Medical billing and coding professionals are critical links between healthcare providers, insurance companies, and patients. As the healthcare industry continues to decentralize, well-trained billing and coding specialists remain in high demand. Advances in medical science have resulted in longer life spans. As aging populations make greater use of medical services, there is a corresponding need for medical coding and billing specialists. The U.S. Bureau of Labor Statistics (BLS) projects that jobs for medical records and health technicians will grow by 13% by 2026.
As aging populations make greater use of medical services, there is a corresponding need for medical coding and billing specialists.
Medical coders and billers do not need postsecondary education, but competition for jobs remains difficult without it. Most employers expect professional certification after a formal training program. The American Medical Billing Association (AMBA), the American Association of Professional Coders (AAPC), and the American Health Information Management Association (AHIMA) grant professional credentials. In this guide we explore the methods you can choose to earn professional certification and begin your medical coding and billing career.
How to Choose a Medical Billing and Coding Program
Employers nearly always expect medical billers and coders to hold professional certification. Several industry organizations grant medical billing and coding credentials, including the AMBA, AAPC, and AHIMA. Medical billing and coding schools equip students with key job skills and prepare them for their certification examinations. Aspiring medical billing and coding professionals can work towards certification through certificate, diploma, or associate degree programs.
Each program leads to a medical coding certification, but each differs in course content, length, and cost. A certificate program delivers core medical billing and coding courses in a short period of time. Diploma medical billing and coding programs are longer and more expensive, but offer additional coursework and training. An associate degree from an accredited medical billing and coding school delivers a liberal arts curriculum in addition to medical coding classes, helping students cultivate useful critical-thinking skills.
Aspiring medical billing and coding students should weigh each training option against their individual career goals and personal needs. If you plan to pursue medical billing and coding training, ask yourself how much time you can commit to schooling. Do you prefer to attend classes part or full time? Is distance education or a traditional campus setting appealing to you when exploring options for medical coding training? Tuition varies between medical coding programs, generally in relation to a program's length and curriculum, so evaluate each carefully.
Certificate in Medical Billing and Coding
A medical billing and coding certificate program, not to be confused with an actual certification, focuses strictly on skills training in preparation for the credentialing exam. Certificate programs are usually shorter and less costly than other medical billing and coding training options. Course credits do not transfer to diploma or associate programs, however.
- Certificate Program Cost
Tuition varies between schools, and often depends on program length. Online medical billing and coding certificate programs range from $1,000-$2,000.
- Certificate Completion Time
Though each school sets its own program length, aspiring medical billing and coding professionals can finish a certificate program within a year.
Diploma in Medical Billing and Coding
Medical billing and coding diploma programs offer an expanded curriculum that further prepares graduates for professional roles. Courses emphasize skills training for the medical office and advanced billing and coding. Diploma programs are longer and more costly than certificate programs, but may include a credentialing exam as part of the curriculum.
- Diploma Program Cost
Tuition varies widely between schools, but medical billing and coding diploma programs generally cost anywhere from $10,000-$15,000 to complete.
- Diploma Completion Time
Curricula, and thus program length, differ substantially between schools, but a student can typically complete a diploma in medical billing and coding in 9-16 months.
Associate Degree in Medical Billing and Coding
Medical billing and coding associate degree curricula deliver not only specific skills training, but also a well-rounded liberal arts education. Graduates are well-versed in communications and technology. Many programs include a credentialing exam with their curriculum, and all of them transfer easily into bachelor's programs for further study.
- Associate Program Cost
Accredited medical billing and coding associate programs can cost students $12,000-$18,000 to complete, depending on the school.
- Associate Degree Completion Time
It takes two academic years to complete an associate degree in medical billing and coding. Some schools offer slightly shorter accelerated programs.
Advancing Your Career in Medical Billing and Coding
Medical billers and coders seeking upward career mobility often return to school for a bachelor's degree in healthcare administration or health information management. Curricula cover medical ethics, legislative compliance, data analysis, and project management skills that are necessary to climb the career ladder in the healthcare environment. Bachelor-prepared medical billers and coders are prepared for decision-making and leadership positions, and hiring managers often prefer this additional education. Bachelor's degrees also pave the way for further study, such as a master's degree in public health or healthcare administration. Most executive roles in healthcare administration require a master's degree. As the table below illustrates, education level directly impacts a professional medical biller and coder's earning potential.
High School Diploma$49,066
Master's and Doctorate$71,701
Career and Employment Outlook for Medical Billers and Coders
- Medical Billing and Coding Specialist
Usually working in an office setting, these professionals interpret medical records and translate them into codes for insurance purposes. In collaboration with other medical office staff, billers and coders review charts and records for completeness and submit invoices to health insurance companies.
Median Annual Salary: $36,545
Education Level Required: Certificate, Diploma, or Degree
- Medical Billing Supervisor
These professionals usually work in hospitals or large medical practices, overseeing a staff of coders and billers. They ensure that records are properly coded and invoiced, facilitating helpful information when necessary. In some offices, medical billing supervisors also work with patient collections
Median Annual Salary: $48,019
Education Level Required: Associate Degree
- Medical BIlling Manager
These individuals oversee all billing operations for a medical practice or facility. Daily duties include supervising a staff of coders and billers, monitoring collection activity, negotiating payer contracts, resolving billing disputes, and training employees. These professionals may counsel patients with large invoices on financial options.
