by Rachael Fishman
The health care industry is one of the largest in the country, providing Americans with over 14.3 million jobs across 595,000 different institutions. According to data from the U.S. Bureau of Labor Statistics (bls.gov, 2012), 5.6 million jobs in health care are expected to be created between 2010 and 2020. Physicians, surgeons, nurses and managers at medical centers are unable to manage entire facilities on their own--many functions are often sourced to trained professionals to keep records and finances in order. Hospitals, insurance companies, diagnostic labs, pharmacies and private practices are looking to hire employees with the proper medical billing and training to help run their respective facilities, collect reimbursements and document important patient information.
Individuals in this occupation are most commonly referred to as medical billers and coders. They are, however, known by other names as well--governmental agencies, such as the bls.gov, and other organizations indicate these persons as health information technicians or medical records and health information technicians.
One common misconception is that medical coding and medical billing programs are one in the same. These two programs and subsequent professions are often grouped together because of shared tasks and end goals: process and maintain accurate records to receive payments. Students sometimes have options to attend a dual program that encompasses both fields, and both of these complementary jobs can be done by one skilled individual. Some of the differences between the two specialties are highlighted below.
- Medical coders review doctors' notes, laboratory test results, imaging studies and patient charts to confirm all documented procedures have been administered. Medical coders must record all services rendered, assign the code associated with each service, then send this data to the medical biller so the reimbursement claim can be delivered to the proper location.
- Medical billers are responsible for collecting money for their health care facility. They must become familiar with alphanumeric codes which represent many different medical terminologies, conditions and procedures. These codes are used to bill patients and distribute claims to their insurance companies.
- Medical auditors analyze medical charts and make sure every rendered service complies with health care guidelines. They must maintain patient confidentiality, check accuracy of coding and minimize documentation and billing errors.
Another misconception is that completion of medical billing and coding programs automatically qualifies an individual for employment in the field. While completing an accredited program does matter, employers may require additional professional certificates, exams or experience prior to hiring candidates.
Before deciding to pursue a medical billing or medical coding certification, consider the following questions.
- What types of programs and courses do medical billing and coding schools offer?
- What are some differences between campus-based and online training programs?
- What are my post-degree, medical billing and coding certification requirements?
- What is the typical medical billing and coding job environment?
- What are my job functions as a medical records technician?
- What types of individuals have the most success in a medical billing and coding career?
- What technological skills will I need to develop during my medical billing training?
- Will I need continued medical coding training in the future?
- What is the average medical billing and coding salary?
- What are future growth projections for medical billing and coding careers? How does the economy or government affect career outlooks?
- What other possible career paths are available to me after completing my medical billing and coding program?
- What should I ask counselors at a prospective medical billing and coding school?
Prospective students can read CareerColleges.com's interview with medical billing instructor, Kathleen Seyfried, to gain more insight into medical billing and coding schools. Our interview with medical biller, Jaclyn Ly, can help to gather more information about the day-to-day responsibilities and tasks associated with this profession.
What types of programs and courses do medical billing and coding schools offer?
There are a variety of programs that offer flexible and challenging curriculums. Typical coursework focuses on software competency, written communication skills, health care transcription and medical terminology. Schools offer different types of programs varying in length, accreditation and specialties. Many programs provide students with additional employment resources, such as association memberships, resume tips and career advisors. Concentrated medical billing and coding programs are usually not available at the bachelor's or master's levels, but some schools do offer related courses as part of a larger health care degree program.
- Certification/diploma programs provide focused curriculum geared to help students pass professional certification exams and begin work in entry-level positions. Medical coding classes include medical records management, anatomy, Current Procedural Terminology (CPT) coding and physiology for mechanical structures. Diplomas and certificates are typically earned in nine months to a year.
- Associate degree programs build upon core offerings at the diploma and certificate levels, rounding out basic curriculum with courses that instill savvy business acumen as well as other transferable communication skills. Medical billing courses help students understand the effects of billing and coding on cash flow; develop competent time management skills; and demonstrate career management tips. Because of its extensive studies, associate programs require at least 18 months to complete, with a more typical timeframe of two years. Students may have the option to continue onto a related bachelor's degree program if they wish, leveraging credits already gained upon receiving their associate degree.
What are some differences between campus-based and online medical billing and coding training programs?
Campus-based medical billing and coding schools provide face-to-face instruction in many locations across the country. Some on-campus programs may even be offered in the evening or on weekends to cater to students' varying schedules. Many programs now incorporate online instruction into the curriculum, providing extra flexibility for those less able to travel. Some career colleges provide opportunities for students to participate in apprenticeship programs or externships, allowing current students the ability to gain valuable, real-life work experience.
Many medical coding online courses are available as well, enabling remote interaction with classroom material and communication with peers. Online programs are great options for stay-at-home parents, full-time workers or anyone with a restrictive schedule. Lectures may be conducted via live webinars or recorded for convenient access at any time. Instructors delegate homework, exams and other assignments through virtual portals, and required work can oftentimes be completed remotely.
