Medical coders/billers are responsible for gathering patient information, including patient medical history, examination results, symptoms, diagnostic tests, treatment history, and more. Once they obtain history, medical coders are then responsible for ensuring the accuracy and patient confidentiality of these files as they present them to healthcare providers or insurance agencies. Medical coders will often communicate with physicians and other healthcare providers in the case that additional patient information is required.

The financial success of a healthcare provider's office often depends on the work of medical coders, as they assume the responsibility of managing the flow of money in and out of the office. Medical coders are responsible for ensuring that healthcare providers receive payment (e.g., from Medicare) for the services that they provide. The main responsibility of medical coders is to create a claim that matches diagnostics, treatments, and procedures with the corresponding numeric codes.

This information will be entered into a database and then sent off to an insurance carrier where it will be approved or denied. Hopefully the claim will be approved, which means that the healthcare provider will be reimbursed. In the case that the claim is denied, the medical coder assumes the additional responsibility of investigating why the claim was rejected and making any updates to the claim.

Career Specializations

AAPC offers coders who demonstrate expertise in their work the opportunity to specialize in 20 different disciplines. Medical coders can obtain certification in these 20 areas without having previously obtained the CPC credential.

• Cardiology: Medical coders in this discipline will have to be knowledgeable of the many surgical procedures that cardiologists perform, including, but not limited to, heart catheterizations and peripheral vascular procedures.
• Emergency Room: ER physicians must perform lifesaving medical procedures under high stress, like repairing lacerations and removing foreign objects from the body. Medical coders working in the ER must be familiar with all of these procedures.
• Urology: Urology coders must code for ancillary procedures like urinalysis and injections, and surgical procedures like cystoscopies and biopsies.
• Dermatology: Medical coders in dermatology must be familiar with all the medical terminology associated with conditions and treatment of the skin.
• Obstetrics Gynecology: Obstetrics services include deliveries and care administered before and after birth. Medical coders in this discipline code for all of these services.

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Available Degree Levels

• Associate Degree: 2 years to complete

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Education & Certification Requirements

Most of those who become medical coders & billers have at least completed an associate degree in a related field. Additionally, credentials for medical coding are offered by the American Academy of Professional Coders (AAPC). Moreover, credentialing in specialty coding is offered by the Board of Medical Specialty Coding (BMSC) and the Professional Association of Healthcare Coding Specialists (PAHCS).

Certification is not required to work as a medical coder, but it is highly recommended. AAPC reports that compared to noncertified coders, Certified Professional Coders (CPC) typically earn 20 percent more on average. Also, certified coders have a greater chance of being hired.

The CPC exam consists of 150 multiple-choice questions which you are given 5 hours and 40 minutes to answer. The exam costs $300 and includes one free retake. In order to pass the exam, you must demonstrate your extensive knowledge of responsibilities associated with working as a medical coder/biller.

These responsibilities include reviewing and assigning accurate medical coding for diagnoses and procedures; knowing rules and regulations of medical coding, including how to integrate medical coding and reimbursement rule changes into the reimbursement practices at a particular provider; and being familiar with the anatomy, physiology, and medical terminology that will be necessary to perform accurate coding. (AAPC)

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Salary Information

In May 2008, the median annual wages of medical records and health information technicians was $30,610. Of those surveyed, the highest 10 percent earned more than $50,060, while the lowest 10 percent earned less than $20,440. The highest-paying industry was the Federal Executive Branch, which paid medical records and health information technicians a median annual wage of $42,760. (BLS)

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Job Outlook

According to the Bureau of Labor Statistics, employment for medical records and health information technicians (i.e., medical billers & coders) will increase by 20 percent over the period of 2008 to 2018. This projected growth is much more than the average growth for all occupations. Because of the increasing number of medical tests, treatments, and procedures being performed, there will be an increasing demand for medical records and health information technicians. The aging population, with its large dependence on healthcare, will also contribute to employment growth for medical billers & coders. (BLS)

Additionally, there will also be an abundance of job openings when medical record and health information technicians retire or permanently leave the occupation. (BLS)

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Related Careers

In addition to a medical biller/coder, you also might consider working as a medical assistant. With this position, your work will also ensure that the offices of healthcare providers run smoothly. Your work as a medical assistant will combine both administrative and clinical duties. For example, you might be responsible for updating and filing patients' medical records or taking medical histories and vital signs. To become a medical assistant, you can plan on completing a one- or two-year training program.

Secondly, a career in medical office administration may appeal to you if you have been thinking about becoming a medical coder & biller. With a career in medical office administration, you can have as many responsibilities as you are willing to take on. For instance, you might work as a medical secretary who performs administrative duties around the office or you might be in charge of a full-scale medical facility. Of course, if you're thinking about taking on more responsibilities, you'll need to complete more education to show that you are capable. The minimum education requirement for a career in medical office administration is the completion of an associate degree and a test administered by the American Health Information Management Association, but many choose to go on and pursue bachelor's or master's degrees.

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