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How to Become A Medical Biller & Coder

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As medical institutions adopt EHRs (electronic health records) at an astounding rate, the importance of medical billers and coders becomes more pronounced. As a field requiring a specialized skill set and massive attention to detail, becoming a medical biller and coder is only a job that everyone can pull off, especially with significant training.

But with an expected 9 percent rise in openings nationally between 2020 and 2030, it is safe to say that many people will have to pick up the mantle of being a medical biller and coder.

If you are interested in the field, below is everything you need to know to become a medical biller and coder and thrive at it.

Technical Requirements in Medical Billing & Coding

In medical billing and coding, meticulousness and attention to detail are critical. It is a medical biller and coder’s job to record vital patient data and inform them that it could end up being the difference between life and death.

To this end, medical coders need to be exceptionally fluent in coding systems, among which are the Current Procedural Terminology (CPT), the International Classification of Diseases (ICD), and the associated Healthcare Common Procedure Coding System (HCPCS).

So technical is the job specification that even after preliminary training is done, coders are still given the options for further certifications to consolidate their knowledge and stand out from the group.

Step By Step Guide to Becoming a Medical Biller and Coder

Postsecondary Education (1 to 4 years)

After a high school education, prospective medical billers and coders can opt for one of three alternatives - a certificate program, an associate’s degree, or a bachelor’s degree.

Of all three options, the certificate program is desired for its speed. It takes less than one year to attain completion, but most of the training is geared toward laying the basic foundation.

Here, students learn the fundamentals of treatment procedures, body systems, and basic coding in ICD-10.

With an associate degree, however, there is a higher reliability and adaptability. Many employees, additionally, will prefer to hire applicants with an associate degree over those with a certificate program. It takes two years to complete.

Lastly, a bachelor’s degree takes the longest time to attain but also offers employers the most complete and most desirable package. They take four years to complete.

College Options

Those seeking a bachelor of science degree in health information management (HIM) may do so at Keiser University, where you complete a 120-credit program that takes 39 months.

Hutchinson Community College provides both a certificate and an associate degree. The certificate program has 38 credits, while the associate degree comprises 63 credits.

Preliminary Credentials (6 months)

Preliminary credentials for medical coders can be earned by taking a handful of examinations. Two of these are available once the programs are completed and offered through AHIMA.

The first is the Certified Coding Associate credential (CCA), while the second is the Registered Health Information Technician credential (RHIT).

AHIMA advises obtaining only a six-month work experience before you take the CCA exam, which consists of 90 to 115 multiple-choice questions. The questions are aimed towards determining competency, commitment, and capability. Application fee is $199.

The RHIT credential, on the other hand, does not necessarily require work experience. The exam is 3.5 hours long and consists of 130 - 160 multiple-choice questions to determine competency, computer proficiency, data analysis skills, and coding diagnosis familiarity.

Nonmembers of AHIMA would have to pay $299 for this exam, while members would pay $229.

Work Experience (1 - 2 years)

Getting work experience after obtaining a medical billing and coding certificate/degree is always a good idea. Employment can be easier to obtain if students use available resources at their schools to network and discover available opportunities.

Being a part of respectable professional organizations like the AAPC or AHIMA can also help significantly.

At this point, medical coders can still get familiar with how it feels to work in the field and even determine whether or not they prefer to work in a hospital or in a physician practice environment.

Extra Credentials (1 - 2 years)

AHIMA provides additional credentials such as the Certified Coding Specialist credential (CCS) and the Certified Coding Specialist Physician-Based certification (CCS-P).

The CCS is geared towards coders in a hospital setting to determine their proficiency in recognizing terminologies, disease processes, and pharmacology, while the CCS-P is for medical coders in a physician-based location.

The examination for CCS contains 115 to 140 multiple-choice questions, while that of CCS-P includes 9 - 121 multiple-choice questions. They both have eight medical scenarios where candidates are to select the appropriate range of medical codes.

Continuing Education

Continuing education is a massive part of being a medical biller and coder. All of the certifications obtained in the second and fourth steps above are only valid with being recertified every other year. For people with a CCA, CCS, or CCS-P credential, 20 continuing education units are required, along with two yearly coding self-reviews for every recertification cycle.

For those with a RHIT credential, however, only 20 continuing education units are required.

Your continuing education activities include Teleseminar, formal education programs, presentations, academic publications, and even AHIMA meetings.

Work Environment

The work environment for a medical biller and coder is practically wherever patients receive medical care and medical care providers are being paid for their services. For this reason, a medical biller and coder can work in a hospital, specialized medical departments, a doctor’s Office, nursing facilities, and even insurance companies.

It is common to find medical coders working in medical laboratories, scientific services, medical clinics, technology support departments, and medical goods companies.

There is plenty of demand for skilled labor in this field.