What are my post-degree, medical billing and coding certification requirements?
Although no state mandates a professional certification prior to practicing in the field, candidates holding a professional certification are more likely to be hired than those without formal education. Many health care providers have different pre-employment requirements, so always contact your prospective employer to find out what experience or accreditations are necessary upon date of hire.
Medical coders are highly encouraged to acquire a Certified Professional Coder (CPC) title. CPC credentials are awarded to those who pass a written exam containing Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS) and International Classification of Diseases (ICD-9-CM) codes. These numeric and alphanumeric codes correspond to patient procedures, products and supplies. Other associations, such as the Association for Healthcare Documentation Integrity (AHDI) and the American Health Information Management Association (AHIMA), also offer certifications. Some of these professional certifications are only available to graduates of associate degree programs.
Keep in mind that medical billing and coding certificate programs are different from professional certifications. The large majority of employers still require professional certifications post-graduation. Many medical coding and billing schools do offer test preparation courses to students, helping them prepare for their CPC, National Center for Competency Training (NCCT), Specialty Coding Professional (SCP) or Certified Medical Billing Specialist (CMBS) certification exams.
National Certified Insurance and Coding Specialist (NCICS): These individuals have passed their NCCT exam and are qualified to become a medical biller or coder. They are prepared to work with insurance agencies and hospitals.
Certified Professional Coder (CPC): This certification showcases mastery of ICD-9, CPT and HCPCS medical coding terminologies and systems. Passing the CPC exam prepares individuals to practice medical coding in physician office settings.
Specialty Coding Professional (SCP): These medical coders possess certifications built upon basic medical coding terminologies and specialty-specific terms and regulations. Over 20 different types of specialty credentials are obtainable.
Certified Medical Billing Specialist (CMBS): Individuals with this certification pass exams covering information about billing and treatment in medical facilities. They can be certified to work in hospitals, private practices or chiropractic offices.
What is the typical medical billing and coding job environment?
Many medical billers and coders work in hospitals, clinics or surgical centers. They also have the opportunity to become independent contractors or business owners. With the proper experience, credible demonstration of expertise in the field and a large client base, billers and coders can practice from home, though this occurrence is very rare.
Medical billers and coders usually work 40 office hours per week, with potential for overtime, and part-time positions are also available. Job opportunities tend to be more abundant around bigger cities--major hospitals reside in sizable metropolitan areas, and many of these hospitals outsource medical billing services to lighten their already heavy burden. Workloads vary from setting to setting, but remember that all medical billers and coders are seated through the majority of the day, often on the computer.
What are my job functions as a medical records technician?
Most core functions relate directly to the maintenance and support of patient records:
- Review charts and financial records to check for accuracy.
- Maintain confidentiality across the network.
- Electronically submit confidential patient data across a given provider's health care network.
- Release medical documents to insurance companies, collection agencies and patients.
- Collect necessary billing and treatment information to manage the facility's billing cycle.
Along with everyday, fundamental tasks, medical records technicians are also asked to carry out some basic administrative duties:
- Transcribe patients' charts, prepare reports and input data into electronic health record (EHR) software.
- Ensure all insurance claims are recorded properly and on time.
- Dictate using a stenotype machine or other technology.
- Compile admission and discharge paperwork for patients.
What types of individuals in medical billing and coding careers have the most success?
Individuals with keen attention to detail are most likely to succeed, as precision and accuracy are necessary to catch errors in patients' information. Some of these tasks require the utmost patience due to its repetitiveness. A medical billing position requires an individual with active listening and comprehension skills, as many interpersonal relationships are managed throughout a typical day. These exchanges can be face-to-face or through the phone with team members or outside agencies. Medical billers must also be dependable and take initiative to complete goals. Deadlines are always a norm as all health care providers rely on the timely reimbursement of rendered services.
What technological skills will I need to develop during my medical coding training?
Technological and computer software skills are now highly expected of medical records technicians. Everyday work depends on computers, technical manuals and patient records for relevant information retrieval. Electronic Health Records (EHRs) are a collection of confidential health information about patients' medical history, allergies, prescriptions, billing information and test results. Medical records technicians must be comfortable managing this software and stay updated on all relevant emerging technology. Individuals must also be comfortable learning other technologies such as database user interface and query software, medical software, classification software and document management software.
Will I need continued medical billing training in the future?
Continuing education is required to stay up-to-date with new technology as well as regulations, compliance standards, health plans and guidelines that may affect training requirements. For instance, medical coders are currently following ICD-9-CM codes to classify patient data. A new version of this collection of code sets (ICD-10-CM) is expected to be implemented by 2013 by the American Medical Association, which means individuals in the field will need to familiarize themselves with this new set of codes through exams or additional trainings. Furthermore, these health care professionals must be familiar with an extensive amount of ever-changing terminology. Continuing education is also needed as recertification is typically required over time.
