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 healthcare 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 coding and billing 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 healthcare 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 healthcare 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.
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 healthcare 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 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.
- Complete medical billing and coding training. Training programs can teach students to accurately interpret medical records, including diagnoses and procedures of healthcare providers, as well as to document and code the information for submission to insurance companies.
- Earn your medical billing and coding certification. Enhance your medical billing and coding training and/or experience through a certification credential. Learn more about earning your medical billing and coding certification credential through the AAPC, which offers a number of healthcare industry certifications.
How Long is a Medical Billing and Coding Program?
Medical Billing and Coding program completion times vary from program to program. However, at Carrington College, you can earn your Medical Billing and Coding Certificate in as few as nine months.
What is Medical Billing and Coding Blended Online?
Blended online delivery includes regularly scheduled classes for medical billing and coding 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.
What to Look for in a Medical Billing and Coding Program
Choosing the right medical coding and billing training 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 coding and billing training 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 medical billing and coding schools and training 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.
What Will I Learn in Carrington College’s Medical Billing and Coding Program?
Some courses you would take if you were to enroll in the Medical Billing and Coding program at Carrington College include:
- MBC10.H 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.
- MBC30.H 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.
- MBC40.H 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.
- MBC501 Externship The externship provides students with field experience in a professional setting. Students practice acquired skills under direct supervision.
Find Carrington Medical Billing and Coding Programs Near Me
Carrington College offers a Medical Billing and Coding certificate program in a Blended Online format. The certificate is conferred from the Sacramento campus and Spokane campus (Washington residents).
Learn more about the Medical Billing and Coding blended online program.
Visit https://carrington.edu/admissions/student-consumer-information/ for important information on program outcomes.
December 19, 2023