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Medical billing and coding probably isn’t the first thing you think of when you hear “medical field”, but it’s every bit as important as the frontline workers. Without proper coding and billing, medical bills would fall on the patient in their entirety. How many people do you know who have thousands of dollars laying around for cancer treatments, medications, and other medical necessities? Me either.
If you’re interested in entering this career field, you’ve come to the right place. We’re going to take a closer look at the responsibilities of a medical biller and coder, so you can get a better idea of what it takes to become one, what you’ll be doing, and what your options are.
What Does A Medical Coder Do?
So, what does a medical coder do, anyway? In the medical field, every operation, prescription, or medical procedure has a standardized code assigned to it. This helps insurance companies understand what they’re being billed for, since conditions vary and not everyone in the medical field uses the same language to describe conditions/ailments, etc.
These codes are then sent off to the billing department to be turned into a billable invoice. Why is this so important? Because without insurance, most medical procedures, medications, etc., would be out of reach for the average person. Medical coders are essentially translating the doctors’ work for the insurance companies, so they can pick up their half of the tab. Proper coding also ensures high-quality care in the future and helps to improve the overall quality of care in the industry as a whole.
Medical coding is one of the most essential medical jobs out there, and you can obtain a certification in just a few months.
You can obtain a CMC (certified medical coder) certification, but you can also obtain several other specialized certifications to broaden your horizons. Specialized certifications can help open up new opportunities for you in other areas, and may even increase your salary by as much as $20,000 per year. Some specialized certifications include:
COC: The certified outpatient coder is a specialization for coders that work in hospitals. A hospital is a very different environment than a doctor’s office and has much more specific requirements for its coders.
CIC: The certified inpatient coder is a specialization for coders who work in inpatient facilities. This is different from a hospital and requires different skills and knowledge.
CPC-P: This stands for Certified Professional Coder-Payer. The specialization is for those wishing to work with the insurance side of things, or the payer side.
There are several other specializations as well, which you can find on the AHIMA website.
What Does A Medical Biller Do?
Online medical billing and coding courses will often put coding and billing together, but they can be two separate jobs. Where the coder takes medical procedures and turns them into code, the biller sends off those codes to be paid for by insurance companies. Essentially, you’ll work in the billing department, ensuring claims are paid for and codes are sent properly.
This is a job that most organizations will lump together with coding, so you’ll likely end up doing both. On the off chance you don’t, however, we’ll cover the separate certifications for billing.
Generally, there are two certifications you can obtain to become a medical biller. The first is the Certified Medical Reimbursement Specialist (CMRS). The second is the Certified Medical Billing Specialist (CMBS). The certification you choose will dictate where you work, but generally, you can fill most biller positions with either certification. Each certification carries a cost of between $200-$300, depending on which organization you choose to take your exam with.
Your certifications can be obtained once you complete your exam(s) and submit payment. While most states don’t have a hard requirement for medical billing, most medical institutions will require that you have a certification in order to work for them.
Training Options and Requirements
Luckily, there are thousands of options for training/education. Most require a high school diploma at the least and take as little as 10-12 months. Or, if you don’t just want certification, you can pursue an associate’s degree. This, of course, takes longer—but can open up more opportunities in the future.
Medical billing and coding can be a viable option for anyone looking to enter the administrative side of the medical field, or for anyone who just needs a career change. A fast-track career, a positive job outlook, and affordable education options make billing and coding one of the best choices available. You can earn a certification in as little as ten months, and with more specializations, you can increase your salary, too.