How to Become a Certified Medical Biller and Coder [4 Steps to Success]

Are you an analytical, aspiring healthcare professional who does your best behind the scenes?

Medical billing and coding (MBC) could be an optimal career option for you.

Read this guide for:

• Answers to three frequently asked questions from medical billers and coders, and
• Four essential steps on how to become a medical coder and earn certification

FAQ from Aspiring Medical Coders:

What is a Medical Code?

A medical code is a prearranged numeric and alpha-numeric set used across the medical industry. Also called medical classification, this standard code serves as a “shorthand” for medical services, procedures, and diagnoses. Medical codes are used to submit billing and insurance claims to receive payment for healthcare services.

Learn more here.

What is a Medical Biller and Coder?

Medical billers and coders accurately input, manage, and organize patient data in electronic health records. They translate patient information into medical code that can be used by health providers and insurance companies. Medical billers and coders, also known as medical records and health information specialists, are liaisons between clinicians, medical billing offices, and patients, and also function as reimbursement consultants.

What is the Difference Between Medical Billing and Medical Coding?

Medical coders translate patient care into current procedural terminology (CPT) codes. Medical billers create a payment claim based on CPT codes. It is common for professionals to be both medical billers and coders. Most employers value candidates with both skillsets.

How Do You Become a Medical Coder or Biller?

Medical billers and coders typically require a postsecondary certificate to enter the occupation, according to the Bureau of Labor Statistics (BLS). However, specific requirements can vary by employer. Additionally, employers may prefer to hire medical coders who have earned professional certification in the field. Certification may be earned through the successful completion of an examination offered by the American Academy of Professional Coders.

 

Four Steps to Become a Certified Medical Biller and Coder

1. Pursue Postsecondary Training

Medical coders and billers should have postsecondary training, in order to understand the fundamentals of the field and standards for medical code. Completing a medical billing and coding certificate at the postsecondary level exemplifies knowledge and experience in the field. Medical billing and coding students study billing and treatment procedures, regulations and compliance, health information technology, and more.

A typical curriculum in medical billing and coding certificate programs includes courses like:

• Human biology
• Computer applications and medical office software
• Introduction to medical insurance and coding
• Medical law and ethics, and
• Medical office management

In Goodwin’s medical billing and coding certificate program, learners also gain practical training experience through Capstone projects and internships. This builds skills such as:

• Analytical skills, which are needed to understand and further translate patient medical records and diagnoses in the most accurate and efficient way
• Attention to detail, which will ensure accuracy when recording and coding patient data
• Integrity and a strong sense of ethics, as medical coders work with confidential patient data
• Interpersonal skills, as medical coders may need to discuss patient information and any discrepancies with other members of the healthcare team (including physicians and finance personnel)
• Technical skills and a working knowledge of electronic health record (EHR) systems and coding and classification software, both of which are necessary for the day-to-day role of the medical coder

Medical billing and coding certification programs also prepare learners to take the Certified Professional Coder (CPC) exam.

2. Become a Certified Professional Coder (CPC)

The Certified Professional Coder exam is offered by the American Academy of Professional Coders (AAPC), and it is the standard entry-level coding certification for medical practice coders.

Flexible medical billing and coding certificate programs, like the one at Goodwin University, offer evening and online classes so learners can study at their convenience, get CPC certified, and start working in as few as 12 to 18 months.

Goodwin’s medical billing and coding certificate program proudly elevates occupational outcomes and develops its students into essential medical billing and coding professionals.

3. Advance Your Career with Additional Credentials

After gaining experience as a certified medical coder, professionals may consider specialty coding certifications in areas such as ambulatory care, family practice, and general surgery, among others. The additional credentials can increase career opportunities, the potential for higher pay, and substantial job satisfaction.

Examples of three American Health Information Management Association (AHIMA) credentials include:

• Certified Coding Associate (CCA)
  After six months of working experience, medical billers and coders can obtain a Certified Coding Associate credential, a nationally recognized achievement in health information management.
• Certified Coding Specialist (CCS)
  Medical coders with at least two years of work experience or one year of experience plus a secondary credential can take the CCS credential. The CCS is for medical coders skilled in classifying patients’ medical data in hospital settings.
• Certified Coding Specialist — Physician-Based (CCS-P)
  Medical coders with at least two years of work experience or one year of experience plus a secondary credential can also take the CCS-P credential. CCS-P is for medical coders who specialize in physician-based settings.

4. Maintain Medical Billing and Coding Qualifications with Continuing Education

Depending on the number of certifications earned, the AAPC and AHIMA require medical billers and coders to re-certify their credentials every two years through continuing education credits. Continuing education units can be acquired through association meetings, educational programs, formal presentations, published academic work, and more.

Optimistic Job Outlook for Medical Billers and Coders

Medical billing and coding professionals can work in various career settings — hospitals, clinics, insurance companies, government agencies, and more.

According to the U.S. Bureau of Labor Statistics, the national median pay for medical billers and coders as of 2020 was $45,240 annually.

From 2020 to 2030, the medical billing and coding profession is expected to grow 9 percent, accounting for 34,400 job openings yearly for medical records and health information specialists.

Obtaining a medical billing and coding certificate from a career-focused institution proves a great return on investment — allowing students to save time and money on school. By enrolling in an accredited medical billing and coding program, learners gain elemental skills for entry-level careers and evolve into respected, knowledgeable, and well-compensated professionals.

 

Are you interested in becoming a certified medical billing and coding specialist?

Click here to learn more about a medical billing and coding career!