Medical Coding & Billing: Where to Start Your Career Journey

The growing need for a universal language in medical documents has fueled the demand for certified and skilled medical coders and billing specialists. The necessity to curb high healthcare fraud costs in the US, the anticipated introduction of ICD-11, and the growing adoption of advanced technologies like AI in coding are some of the other critical factors driving this demand. Moreover, in the post-pandemic world, consumers are exhibiting an increased propensity for telemedicine. A 2021 survey reveals that over 40% of consumers plan to continue using telehealth even when the pandemic wanes, which represents a jump from merely 11% of consumers availing these facilities before 2020. About 40% to 60% of consumers are interested in a broader range of virtual health solutions. As virtual visits gain momentum in the future, documenting these patient interactions is likely to pose a challenge for health information management (HIM) leaders. This will also create a high demand for medical billing and coding training.

A career as a medical biller or coder could be a lucrative option for you, especially if you have sound analytical skills, interpersonal skills, and a detail-oriented approach. As per the US Bureau of Labor Statistics (BLS), the median wage of people working in this sector was $51,840 in May 2020. Those who received medical billing and coding training got 27% more in average annual salary than their non-certified peers. Job opportunities are also projected to grow. The BLS forecasts a growth rate of 9% in these jobs between 2020 and 2030, which exceeds the average. Moreover, these jobs can also be pursued remotely, making them a good option amid restrictions. This is why more than 50% of the coders working in a hospital or a health system were completely remote in 2020, while only 17% were based entirely on-site. 

The first step in your career journey is to know how to become a medical biller and coder. Contrary to popular belief, medical coding and billing are two distinct career paths. Consider them as two sides of the same coin, they do have some shared responsibilities. The end goal is the same as well, which is third-party reimbursement. However, you need separate credentials to pursue these professions. So, here’s how to go about it.

What is Medical Coding?

Medical coders play a vital role in the healthcare ecosystem. Their expertise in understanding medical codes, government regulations, and payment policies allows them to translate thousands of things. Right from what a doctor prescribes on a patient’s chart to what procedures were conducted and when a patient checked out of the facility. All tests and diagnoses are assigned a proper code so that the billing department can charge the patients appropriately, and insurance companies can provide accurate coverage. 

How to Become a Medical Coder?

Now that you know a little about the job, let’s understand how to become a medical coder.

Step1: Meet the Basic Requirements

Aspiring medical coders can begin their careers without any postsecondary education. Students sometimes invest years to complete an associate’s degree or bachelor’s degree in areas like healthcare administration or health information management to pursue a career as a medical coder. These degrees are not mandatory to begin a career. Instead, the certification has now become a norm and even students with degrees will need to obtain one to kickstart their careers as medical coders. Being certified in specialty practice not only increases the chances of getting your first job but also proves useful in advancing your career. 

Step 2: Get the Medical Coder Training 

Employers have a strong preference for certified coders. Certifications available for this role include the Certified Coding Associate (CCA), Certified Professional Coder (CPC), and Registered Health Information Technician (RHIT). The certifications require specialized education to qualify for the respective exams. Choose a certification training program that offers a spectrum of certification courses and a curriculum for in-person teaching and online instruction. A cloud-based learning portal can help you take your lessons from anywhere and learn at your own pace.

Step 3: Get Medical Coding Experience

Once you acquire these basic credentials, you can apply for a job as a medical coder in a variety of institutions. Much of the coding can be done remotely while working from home.

Step 4: Get Advanced Certifications for Career Growth

Depending on the type of services you wish to code and your preferred workplace setting, there are several certification courses available. You can choose certifications like the Certified Outpatient Coder (COC), Certified Risk Adjustment Coder (CRC), or Certified Coding Specialist (CCS). Also, huge opportunities exist for those who specialize in a particular medical specialty.

For instance, the Cancer diagnostics global market is expected to expand from $170.21 billion in 2021 to $239.25 billion by 2025, with a CAGR (compound annual growth rate) of 8.9%. This represents opportunities for coders with the Certified Hematology and Oncology Coder (CHONC) credential. 

Step 5: Get a Job and Work Towards Career Advancement 

When looking for jobs in this sector, identify the work environment that suits you. Would you prefer the fast-paced work environment of a hospital or the serenity of a doctor’s clinic? It’s important to note that larger healthcare providers offer approximately 19% higher salaries than a solo doctor’s office. After you get a foot in the door and gain work experience, you can begin evaluating opportunities that lie before you.

What is Medical Billing? 

Before diving into medical billing training, it’s important to understand what the job entails. There are 3 parts of this job – patient billing, creating claims, and transaction reports. An expert biller will have the skill to help all involved parties navigate the complexities of compliance norms, laws, and regulations. They also have the knowledge to optimize revenue cycle management solutions for the organization. 

Now, we come to the quarter of how to become a medical biller.

How to Become a Medical Biller? 

Step 1: Earn a High School Diploma 

You can get entry-level jobs as medical billers with a high-school diploma (or equivalent). But, to boost your career options, you need advanced training and certification.

Step 2: Enroll in Medical Billing Programs

Institutions that offer medical billing and coding programs may offer certification programs to advance your career. The medical billers communicate with healthcare professionals regularly to garner more information on diagnoses and review clinical systems. Just like coders, they must also understand how to comprehend medical records and get familiar with CPT®, HCPCS Level II, and ICD-10-CM codes.

You can choose the Certified Professional Biller (CPB™) training from a reputed institution. The training will provide knowledge of medical terminology, coding, and information technology.

Holders of the CPB certification are equipped to handle all aspects of the revenue cycle, have expertise in the application of payer policy and have knowledge of all healthcare regulations and laws as well as coding guidelines. In 2021, CPBs had one of the highest salary hikes in the HIM sector, at an annual growth of 5.10%.

Some other certifications that can advance your career as a biller are the Certified Medical Reimbursement Specialist (CMRS) and Certified Medical Billing Specialist (CMBP).

Step 3: Pass Exams and Look for Jobs 

Most medical billing programs include about 40 to 80 hours of coursework.While it is possible to complete the program in just weeks, there is a lot to learn. Many programs allow you to go through the coursework at your own pace, which means you can take between four to six months, or even up to a year, to complete the program. After that, you will need to pass an examination and get your certificate.

If you are wondering how to become a medical biller and coder, some programs combine billing and coding curriculum into a single course and provide a dual certification.

The size of the US medical coding market is expected to reach a value of $31.4 billion by 2028, growing at 8.3% from 2021. With the frontline clinical workforce battling the fluctuating rate of covid-19 infections, coding and billing specialists are expected to drive innovative revenue cycle management solutions in hospitals and practices. If you are interested in a career in the healthcare sector but cannot afford the time or cost of a degree program, these certifications are just what you need.

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