What is Medical Billing and Coding?

What is Medical Billing and Coding?

Medical billing and medical coding offer plenty of employment opportunities and has a relatively high earning potential. Medical billers and medical coders serve as middlemen between patients, healthcare providers, and insurance companies. Learn about the outlook and salary potential for this job and the different types of certifications and benefits of getting high-quality education and training to succeed. 

What is medical billing and coding? Medical billing and medical coding is the process of identifying diagnoses, medical tests, procedures, and treatments in clinical documents. The patient data from these documents are then transcribed into standardized codes, used to bill both government and commercial payers to reimburse the physicians. If you are considering a career in medical billing and coding, this article will guide you in the right direction. 

What Does a Medical Biller and Coder Do? 

Medical billers and coders or health claims specialists process the health insurance claims for medical professionals and healthcare facilities. You can work either as a medical coder or as a medical biller. However, some positions require you to do both. 

Medical coding is the process of translating what was written by the physician (a diagnosis or prescription for medication) into the corresponding numerical code. Since there are thousands of codes for various procedures, diagnoses, and treatments, a medical coder needs to be relatively familiar with the different sets and subsets of codes. Examples of these are the International Classification of Diseases (ICD) or Current Procedure Terminology (CPT). The medical coder will read the healthcare provider’s report and then translate that information into codes. Each code has its own set of guidelines and rules. A coder needs to place codes in the correct order and be very accurate. 

Medical billing is the process of taking the code information provided by the coder and creating bills (or claims) for the insurance company. A medical biller will take the codes that indicate symptoms of the patient, the physician’s diagnosis, and the prescription to create a claim using a form or specialized software. This will then be sent on to the insurance company. Once they have evaluated it, the claim gets sent back to the medical biller, who will then determine how much is owed by the patient. The biller will then create a bill for the patient and the amount that the insurance company pays will be deducted from the original cost. Therefore, a medical biller acts as the middleman between patients, healthcare providers, and insurance companies. 

Job Outlook and Salary Potential 

A career in medical billing and coding has a lot of promise. Despite a struggling economy, medical billing and coding is still an in-demand profession. According to the US Bureau of Labor Statistics, medical billing and coding are one of the top 20 fastest-growing occupations. It is expected that employment within this field will grow at 8% through 2029 and beyond. This number is double the overall average of 4% for most other professions. It is believed that the aging population and increasing health concerns are responsible for the high demand for medical billers and coders. 

Medical billing and coding can be an attractive healthcare-related field. The U.S. Bureau of Labor Statistics indicates that the median salary is $21.20 per hour or more than $44,000 annually. Generally, medical coders tend to earn more than medical billers, but some jobs require you to fill both positions for a higher salary.  

Certain factors can also affect your salary, for example, where you live and whether you live in a city or rural area. The salary for medical billers and coders varies from state to state and is significantly higher in cities. Where you work as a medical biller and coder will also determine your salary. Hospitals tend to pay the most, medical and diagnostic laboratories offer an average pay rate, and doctors’ offices or outpatient care facilities are on the lower end. Additionally, if you choose to work remotely for an independent company, your rate may be different. Finally, your level of education and certifications will influence your pay as well. 

Three Types of Certifications 

As with most professions, the more education you have, the higher your income will be. Medical billers and coders who have certified credentials will generally earn more than those who have done training but haven’t passed a certification exam. If you are interested in a career in the field of medical billing and coding, it’s important to know about the three main types of certifications: 

• Certified Professional Coder (CPC) exam offered by the American Academy of Professional Coders (AAPC). 
• Certified Coding Associate (CCA) exam offered by the American Health Information Management Association (AHIMA). 
• Certified Billing and Coding Specialist (CBCS) exam offered by the National Healthcareer Association (NHA). 

Education and Training 

To ensure that you pass your certification exam and can earn a good salary as a medical biller and coder, you need to get a high-quality education. Your training will be the biggest factor influencing your salary range since your education will determine where you can work as a medical biller and coder. That’s why choosing your training and type of certification is a vital part of the process. Medical billing and coding can be a highly lucrative profession and it’s important that you take the right steps to enter this field. 

Consider a training course that covers the legal, ethical, and regulatory concepts within the field. Additionally, one that helps you to fully understand the revenue cycle from patient registration all the way through to reimbursement and collections. Our Medical Billing and Coding course will teach you these practical aspects while also providing extra education that will help you in the field, such as medical terminology, disorders, procedures, and treatments.  

Get Started with Medical Billing and Coding 

Now that you know how much potential this field has, it’s time to take action. Medical billing and coding is a field that offers plenty of job opportunities and the possibility of earning a good income. If you’ve been looking for a career in healthcare that is worth trying, medical billing and coding would be it. 

Are you ready to start today? Enroll in our online Medical Billing and Coding course to help kick start your new career in the healthcare industry.