What is medical billing and coding? It refers to the system used by medical facilities to receive reimbursement from health insurance companies. Health care providers rely on medical billers and coders to keep their records accurate and submitted in a timely manner to insurers. Graduates of medical billing and coding programs may be responsible for all the following duties:
- Reviewing patient records for completeness and accuracy.
- Maintaining data in clinical databases and registries.
- Applying clinical codes to patient procedures.
- Submitting data electronically for insurance reimbursement.
- Maintaining the confidentiality of patient records.
Medical Billing and Coding Specializations
Falling under the umbrella of medical records and health information technicians, billers and coders may wear many hats or they may specialize. Often, they fall into one of the following three categories.
- Health Information Technicians: These professionals may perform many functions within an office. They may maintain records and databases as well as track patient outcomes and compile data for storage or reporting.
- Medical Coders: Medical coders have the job most often associated with medical billing and coding schools. They may review patient information for preexisting conditions, retrieve patient records and act as liaisons between the medical provider and the billing office or insurer.
- Cancer Registrars: Cancer registrars compile and analyze cancer patient information, review patient records and pathology reports and assign the proper classification codes for diagnosis and treatment of benign tumors and cancers.
How to Become an Medical Biller
Since medical billers and coders are dealing with complex reimbursement systems, they must have some formal education after high school. Consider these steps to become a medical biller and coder:
- Earn a high school diploma or equivalent.
- Aim to complete postsecondary training -- a certificate or associate degree can help you rise above the competition.
- Gain experience working in the field.
- Consider official certification beyont postsecondary training to improve your career advancement options later on.
When in school, medical billing and coding schools often have a curriculum that teaches all the following:
- Medical terminolog
- Health data standards
- Classification and Coding Systems
- Healthcare Reimbursement Systems
Medical Billing and Coding Degree Programs
Given how much material is taught, you may be wondering how long is school for medical billing and coding. Although these programs must cover a lot of ground, they can usually be completed in two years or less. Your actual time in school will depend on which of the following two routes you take.
- Diploma/Certificate: These non-degree programs may run anywhere from a few months to one year in length. Their curriculum may include courses on medical terminology, types of health insurance and coding practice. Some even include the cost of preparing and taking the exam for medical billing and coding certification programs.
- Associate Degree: An associate degree in medical billing and coding can take two years to complete. It may provide a more in-depth review of medical billing and coding procedures as well as instruction in topics such as electronic medical records. An associate degree may be a good choice for those hoping to move into supervisory positions or who plan to one day pursue a bachelor's degree.
Schools for Medical Billing and Coding
Since much of the work of medical billers and coders is computer-based, this is a field that lends itself well to online learning. You can find a number of medical billing and coding online schools, and these may offer diplomas, certificates and degrees. In addition to textbook instruction, online medical billing and coding schools may use computer simulations to provide students with real-world experience.
Medical Billing Coding Certifications
While a few states may require cancer registrars be licensed, medical billers and coders don't need any government credentials to work. However, many employers prefer to hire those who have obtained a voluntary certification. Medical billing and coding schools often prepare students for these certifications as part of their curriculum.
The following are a few of the medical billing and coding certification programs available:
- Certified Professional Coder (CPC) from the AAPC
- Certified Professional Biller (CPB) from the AAPC
- Certified Billing and Coding Specialist (CBCS) from the National Healthcareer Association
- Certified Coding Associate (CCA) from The American Health Information Management Association
- Certified Coding Specialist (CCS) Certified Coding Specialist (CCS)
- Certified Medical Reimbursement Specialist (CMRS) from the American Medical Billing Association
Additionally, more than a dozen specialty coding certifications in fields such as family practice, obstetrics and gynecology and pediatrics are available from the AAPC and The Professional Association of Healthcare Coding Specialists.
Each certification program has its own criteria. Most require applicants graduate from approved medical billing and coding schools and pass an exam. Some may have work experience requirements as well.
Medical billing and coding career advancement
Medical billers and coders may advance their careers in several ways. By earning additional certifications, such as specialty designations, they may be able to move into new positions. Some professionals may advance to supervisory roles once they have experience while others choose to go back to school for a bachelor's degree. Gaining additional education could lead to a career as a medical or health services manager.
Best Medical Billing and Coding Programs
In order to sort out the top medical billing and coding programs from the rest, we analyzed U.S. Department of Education data on hundreds of community colleges and vocational schools. We looked at variables like total attendance, program availability, graduation rate, online education enrollment and the job market success of graduates. Check out our list and see if one of these programs sounds right for you.
Founded in 1995 as a school for dental assistants, Community Care College expanded its catalog of programs soon after and now offers career training in nearly a dozen specialties. The learning environment here is close-knit -- fewer than 600 students attended in 2018 -- which may have contributed to its top-tier graduation rate.
Medical billing and coding programs at CCC: Two different medical billing and coding programs are offered at this Tulsa school. Students can choose either an 11-month diploma program or a longer degree plan that provides more well-rounded instruction. Whichever program you choose, all courses are available fully online.
This Illinois institution of roughly 5,000 students has been accredited by the Higher Learning Commission since 1973. General education, technical and career education and university transfer education are all part of its mission as a comprehensive community college, and more than one-third of students attend at least some courses online.
Medical billing and coding programs at Lake Land: Billing and coding programs here are packaged as Associate of Applied Science (A.A.S.) degrees in medical coding and health information, or a certificate as a medical coding specialist. Billing topics like medical insurance reimbursement are also covered. The health information coursework serves as a foundation for additional jobs in health care administration.
Established in 1965, this school named for junior college pioneer Dr. William Rainey Harper serves more than 13,500 students each semester. It had the best 2017 retention rate among the schools on our list, and around 88 percent of graduates report still being gainfully employed six years after completing their education.
