Medical billing and coding is an in-demand career path that plays a crucial role in modern healthcare administration.
Coders and billers work behind the scenes to translate patient encounters, diagnoses, treatments and procedures into billing codes that are then used for accurate reimbursement and documentation. As the healthcare industry continues to evolve, the demand for skilled professionals in this field is growing.
If you’re interested in pursuing a career in medical billing and coding, you may be wondering: what does it take to land a job? This comprehensive guide will provide an overview of the key steps, as well as advice and resources to help you achieve your goal. Let’s start with some background information and definitions.
Definitions
Medical billing involves submitting and following up on insurance claims to facilitate payment of health services provided.
Billing specialists are responsible for correctly coding all procedures, verifying patient insurance eligibility and benefits, tracking down missing or incomplete information, responding to denial resolutions, collecting payments and posting reimbursements.
Medical coding is the translation of written medical documentation and records about diagnoses, treatments, procedures and services into standardized alphanumeric codes.
There are two main coding systems used in the United States – ICD-10-CM/PCS (International Classification of Diseases) for diagnostic and inpatient procedure codes, and CPT (Current Procedural Terminology) codes for outpatient procedures and services.
Medical coders review charts and other clinical documentation provided by physicians and other healthcare providers to assign the appropriate ICD and CPT codes.
The main roles of a medical biller and coder are interrelated. Coders assign diagnosis and procedure codes by reviewing patient charts which then feed into the billing process where claims are created and submitted to insurance companies for payment.
With complete and accurate coding, billers can ensure maximum appropriate reimbursement for healthcare services rendered.
Education
While on-the-job training is an option, a medical billing and coding certificate or associate’s degree from an accredited training program is highly recommended to be competitive in today’s job market.
Most employers prefer candidates who hold a credential from the American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA).
Certificate programs take approximately 9-12 months of full-time study and cover anatomy and physiology, medical terminology, pharmacology, legal and ethical coding guidelines, insurance processing, and hands-on practice with real-world coding scenarios and cases.
Associate’s degrees in medical billing and coding involve general education requirements in addition to specialized coursework and usually take two years to complete.
When choosing a school, look for programs accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM).
CAHIIM accreditation ensures the curriculum meets national standards and prepares students for certification exams. Also check graduation and career placement rates to find programs with a proven track record of student success.
Anatomy and medical terminology courses lay the foundation for understanding human body systems and related medical vocabulary needed for coding.
You’ll also learn reimbursement methodologies, HIPAA compliance standards, coding conventions and guidelines. Hands-on assignments allow for applying skills with practice cases. Capstone projects may incorporate simulation software to gain experience working with digital health records.
Completing an accredited educational program is one of the most important steps to build a strong foundation for a career in this field. Employers value candidates who have earned medical billing and coding credentials through formal training.
Certification
After graduation, it’s highly recommended to become certified in either medical billing or coding to validate your competency and expertise to potential employers. The two main nationally recognized certifications are:
- Certified Professional Coder (CPC) from AAPC – For medical coders, with separate certifications available for hospital inpatient (CPC-H) and physician office settings (CPC).
- Certified Coding Specialist (CCS) and Certified Coding Associate (CCA) from AHIMA – Broader certifications for both coding and aspects of medical billing/reimbursement.
To qualify for these certifications, candidates must meet education and experience requirements like graduation from an accredited program.
The exams themselves are challenging and computer-based, covering in-depth knowledge of current coding guidelines, regulations and real-world coding scenarios. Maintaining certifications may involve continuing education credits each certification period as well.
Certification communicates to employers your competence levels meet national standards and validates your classroom learning. It leads to higher earning potential and more career opportunities compared to non-certified individuals. Take the time to get certified – it’s an important credential to have when launching your job search.
Job Search Resources
With the proper education and credentials established, you’ll want to maximize your Medical coding job search success.
Here are some key recommendations:
- Research job sites like Indeed.com and LinkedIn for open positions at hospitals, medical billing companies, insurance providers, and physician practices near you. Look also at government and pharmaceutical company opportunities.
- Consult professional association job boards like those offered through AAPC and AHIMA. These specialize in healthcare IT and coding roles.
- Consider signing up with recruiting agencies that specialize in medical staffing. They maintain close contact with employers seeking coders and billers.
- Ask your schools’ career centers if they maintain alumni databases or host job fairs connecting students to hiring companies.
- Tap your professional networks on LinkedIn – connect with coding professionals already in roles you aspire to and ask for informational interviews or referrals.
- Check hiring websites of large insurers like UnitedHealth Group and Aetna for openings at their processing facilities nationwide.
- Consider telecommute coding jobs for those offered through hospitals in other states using digital records systems.
- Apply for contract medical coding positions while you build experience towards full-time roles.
When applying, be sure your resume emphasizes your education credentials, relevant experience like internships or externships, software skills, certifications held, and strong communication/organization abilities required for the job. Highlight any clinical exposure or healthcare administration coursework as well.
In the Job Interview
If selected for an interview, focus on demonstrating your passion for healthcare alongside coding/billing expertise. Employers want to feel confident in your ability to adapt to their workflows as well as ongoing industry changes. Some tips:
- Research the organization and be prepared with thoughtful questions about their focus, clients, technologies used and growth initiatives.
- Provide real-world examples of coding scenarios you’ve encountered and how you access resources to resolve complex cases.
- Discuss your certified credentials and commitment to continuing education requirements.
- Emphasize communication skills through examples of interactions with providers, patients or insurance companies.
- Highlight relevant software like EMR platforms, coding software, billing applications and your eagerness to learn any new systems.
- Connect your education and any internship experiences back to the position responsibilities.
- Display professionalism, strong work ethic and problem-solving approach through your responses.
- Follow up after interviews by emailing thank you notes within 24 hours to reiterate interest.
With the right credentials, focused job search strategies and solid interview skills, you’ll be well on your way to starting your healthcare career as a medical biller or coder. Developing connections within the industry will also lead to ongoing opportunities to advance professionally over time. Be willing to adapt as technology and industry demands change.
Practical Considerations
Remember, this career paths takes continued dedication to remain knowledgeable on all coding guidelines and regulatory updates – it’s certainly not a passive role.
Medical coding and billing standards evolve regularly to accommodate new procedures, diagnoses, payment methodologies, and laws. Continuing education is therefore required to maintain certified status as well as stay on top of changes impacting the work.
Additionally, there may be opportunities and challenges associated with new specialization areas. For example, roles focused on specialty practices like cardiology or oncology call for deeper understanding within those niches.
Elsewhere, remote and work-from-home coder jobs have become more widespread, requiring strong self-motivation and time management skills outside a traditional office setting.
Workloads fluctuate too depending on seasonal healthcare trends or insurance processing times. Billing teams in particular juggle tight submission deadlines amidst provider delays, rejections and claim resubmittals.
Stress levels rise near quarter-end benchmarks. Self-care and taking breaks remain important to avoid burnout.
On a positive note, you’ll have many employers seeking your services across various sectors. Room for growth exists into managerial or auditing roles with additional certifications as well.
Median salaries top $40,000 for entry-level positions, increasing substantially higher for those with experience. Job security remains stable overall amidst rising healthcare spending.
Conclusion
With diligent education and continuous professional development, a career in medical billing and coding offers engaging work, applicable skills and financial stability.
By following the steps outlined here – from choosing a quality training program to pursuing certification and targeted career strategies – you’ll be well-positioned to land entry-level roles and start your journey in this important industry.
Stay focused on serving patients through accurate claims processing and you’ll find rewarding work while contributing to better healthcare delivery and administration. Here’s wishing you the best of luck launching your new career path!