Medical Billing and Coding Career Overview

Medical coders and billers are critical to the healthcare industry. They contribute to the accuracy of patient data and the timely reimbursement of medical providers.

Benefits of Working in Medical Billing and Coding

1. Opportunities to work from home: Many healthcare organizations outsource their billing and coding tasks to self-employed contractors or companies that specialize in providing these services. So, it's possible to work in medical billing and coding jobs from home and on a flexible schedule.
2. The chance to earn a good salary without a four-year degree: With two years or less of medical billing and coding training, you can qualify for meaningful jobs. You can also pursue certifications that significantly increase your income potential.
3. Enhanced job security: Health information coders and billers are essential to the medical sector. Codes and regulations change frequently, and the nation's aging population is putting more and more demand on the healthcare system. So, the demand for specialists in this field should stay strong.

What a Medical Biller and Coder Does

Medical billing and coding specialists, also known as medical records specialists, use the information from medical reports to classify specific diagnoses and procedures. That coded information gets used for things like:

• Updating patient records
• Compiling statistical data
• Submitting insurance claims
• Preparing invoices

Some people in this field do all aspects of the job, especially if they work for small employers. But it's also common for people to handle just coding or billing (not both).

Medical coders typically do things like:

• Identify patients' medical conditions and treatments based on notes and reports from physicians or other healthcare providers.
• Assign the correct numeric or alphanumeric codes to each specific diagnosis and procedure.
• Refer to official code books, databases, or other reference materials as necessary.
• Ask for clarification from healthcare providers when needed.
• Update and ensure the accuracy and privacy of patients' medical records.

Medical billers generally do things such as:

• Assign costs based on the codes in newly updated patient records.
• Prepare and file health insurance claims with private insurers or the public agencies that run Medicaid or Medicare programs.
• Follow up with insurers when claims have not been processed or paid.
• Get pre-authorization letters or confirmation of eligibility before patients receive treatments.
• Seek clarification when conflicts or inconsistencies arise.
• Communicate with patients to answer questions or explain the status of claims.
• Create and send invoices to patients for services that insurance won't cover.
• Set up and manage monthly payment plans for patients.
• Turn delinquent accounts over to debt collection agencies.

Work Settings

Medical billing and coding professionals tend to work in environments such as:

• Hospitals
• Clinics
• Doctors' offices
• Long-term care facilities
• Home offices
• Rehabilitation centers
• Hospices
• Diagnostic imaging centers
• Medical laboratories
• Corporate or government offices

Specializations

Some medical coders and billers work in general areas like family practice. Others work for specialized physicians or in specific types of departments or practices, often after gaining special medical coding certifications. Becoming a coding specialist for a particular area of medicine can sometimes reduce the number of codes and medical terms you need to know and stay updated on. It can also lead to a higher income.

Medical Billing and Coding Salary

The Occupational Outlook Handbook (OOH) reports the median medical billing and coding salary in 2023 was $48,780. Those at the top end of the wage scale earn more than $77,810.

According to a medical coding salary survey by AAPC, certified coding specialists tend to earn much more than their non-certified counterparts. In 2023, certified medical records specialists earned an average median salary of $67,680. That's more than those without certification. Plus, those with multiple certifications earned even more.

Job Openings & Outlook

The Bureau of Labor Statistics (BLS) projects that medical records specialists (which include coding and billing specialists) will experience higher than average employment growth from 2022 to 2032.

The ease of finding a job depends on the approach you take. If you don't get a formal education in this field, finding a job may be more difficult than it otherwise would be. Certification is also critical for improving your chances. Many places will prefer a certain level of education as well as particular certifications.

Also, your prospects may be better if you seek an entry-level job in an outpatient setting (like a doctor's office) rather than an inpatient environment (like a hospital).

Remote coding jobs are often geared toward those with a good amount of experience.