What is the average medical billing and coding salary?
According to the Bureau of Labor Statistics, the median annual salary for a medical records and health information technician across the United States is $32,350. Actual salaries can vary depending on experience, geographic location and employer.
Median salary ranges of medical records technicians by percentile across the United States:
Source: Bureau of Labor Statistics, 2012
Mean annual salaries may vary by state of employment. Mean annual salary for a subset of states is included for reference. Visit bls.gov for a more comprehensive list of states.
- District of Columbia: $43,140
- Florida: $33,860
- Hawaii: $42,430
- Louisiana: $29,120
- Massachusetts: $40,230
- Mississippi: $27,230
- New Jersey: $47,050
- New York: $38,990
- Texas: $34,420
- West Virginia: $27,750
Lastly, mean annual salaries may also vary by type of employer:
- General medical and surgical hospitals: $37,020
- Physician offices: $29,030
- Nursing care facilities: $33,380
- Outpatient care centers: $31,440
- Federal executive branches: $46,090
- Grant-making and -giving services: $43,830
- Insurance carriers: $42,820
What are future growth projections for medical billing and coding careers? How does the economy or government affect career outlooks?
According to the Bureau of Labor Statistics, employment of medical records and health information technicians is projected to grow by 21% between 2010 and 2020. Changes to the health care system, government regulations and the population are all factors affecting career outlook. An ever-growing, aging population requires increased health care, creating more opportunities for medical records technicians to assume roles that health care practitioners simply do not have the capacity to handle. This field is also expected to grow because of the increasing number of hospitals adopting Electronic Health Record (EHR) technology. The American Hospital Association reports that the percentage of U.S. hospitals that have adopted EHRs increased from 16% in 2009 to 35% in 2011.
The Health Insurance Portability and Accountability Act (HIPAA) is a set of national security standards and rules for health care providers to maintain data confidentiality and privacy of their patients. The Patients Protection and Affordable Care Act (PPACA) was recently signed into legislation by President Obama. This reform is intended to increase electronic medical health record adoption and provide individuals with lower health care costs, increased insurance coverage, new benefits, protections and increased government subsidies. Implementation of these laws ensures each patient will have their medical and financial files secured in electronic exchanges between insurance companies, hospitals, administrators and collection agencies. Based on current legislation, these health care reform laws are anticipated to roll out in the next several years. This legislation will increase the need for more medical records technicians to manage the growing amount of electronic files in hospitals' databases.
What other possible career paths are available to me after completing my medical billing and coding program?
There are several different paths to follow after graduating from a medical billing program. These roles may vary in job demand, average pay and/or experience requirements:
- Medical assistant
- Medical biller
- Medical auditor
- Medical transcriptionist
- Medical coder
- Health information manager
- Health information technician
Choosing the right school can be a difficult task. In addition to your own research, be sure to contact your prospective school's counselor to review some questions.
- What is the job placement rate for students who complete their medical billing and coding program?
- What are the student demographics for medical billing schools?
- Do they offer any apprenticeship/internship programs?
- Does the school have a career counselor to assist graduates with job placement?
- How flexible are the medical billing and coding courses?
- Does the program offer online courses?
- Will I be able to interact with peers in my medical billing and coding classes?
- What happens if I have to take a temporary leave from school?
- Will test preparation classes be part of my curriculum?
If online options are available, consider some more questions for your counselor:
- How will I communicate with my online instructor?
- Will I have 24/7 support for my online medical billing courses?
Remember to use these questions as the base of your research. List and ask all the questions that are most relevant to your individual personality and schedule.
Additional medical billing and coding career resources:
"http://www.whitehouse.gov/healthreform/healthcare-overview" | Affordable Care Act of 2010: Health Insurance Reform Information
"http://www.aapc.com/" | American Association of Professional Coders
"http://www.ahima.org/" | American Health Information Management Association
"http://www.aha.org/" | American Hospital Association
"http://www.ama-assn.org/" | American Medical Association
"http://ambanet.net/AMBA.htm" | American Medical Billing Association
"http://www.ahdionline.org/" | Association for Healthcare Documentation Integrity
"http://www.bls.gov/ooh/Healthcare/Medical-records-and-health-information-technicians.htm" | Bureau of Labor Statistics: Medical Records and Health Information Technicians
"http://physicianswebsites.com/" | Medical Association of Billers
"http://www.onetonline.org/link/summary/29-2071.00" | O*NET: Summary Report for Billing, Cost and Rate Clerks
"http://www.hhs.gov/ocr/privacy/" | U.S. Department of Health and Human Services
Rachael is an online marketer focused on marketing strategy and research. She received her Bachelor's degree in Psychology and Master's degree in Business. Rachael continues to pursue her love of the outdoors, hiking and spending time in local parks.