Medical Billing vs. Medical Coding
Reviewed by Brandy Gleason MSN, MHA, BC-NC
The healthcare system is a complicated machine, relying on many different types of professionals to keep it running smoothly. Doctors, surgeons, and nurses certainly play important roles —and so do pharmacists, physician assistants, physical therapists, nutritionists, technicians, and medical billers and coders.
Medical billers and coders make sure healthcare facilities earn enough revenue by sending claims to insurance companies and statements to patients. In short, they ensure that procedures are properly paid for. However, both professions take on unique responsibilities.
If you're interested in the field, then it's important to know the difference between medical billing and coding. This guide explores those differences as they relate to job duties, work environments, certification requirements, and salary outlook.
What Is the Difference Between Medical Billing and Coding?
Medical coders and billers work alongside each other to achieve the same goal, but they take on distinct roles. Below you can see a breakdown exploring the differences between medical billing and coding.
Job Duties Are Not the Same
Medical coders translate healthcare services and diagnoses into codes that are universally understood by insurance agencies. These codes, a series of numbers and letters, serve as a sort of shorthand that ensures billing and payment is correct and follows regulatory requirements. These professionals know what codes to enter for "new patient visit of low complexity" or a diagnosis for pneumonia. These codes determine how healthcare services receive payment, whether through insurance reimbursement or direct patient payment.
Medical billers pick things up from there, using these codes to actually file insurance claims. This involves working with insurance companies, particularly involving any disputes about denials and rejections. Finally, medical billers send out statements to patients.
That said, at smaller healthcare facilities or doctors clinics without as much staffing, sometimes one person streamlines the insurance billing process and works as both a medical coder and biller. Individuals interested in coding and billing can become trained in both areas of expertise if they wish.
Medical Billers Work With Patients; Medical Coders Do Not
Although medical billers do not work with patients in a clinical sense, they do speak to patients regularly about their payments. This isn't always an easy task, particularly when patients aren't happy with their healthcare bills or when they receive rejections from health insurance companies. Therefore, medical billers need to be empathetic and patient.
Medical coders don't work with patients in their day-to-day responsibilities. Instead, their duties focus on records and data input.
Because of these differences, introverts and extroverts may be best suited for different jobs. Medical billers spend their days speaking on the phone with insurance representatives and patients, which lends itself to a more extroverted personality.
On the other hand, medical coders generally work with records and computers. Although they do work with other healthcare staff, they spend the majority of time working independently — an ideal job for introverts.
Separate Certification Requirements
Professional certification can help individuals qualify for certain jobs. Medical coders can choose from various credentials, including:
- Certified professional coder (CPC) from AAPC
- Certified coding associate (CCA) from the American Health Information Management Association
- Certified coding specialist (CCS) from the American Health Information Management Association
Medical billers don't necessarily need professional certification to work, but it can help them land a job or negotiate their salary. Billers should consider the certified professional biller credential from AAPC.
Many professionals in the field attend vocational training programs at colleges, receiving a certificate of completion once they graduate. These programs typically last 1-2 years, and they teach aspiring medical coders and billers the specialized information about health insurance and medical terms they need to succeed in their jobs.
Some students prefer to enroll in an associate degree program in coding and billing instead of vocational training. At the end of their education, graduates earn a full degree instead of a specialized certification.
Distinct Salaries and Job Outlooks
When it comes to medical billing vs. medical coding salary, medical coders generally make more than medical billers. Medical coders earn an average annual salary of about $43,260, according to PayScale data from June, 2021. By contrast, PayScale data from the same time shows that medical billers make about $40,340 in mean annual earnings.
Medical coders also have a higher general earnings potential, especially as they continue to work through their careers. Late-career medical coders make an average of $50,240 per year, according to PayScale data from June, 2021, while late-career medical billers earn a $45,250 average salary annually.
The Bureau of Labor Statistics (BLS) categorizes these professionals as medical records and health information specialists. The BLS projects that the profession could grow by 8% from 2019 to 2029 —much faster than average.
Frequently Asked Questions About Medical Billing vs. Medical Coding
Medical billing and coding are two distinct jobs, with coders and billers completing specialized tasks. However, they rely on each other to accomplish the same goal. In some cases, an individual may need to take on the role of both a medical biller and coder. This usually occurs at small medical facilities or doctor's offices.
You should consider several factors when making the choice between medical billing vs. medical coding. For instance, think about whether you prefer working on your own or with people. Take into account other factors as well, such as your salary expectations and the opportunities available in your area.
Yes, it's certainly helpful for billing and coding professionals to have a basic understanding of the procedures for which they're billing insurance companies and patients. Vocational training programs and associate degrees often include courses such as medical terminology and human anatomy to help aspiring medical coders and billers master this knowledge.
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As an assistant professor of nursing and entrepreneur with nearly twenty years of varied nursing experience, Brandy Gleason teaches within a prelicensure nursing program and coaches students. Brandy brings additional expertise as a bedside nurse and leader, having held roles at the managerial and senior leadership levels. Her passion and area of research centers around coaching nurses and nursing students to build resilience and avoid burnout. Brandy is an avid change agent when it comes to creating environments that contribute to the wellbeing of students.
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