Median Annual Salary: $50,902
Education Level Required: Bachelor's Degree
Programmatic Accreditation for Medical Billing and Coding Programs
When a school holds accreditation, it means that it has been vetted against established standards. A school may hold national, regional, or programmatic accreditation. National accreditation refers to a specific type of education, such as vocational school or distance learning. Regional accreditation signals that a school has met standards that govern fair admissions policies and sound academic programs. The difference between regional and national accreditation can be confusing. Even though regional accreditation groups schools by areas of the country, it carries more academic heft than national accreditation.
The U.S. Department of Education and the Council for Higher Education Accreditation both maintain free public databases of accredited postsecondary schools. When a specific program meets standards established by an industry organization, it is programmatically accredited. Programmatically accredited medical billing and coding programs are recognized by the Commission on Accreditation of Health Informatics and Information Management Education.
Medical Billing and Coding Program Admissions
Before you submit any applications to medical billing and coding schools, first consider the program options and select a program length that fits your career goals and lifestyle. The shortest or cheapest route to a credential is not always the best solution, particularly if your long-term goals involve career mobility or further education. When you determine your end goal, choose 3-5 schools in your area that offer accredited programs.
Whether you choose to pursue a certificate, diploma, or associate degree, the process for applying to a campus-based medical billing and coding school is generally straightforward. First you must submit an application, which is typically done online with the school's own application. The CommonApp is not often employed by schools offering medical billing and coding courses. After you submit the application, you must submit your ACT scores (if required) and your high school transcripts. Some schools require applicants to take a pre-application placement exam.
- Application: Most medical billing and coding schools host online admissions applications on their websites. The application requires basic contact information and a short summary of your educational objectives. This may be in the form of a short essay question, or it may require you to write a separate essay and submit it with the application.
- Transcripts: Regardless of your choice of certificate, diploma, or associate degree, you must present proof of your high school diploma or GED in the form of transcripts. These official academic records are formally requested by applicants and sent directly to potential schools. Some schools allow applicants to submit unofficial transcripts themselves.
- Application Fee: The application fee varies by school, but it is generally not excessive. Aspiring medical billers and coders typically pay no more than $100 to apply, and often not more than $50.
Core Courses in a Medical Billing and Coding Program
All medical billing and coding programs devise their own curriculum, but they all emphasize a specific skill set. Longer programs often explore other topics that are adjacent to medical billing and coding work. Below, we've listed five sample courses of a typical medical billing and coding program.
- Body Systems, Disease Processes, and Treatment Procedures
A study of the terminology and abbreviations relative to anatomy and physiology of the integumentary, reproductive, musculoskeletal, cardiovascular, respiratory, endocrine, lymphatic, nervous, urinary, and digestive systems. Students also explore terminology related to the diagnosis and progression of infectious and chronic diseases, and their appropriate treatments.
- Basic Coding with ICD-10
An overview of concepts, procedures, and terms in ICD-10. Students are introduced to AHIMA's Standards of Ethical Coding, the ICD-10, and the ICD-10's coding guidelines. Students gain familiarity with appropriate coding procedure, and will be expected to properly code fundamental diagnoses and surgical procedures.
- Procedure and Diagnosis Coding
An intermediate study of coding practice and procedure that emphasizes physician services. Students gain a comprehensive understanding of major medical procedures, the indications for them, and the techniques involved in them. Students practice properly coding surgical procedures, laboratory tests, and diagnostic tests, understanding when to query the physician for more information.
- Medical Billing Practice and Procedure
A study of billing and reimbursement standards and best practices. Special topics include claims processing, insurance payment methods, disability, Medicare/Medicaid, TRICARE military insurance, and worker's compensation insurance. Students explore fraud detection, regulatory and compliance requirements, and managed care.
- Healthcare Data Management
An introduction to the medical records systems used in healthcare administration, including storage, numbering and filing systems, indexes, data collection, and registers. State and federal legal implications, HIPAA security provisions, patient confidentiality, and the release of protected health information receive special attention.
Professional Organizations in Medical Billing and Coding
Medical billing and coding organizations have much to offer students and recent graduates. Most of them offer networking opportunities at local events, and many sponsor large conferences where attendees can earn continuing education credits while mingling with their peers. Association websites commonly host job boards and online continuing education options, as well as work-related advice blogs and legislative analysis. Many provide discounts on products necessary to medical billers and coders. Below are just three of these associations.
This national organization offers credentialing, a jobs board, and extensive networking opportunities for members. AMBA also hosts webinars and standalone online courses about topics of interest to the industry.
AAPC is an enormous credentialing and training organization that also offers professional networking opportunities. Member benefits include a jobs board, product discounts, and free webinars on special topics in the industry.
HBMA is a professional trade association dedicated to revenue cycle management in healthcare. Members enjoy regulatory news announcements and analysis, professional networking opportunities, and a jobs board.