In 2020, 91.4% of Americans had health insurance in some form or another, according to the U.S. Census Bureau.1 Those who use health insurance may not think about how the cost of an office visit is processed and ultimately asks them to make their copay, but for doctors and other medical professionals, it’s incredibly important that office visits, tests and other medical procedures are properly processed and sent to insurance carriers so that they can be paid for their labor. Often, doctors are too busy to handle this themselves. That’s why there is an entire industry of medical billing and coding where workers handle these processes.
If you want to work in health care fast, but are not too excited about patient care, there are plenty of opportunities for you to succeed. One option for those who are interested in the business side of medicine is medical billing and coding. Learn more about this career, how to work in this field and more.
What is Medical Billing and Coding
Medical billing and coding is a part of the medical reimbursement cycle, and actually encompasses two separate jobs. Medical billing is the process of invoicing, submitting and following up on claims with health insurance companies, either private like major health care providers Aetna or UnitedHealthcare, or public such as Medicaid. Medical billers need to keep track of patient procedures and billing records to make sure they receive payment.
Medical coding, on the other hand, is the process of translating medical procedures into common medical codes used in the health care industry. Medical codes help summarize the medical services a patient receives. Those codes then document a patient’s health records and describe procedures that are performed to treat those conditions.
What Does a Medical Billing and Coding Worker Do?
Both medical billers and coders use languages like Current Procedural Terminology (CPT®),2 which is a uniform language for coding medical services and procedures to streamline reporting. Other medical coding languages include International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)3 and HCPCS Level II.4 These codes help turn what a doctor may note as running a test for strep throat into a precise process that can be understood by health insurance companies.
A medical coder translates patient records into various languages, while a medical biller submits those codes to various agencies for payment. The medical biller needs to understand how to read medical records and, like the medical coder, be familiar with the various code languages. Medical billers must also keep track of claims to make sure they are appropriately processed by health care payers to make sure the medical practice receives reimbursement. This involves precise record keeping.
Medical billers’ duties may vary depending on where they work. They can include both front- and back-office jobs such as gathering patient information, verifying health plan coverage, checking prior authorizations, collecting copays from patients, and ensuring medical codes are accurate before sending them to payers.
Why Work in Medical Billing and Coding
Medical billing and coding is a growing career with high demand.5 Health care occupations are projected to add more jobs than any of the other occupational groups. This growth in health care positions is attributed to an aging U.S. population that requires more medical services. As the demand for health care grows, so does the need for those who support health care practitioners.
Start Your Career in Medical Billing and Coding
Carrington College focuses on small class sizes and hands-on training. Here you’re more than a face in a room. Take the first step on your way to a new career in medical billing and coding.
How to Become a Medical Biller and Coder
Medical billing and coding is one health care profession that you can start quickly with fairly limited schooling. Here is a typical way to learn how to become a medical biller and coder.
- Research the profession. Medical billing and coding isn’t for everyone, so make sure you know what kind of skills you will need and assess if you are a good fit.
- Find the right medical billing and coding program. Assess schools to make sure they meet your needs, be they financial or just a schedule. Some medical billing and coding programs are offered online for convenience.
- Choose if you want to pursue a certificate or an associate degree. There are pros and cons to both options. A certificate can get you into the working world fast, while an associate degree can give you a more well-rounded education.
- Complete medical billing and coding training. Depending on if you chose a certificate or degree program, this can include courses on medical ethics, anatomy, or more.
- Consider AAPC medical billing and coding certification. The Certified Professional Coder examination is one way to show to employers that you have mastered the craft of medical coding.11
How Long is a Medical Billing and Coding Program?
Depending on if you want to pursue an associate degree in medical billing and coding, or if you just want to get a certificate, medical billing and coding programs can be fairly quick. If you only want to get a certificate of achievement, it can take as few as nine months. At Carrington College, an associate degree in medical billing and coding can be completed in as few as 16 months.
What is Medical Billing and Coding Blended Online?