Medical billing and coding programs at Harper: Two levels of program are offered here: an A.A.S. degree in health information technology (HIT), and a 19-credit certificate in HIT and medical coding. The certificate can be earned on a fast-track plan that requires students to attend classes just two nights a week.
A total of more than 250 degree and certificate programs are available at Sinclair Community College, where the student-faculty ratio is a comfortable 17:1. Sinclair also reported an average out-of-pocket cost of just over $2,900 for students receiving grant and scholarship aid -- one of the lowest among all the schools we surveyed, which may be indicative of why it's also one of the top vocational schools in the U.S.
Medical billing and coding programs at Sinclair: The certificate program in medical billing and coding at this Ohio school consists of 24 credit hours and can be completed in three semesters of full-time study. All courses necessary for the certificate plan have online options available.
The catalog of career training programs at Moraine Park Technical College features more than 100 study plans, including several that can be completed via distance education. The institution of roughly 5,000 students maintains full-service campuses in Fond du Lac, Beaver Dam and West Bend, as well as regional learning centers in Ripon and Jackson.
Medical billing and coding programs at MPTC: The Wisconsin school's technical diploma for medical coding specialists may require either 29 or 30 credits, depending on which anatomy course you choose. All courses on the schedule can be directly transferred into Moraine Park's A.A.S. program in HIT if you decide to pursue advanced career education.
A total of five locations make up the Savannah Technical College system, including an education center on Fort Stewart Army base and an aviation training center at a second Savannah location known as the Crossroads Campus. Students who prefer the option of one-on-one time with professors should be comfortable here, thanks to the 16:1 ratio of students to faculty.
Medical billing and coding programs at STC: The program here is packaged as a technical certificate of credit in medical coding and insurance data. The minimum number of credit hours required to earn the certificate is 28, and it takes at least three school terms to complete.
Joliet Junior College became the first community college in the U.S. when it admitted its original class of students in 1901, and it's held itself to a high standard of education ever since. More than 89 percent of JJC graduates report still being employed six years after finishing their degree plans.
Medical billing and coding programs at JJC: The catalog here doesn't mention medical billing -- the program is known as a medical coding specialist certificate -- but that doesn't mean you won't learn it. Health care reimbursement is one of the eleven courses required in the 37-credit curriculum.
This member of the Technical College System of Georgia serves an 11-county area in the heart of the Peach State. Degrees here have the lowest average net price among all schools on our list, with students paying around $2,550 for a full year of classes after grant and scholarship aid is applied.
Medical billing and coding programs at CGTC: Medical billing and coding training is available through two technical certificate of credit programs: a 20-credit plan for medical billing clerks and a 24-credit plan that covers both billing and coding. Most employers will prefer candidates with skill in both, so choose wisely.
The suburban Chicago campus of Moraine Valley Community College spans nearly 300 acres and features an average class size of 21 students. More than 14,000 learners and trainees attend classes here each semester, and around 85 percent of those enrolled hold down jobs while they work towards their degrees.
Medical billing and coding programs at MVCC: The 41-credit coding specialist certificate here is one of the more comprehensive certificate plans among our top ten schools. Students take in-depth study of medical coding systems like CPT, HCPCS and ICD-10-CM and take two full-term courses in medical billing and reimbursement.
Indiana's Ivy Tech Community College is one of the largest two-year schools in the country, comprising more than 40 locations and educating over 75,000 students in total each semester. Despite its large population and expansive reach, Ivy Tech maintains a manageable student-faculty ratio of 17:1.
Medical billing and coding programs at Ivy Tech: The billing and coding program here can be completed entirely online, and that's not the only flexibility bonus that Ivy Tech students get. It's also an entirely self-paced program, meaning that you're given a 12-month period in which to complete your course requirements whenever works best for you.
Skills and Qualities for Medical Billers and Coders
To excel in this job, you need to have certain traits and abilities. The following are a few of the skills possessed by successful billers and coders.
- Reading Comprehension: - Billers and coders may need to review notes from patient visits to understand what procedures were provided and how care should be billed to insurers.
- Critical Thinking: - Critical thinking skills come into play when medical billers and coders are presented with information that is not clear or an insurer rejects a bill. Workers need be able to determine how best to respond and resolve the issue.
- Near Vision: - Medical billers and coders do much of their work on the computer and must be able to clearly and comfortably read the screen.
- Category Flexibility: - This ability refers to how well a person can group information using sets of rules. It's an important trait for billers and coders who have decide how to group and label procedures for billing purposes.
- Information Ordering: - Similarly, medical billers and coders must follow exact systems for insurers to accept and pay bills, and information ordering is the ability to arrange things according to a set of rules.
Medical Billing and Coding Salary and Career Outlook
What is medical billing and coding salary, you may ask. The chart below provides a range of incomes for professionals nationwide. However, your medical billing coding salary may vary depending on your region, education and certification. Job growth for the profession can also vary across the country. But here's a look at what is expected nationwide for the coming years:
Career | Total Employment | Average Salary | Projected Job Growth |
|---|---|---|---|
| Medical Dosimetrists, Medical Records Specialists, and Health Technologists and Technicians, All Other | 331,790 | $46,590 | -57.5% |
Professional Resources for Medical Billers and Coders
From advocating for workers to offering medical billing and coding certification programs, here are a few resources that are important to the profession:
- AAPC - Previously known as the American Academy of Professional Coders, AAPC has 180,000 members and is the largest healthcare business training and credentialing organization in the world.
- American Medical Billing Association - The AMBA says it represents the gold standard in serving medical billers through certification, free webinars and other services.
- The American Health Information Management Association - Founded in 1928, AHIMA has a long history of supporting the work of health information professionals through certification, continuing education and advocacy.