This article contains information about to how to become trained as a medical billing and coding specialist. You will learn about the many career options today available for these healthcare workers, and how you can get a certificate or degree in this field. Also included is information about becoming certified in the field.
What Is a Medical Billing and Coding Specialist?
The healthcare field is experiencing a high level of digitization of patient information and other critical data. Therefore medical billing and coding specialists are becoming the administrators and custodians of patient medical records in healthcare facilities that range from nursing homes to hospitals to doctors’ offices.
Typical job duties of medical billing and coding specialists are:
- Organizing and maintaining patient records and databases so that doctors and nurses may access correct and complete information about patients quickly.
- Translate the notes of healthcare professionals to standard healthcare codes. This allows healthcare workers to look at a brief overview or summary of the patient’s health situation quickly rather than having to page through extensive doctor notes.
- Update records or the treatments and procedures for a patient. Coding specialists ensure that when each patient gets treatments or procedures, the file for that patient is updated. Also, looking at the treatment history for the patient gives the coder the chance to track service and treatment quality for the patient.
- Improving the level of communication between billing agencies and healthcare professionals. One of the biggest challenges in the US healthcare system today is to get information from healthcare workers to the insurance companies and others that process claims and handle the money. Using standardized codes allows the medical coder to communicate a complex illness or treatment and diagnosis to the billing agency. That information is then used to charge the insurer or patient properly.
Why Get a Medical Billing and Coding Specialist Certificate?
The healthcare field is generally growing at a very rapid pace, with 20% growth in jobs anticipated by 2024. Part of this trend includes a rapid growth in demand for medical records and health information technicians, including professionals who can handle medical billing and coding.
The Bureau of Labor Statistics or BLS reports that job growth in this field will be a healthy 15% by 2024, which is much faster than average. More Americans are getting older and living longer, and need to have more medical procedures. This means that there will be many more claims for reimbursement from health insurance companies.
There also is much wider use today of electronic health records or EHRs, so there will be more demand for medical billers and coders to be able to effectively manage and classify this information.
Training Programs for Medical Billing and Coding Specialists
The best way to get a medical billing and coding specialist position is to complete a certificate training program, followed by taking one of several certification examinations. Many of these programs can now be completed online, and they are available through many community colleges and vocational schools throughout the country.
In these programs, which can range from one to two semesters in length, students learn anatomy and physiology basics, and medical terminology. They also learn specialized information about medical billing coding systems and how to deal with health insurance companies, and other important skills so that they are successful in the field.
For example, DeVry University offers an undergraduate certificate in medical billing and coding that consists of 10 courses and 34 credit hours. Required coursework for this one year program includes:
- Fundamentals of Human Anatomy and Physiology with Lab: This class provides students with a basic overview of human body function and structure. Topics are cell function and structure, and a general survey of all major human body systems. Connections and interworking relationships between all of the systems are also covered. There is lab work that includes simulation and computer lab exercises.
- Fundamentals of Pathophysiology: Develop a foundational knowledge of clinical manifestation and pathogenesis of disease so to work effectively with health information and to communicate well with various healthcare providers. Some of the covered material includes medical terminology, anatomy/physiology, and human disease mechanisms
- Pharmacology and Medical Treatment: Covers indications for using the most commonly prescribed drug treatments for various diseases and illnesses. Classifications and terminology of drugs and how they affect the human body are covered. Also explored are surgical interventions and therapeutic treatments.
- Introduction to Health Services and Information Systems: Covers the organization, history and current issues in the healthcare delivery system in the US. How system components and care providers interrelate are explored. Regulatory compliance, accreditation and licensing also are covered. Finances and quality management is also reviewed.
- Current Procedural Terminology Coding With Lab: The knowledge of the clinical classification systems is covered and expanded by presenting principles of procedural terminology, which is used to code procedures that are commonly performed by healthcare professionals. You will do practice exercises where you assign medical procedure codes and apply guidelines for evaluation and management codes and modifiers to various case examples.
After you have completed your certificate training program in medical billing and coding, you then will be ready to take external industry certification examinations so that you can find work in the field.
About Certification Examinations
One of the most important industry certification examinations in this field is the Certified Coding Associate exam. The CCA credential has been a nationally recognized achievement standard in the field since 2002. This credential shows that a coder has exhibited coding competencies and professionals skills across all healthcare settings, from hospitals to doctors’ offices.
Many certificate programs, including DeVry, will pay for one CCA certification examination per student.
To become a CCA, you will need to pass the American Health Information Management Association’s examination. The CCA designation is the starting level of certification that is offered by this association for medical coders. Note that AHIMA also offers the certified coding specialist credential or CCS, which is for the experienced medical coder with several years of professional experience.
The CCA examination has 100 multiple choice questions and will test your knowledge in clinical classification systems, reimbursement systems, and other important areas of medical coding. To keep your CCA designation, you have to complete 20 CE credits every two years.
It is recommended that the student select an accredited medical billing and coding specialist program. This ensures the student that he is learning vital skills that will prepare him for the medical billing and coding field.
The most common accreditation agencies in this field is the Commission of Accreditation for Health Informatics and Information Management Education (CAHIIM), which provides accreditation for programs.
The other is the American Academy of Professional Coders (AAPC), which certifies medical coders.
Becoming a medical billing and coding specialist is a desirable career choice because of the growing demand for all types of healthcare professionals. A worker in this field who is trained, certified and has a few years of experience can eventually earn a promotion into management and various other higher paying positions as well.
- Centura College. How Much Does Medical Billing and Coding Specialist Make? (n.d.). Retrieved from http://centuracollege.edu/blog/how-much-does-medical-billing-and-coding-specialist-make/
- DeVry Institute. Medical Billing Undergraduate Certificate. (n.d.). Retrieved from https://www.devry.edu/degree-programs/health-sciences/medical-billing-coding-undergraduate-certificate.html
- Medical Records and Health Information Technicians. (2015, Dec. 17). Retrieved from https://www.bls.gov/ooh/healthcare/medical-records-and-health-information-technicians.htm#tab-6