Blended Online delivery includes regularly scheduled classes that are offered via online delivery. Students participate in a live class, as if it were an in-person class. Blended Online delivery also includes coursework that is not time specific, with on-demand videos, reading assignments and virtual activities that are self-paced with scheduled deliverables.
How to Find Medical Billing and Coding Jobs
Medical billers and coders work in health care, but there are many different options for where you can work. Basically any medical provider who bills insurance may have a need for medical billers and coders, this includes hospitals, physicians offices, home health care services, residential treatment facilities, dental offices, and every other medical office you can imagine.
When looking for medical billing and coding jobs, first check for major medical groups in your area. This will vary by state and city. The next best place to look for jobs would be major listing sites like Indeed, or industry specific boards like the AAPC.12
What to Look for in a Medical Billing and Coding Program
Choosing the right medical program for you is a big decision. The right training can open doors for better jobs and possibly salary down the line. While many institutions may offer medical billing and coding classes, it’s important that you look for the one that fits your goals and lifestyle.
A few core things to look for when considering medical billing and coding programs include:
- Small class sizes. When learning to be a medical biller or coder you want individual attention from your instructor.
- Program format. It’s important that you choose a program that fits your learning style and lifestyle. Carrington College offers the Medical Billing and Coding program via a Blended Online Delivery method.
- Externships or career training. Most programs include an opportunity to learn in the real world before you even graduate! You’ll earn an impressive experience that looks great on your resume.
- Cost. Education is a major investment, but it’s an investment in your future. At Carrington College and many other institutions, we participate in most financial assistance programs, both federal and state, as well as private financing. Student loans, grants, and scholarships are available to those who qualify. For complete information on current tuition costs, please see the academic catalog.
Medical Billing and Coding Certificate vs Associate Degree
Another major decision you’ll make when considering medical billing and coding school is if you want to pursue an associate degree or a certificate. Both options provide you with the skills you need to start working in medical billing and coding. The major difference is the length of the program. With a medical billing and coding certificate program, you will focus on medical billing-specific courses. If you were to pursue an associate degree option you may take additional coursework including:
- Computer literacy
- English writing and composition
- Social sciences
Discover Your Career in Medical Billing and Coding
Carrington College’s Medical Billing and Coding Program offers you the hands-on training you need for a job in medical billing and coding. Take the first step on your way to a new career.
What Will I Learn in Carrington College Medical Billing and Coding Programs?
Some courses you would take if you were to enroll in the Medical Billing and Coding program at Carrington College include:
- MBC 10 Medical Billing and Coding Theory 1 This course provides an overview of medical insurance, medical ethics, confidentiality practices and the life cycle of an insurance claim. Anatomy, physiology and terminology units including levels of organization, anatomical position, planes and body cavities and related medical terminology are presented. An overview of the musculoskeletal system is presented, as are associated coding and medical terminology.
- MBC 30 Medical Billing and Coding Theory 3 This course focuses on day-to-day medical financial practices, patient statements, collection techniques and communication skills. It addresses cultural diversity, HIV and AIDS. An anatomy, physiology and terminology unit is presented on the gastrointestinal, genitourinary and reproductive systems.
- MBC 40 Medical Billing and Coding Theory 4 This course provides students with an understanding of the various models of managed care including Medicare, Medicaid and Medi-Cal. Topics include federal and state guidelines, eligibility requirements, benefits, managed care implications, participating providers, pre-approval of services guidelines and step-by-step claim form instructions. It includes extensive ICD-10 coding, CPT coding and authorizations and referrals. An anatomy, physiology and terminology unit is presented on the cardiovascular system and related coding and medical terminology.
- MBC 501 Externship The externship provides students with field experience in a professional setting. Students practice acquired skills under direct supervision. This is a credit/no credit course.
Find Carrington Medical Billing and Coding Programs Near Me
Carrington College employs a skilled faculty who are experts in their field. Learn anatomy, physiology, coding languages, medical ethics and more with our program.
Learn more about the Blended Online Program options.
Visit https://carrington.edu/admissions/student-consumer-information/ for important information on program outcomes.