next ten years.
People are getting older within the baby boomer generation, which means more medical services will be rendered.
Those services require someone to bill and code them, which is exactly what you want to do!
All of these new accounts, as well as the use of the internet and digital health records, means medical billers and coders will be needed even more.
If you have a certification in health information or impeccable computer skills, you will have a solid career as a medical biller and coder.
Employment Growth Projection: 9%
2020
2030
That's a higher than average projected growth of 28,600 jobs.
Medical Biller and Coder: Interest Over Time
Should You Become a Medical Biller and Coder?
Overall Satisfaction: Medium
Although medical billing and coding can be a lucrative career, many people feel that there are quite a lot of changes in the industry which makes it hard to enjoy their job.
This doesn’t mean that the job is all bad, many people find it demanding yet rewarding.
Being able to decipher physician documents and code the results for patients can take some time, which can be difficult for some people.
You won’t be moving quickly through papers at your desk with this job, so if you are detail-oriented you will do great in this career.
The hours that you work depend on whether you work in a doctor’s office, hospital, or work from home.
Average Salary: Medium
As of 2019 in the United States, a medical biller and coder can make around $40,000 a year on average.
Typically just starting out, a medical biller and coder will make around $38,000 a year.
Though, with experience and education, you can expect to make as much as $44,000 a year.
In order to make the most profit as a medical biller and coder, you’ll want to make sure you have the correct certifications, any additional skills, and proficiency in the content.
Job Growth Outlook: High
The career outlook for a medical biller and coder looks like it has positive potential.
Studies show that growth will rise around 13% through 2026.
This is higher than many other careers in the same field.
The baby boomer generation is growing older, which means many more people are going to need medical care.
More medical care means more work for medical billers and coders.
Nearly all hospitals and doctor’s offices are going digital with their records, this means that you’ll likely have more work to do as well.
Education Duration: 1-2 Years
Depending on where you go for your program, what state you live in, and whether you do your program online or on-campus, the program you enroll in may take between eighteen and twenty-four months to complete.
Neither program is better than the other, as both will cover all of the basics that are needed in order to secure a career in the field.
It just depends on how many times a week the program classes meet and so on.
Once you finish your program, you are going to want to become certified.
This can take another few weeks in order to get your certification diploma.
Personal Skills Needed
It takes a special person to become a medical biller and coder.
The job requires that you understand medical documents and reports so that you can give that information to insurance companies.
Some of the skills that you’ll need for this job include:
- Attention to detail
- Excellent communication skills
- Customer service skills
- Accounting and bookkeeping knowledge
- Able to work as a team
- Understanding of computers
- Assertive
- Problem-solving skills
Those are just a few of the many characteristics you must have in order to be successful in this career.
If you don’t think you can sit at a computer for quite some time trying to decipher medical transcripts, this is not a job that you will enjoy.
Frequently Asked Questions
Q. How much does a medical biller and coder make?
The average medical biller and coder can make around $40,000 a year.
Those that have more experience and education can typically make around $44,000 a year.
If you are just starting out as a medical biller and coder, you’ll likely make around $38,000.
Depending on where you live and how much experience you have, you can make a great career out of being a medical biller and coder.
Those that live in larger populations will likely make more than people who live in small towns, although since a lot of medical billing and coding can be done online, people who live in smaller populated areas are gaining access to more work.
Q. What does a medical biller and coder do?
It may not seem like it, but there is a lot going on behind the scenes at your local hospital or doctor’s office.
Medical billers and coders are there to support physicians and medical personnel when it comes to various healthcare procedures.
Once a procedure is done, a medical coder will find the code that belongs to that procedure.
After that, the biller sends the code and other medical records to the insurance company.
Q. How long does it take to become a medical biller and coder?
The length of a program can really depend on the program that you decide to go with.
Some programs take as little as eighteen months.
While other programs can take up to two years.
As long as you stick with an accredited program, the length of time that it takes shouldn’t matter too much.
You’ll learn equally as well in longer programs and shorter programs.
Sometimes, longer programs provide internships that can set you up in the future.
Q. Is there a demand for medical billers and coders?
The short answer is yes!
The long answer is that there has been an influx of healthcare procedures being done due to the fact that the baby boomer generation is aging.
More and more people are heading to the hospital or doctor’s office for treatments.
Not only that, but almost every hospital and doctor’s office in the country has gone digital with their files and records.
Q. How much does it cost to become a medical biller and coder?
The cost of your program can also vary depending on which one you choose.
Most technical school programs cost anywhere from $1,000 to $2,500 to attend.
It’s also possible to obtain a medical billing and coding associate degree from some institutes, which can cost a little more at anywhere from $8,000 to $19,000.