What to Know About Medical Billing & Coding
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When you visit the doctor, chances are that you rely on your health insurance to help cover the costs. But the process of paying for medical care doesn't happen automatically — it takes trained and specialized individuals to make sure insurance claims are made correctly.
This is where medical billers and coders come in. The two jobs are distinct, but these professionals work together to accomplish the same mission: making sure that insurance covers the cost of a patient's medical care and that physicians get paid.
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If you're interested in earning a medical billing and coding certificate and starting a new career, but you're not sure what to expect from a job in this field, this guide is for you. The following provides an introduction to the medical billing and coding career and explores job outlook and salary expectations for these professionals.
What Is Medical Billing and Coding?
Medical billing and coding involves the process of translating the healthcare a patient receives into insurance information. These professionals translate data about clinical tests, treatments, and procedures into standardized codes. These codes determine how physicians are paid, either through patient bills or insurance claims.
Medical coders and billers work with medical records to reach the same goal, but they take on different roles.
Medical coders begin the process. They identify information about healthcare services, and then turn that information into the universal codes used by insurance companies.
Medical billers take the next step. They process the insurance claims and bill the insurance companies, making sure they pay their part for healthcare services.
Medical billers and coders play a crucial role in the healthcare industry. They help ensure that patients do not overpay for their healthcare services. Their work also guarantees that doctors, physicians, nurses, and other medical workers are paid properly.
What Is the Career Outlook for Medical Billers and Coders?
Aspiring medical billers and coders can look forward to joining a growing field.
As of 2019, just over 340,000 individuals worked as medical records and health information specialists, the umbrella term under which the Bureau of Labor Statistics (BLS) categorizes medical billers and coders. The BLS projects that number will increase by 29,000 from 2019-2029 — that's a projected growth rate of 8%, which is much faster than average.
The BLS attributes that growth to the aging U.S. population, which will require an increasing number of medical services, leading to more records and reimbursement claims. The healthcare industry could also see an increase in the number of cancer registrars, according to the BLS.
That said, the medical coding and billing industry may need more time to recover from job losses after the COVID-19 pandemic, according to For the Record — an industry trade publication. The article notes that medical coders were hit hard by the pandemic as healthcare professionals focused their attention on the virus and annual patient visits decreased.
The professional landscape may change as well, the publication reports. As medical coders and billers return to work, they may find that healthcare employers continue to hire remote workers, even as the pandemic slowly subsides.
What Is the Salary Potential for Medical Billers and Coders?
In 2020, individuals working in the medical records and health information specialists profession earned a median annual salary of $44,090, according to the BLS.
However, salaries vary, ranging from below $26,550 to above $66,260, as BLS figures show. Additionally, location can affect medical coding and billing salaries considerably. For example, workers in this profession made annual mean wages over $50,000 in New Jersey, the District of Columbia, California, Connecticut, and Hawaii.
Salaries also vary by industry. Those who work in the pharmaceutical and medicine manufacturing industry earn an average salary over $62,000. Medical billers and coders who work for insurance carriers and scientific research and development services make mean wages of over $52,000.
According to PayScale data, medical coders earned an average base salary of nearly $43,260 in June 2021. Alternatively, PayScale reports that medical billers made average annual earnings of $40,340 in June 2021.
With increased work experience, the salary potential for coders and billers typically increases. Entry-level medical billers, for example, brought home a mean annual wage of $34,920 in June 2021, according to PayScale data. But after working in the industry for several years, late-career professionals earn an average salary of over $45,250.
The same trend holds true for medical coders. PayScale data from June 2021 shows that entry-level workers in this profession earn about $36,910 a year, which increases to $50,240 for late-career medical coders.
Frequently Asked Questions About Medical Billing and Coding
Do you need to be certified to work as a medical biller or coder?
You don't necessarily need to be certified to find employment as a medical biller or coder. However, many employers look for job candidates with industry credentials, which show that job seekers have mastered the skills they need to work competently in the industry. Plus, certification programs can help you get your start if you don't have any coding and billing knowledge or experience. That training can give you confidence as you begin your career, and you can even use it as a salary negotiation tool. Many colleges and professional associations host medical billing and coding certificate programs.
How long does it take to become a medical biller or coder?
The answer to this question varies, based on the path you take. Technically, you can begin your medical billing and coding career as soon as you earn your high school diploma or GED certificate. However, without the right training, you may find yourself struggling to land a position. The answer to this question varies, based on the path you take. Technically, you can begin your medical billing and coding career as soon as you earn your high school diploma or GED certificate. However, without the right training, you may find yourself struggling to land a position. Some training programs last just a few weeks, while an associate degree in medical coding and billing typically takes two academic years to earn.
What is the average cost of medical billing and coding programs?
The average cost of medical billing and coding programs depends on what type of program you attend. If you decide to attend a certification program at a college or university, these programs typically cost $100-$200 per credit. For a 30-credit program, the total cost could reach $3,000-$6,000. However, many colleges offer financial aid options or scholarship opportunities to help reduce out-of-pocket costs.
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Brandy Gleason MSN, MHA, BC-NC
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.