The U.S. healthcare industry is massively complex system of integrated patient care providers, health service organizations, insurance companies, pharmacology businesses, medical product suppliers and more. Navigating the diagnostic, reporting, and payment processes falls under the purview of medical billing and coding professionals. A diverse occupational field, medical billing and coding includes positions such as coding specialist, reimbursement manager, billing compliance specialist, medical coder and compliance auditor.
In these roles, medical coding and billing professionals handle a variety of tasks, from calculating patient charges to preparing statements; from collecting patient diagnoses to submitting patient data to insurance carriers. The following pages provides an overview of the career training options for prospective medical billers or coders, including online options, curriculum, credentials and certifications, as well as an interview with a medical biller with several years of experience.
Medical billing and coding professionals combine a wide variety of skills and knowledge of vital information about insurance processing, compliance regulation, patient’s rights and terminology. Finding the right online program can be challenging, considering the multitude of options at schools offering certificates, diplomas and associate degrees. Overwhelmed by choices? The search tool below can lead right to the schools that offer the programs and training at the level that matches your goals. Programs are sorted by degree level, accreditation, type of school and the cost of tuition.
The training programs of medical billing and coding professionals have experienced a significant transition during the past decade, growing into some of the most popular distance education programs in the country. A professional, practice-based form of training, these educational programs are designed to equip students with industry-specific skills required for entry-level positions in a variety of healthcare settings. Because there is no singular educational requirement to become a medical biller or medical coder, prospective professionals in the field have a selection of training avenues to pursue.
Medical billing and coding educational programs fall into three general formats: certificate, diploma and associate degrees. There are undergraduate (bachelor’s) and graduate (master’s) degrees available in the field, but they generally fall under a larger umbrella of health services, health informatics or related fields. All three of the common types (diplomas, certificates, associate degrees) can be completed entirely online, providing a level of flexibility to working professionals.
The educational breakdown of medical and billing coding varies, according to the American Academy of Professional Coders (AAPC). In its annual survey, the AAPC revealed that slightly over 20 percent of its members surveyed have no college education, while approximately 52-55 percent possess some college education or an associate degree. No matter what the level of certificate or degree, medical billing and coding training programs share the same instructional foundations: Current Procedural Terminology (CPT), ICD Coding and Healthcare Common Procedure Coding:
No matter the training program, students are generally qualified to sit for several national certification examinations upon graduation:
Online certificate programs self-paced, allowing students to study and complete their coursework on their own schedule and time. Depending on the program, certificates may be completed in as little as four months, but may require 12 or more months to finish. Certificate programs can be considered shortened versions of career diploma and associate degree programs. They are aimed at students seeking new career skill development or an opportunity to enhance their existing professional skills. Although the number of credits varies, the curriculum of certificate programs focuses on preparing graduates for entry-level positions in the industry in setting such as hospitals, physician’s offices and clinics.
The curriculum offers students foundational training in areas such as office procedures, medical terminology, pathophysiology, electronic medical records, business English and pharmacology. Some of the common outcomes shared by online certificate programs in medical billing and coding include the following:
Students who complete an online certificate in medical billing and coding can traditionally apply credits from their program as electives towards a future online associate or bachelor’s degree program.
Like the certificate, diploma programs in medical billing and coding can be completed entirely online. Diplomas exist between the short-term, career-focused certificate and the longer, more comprehensive associate degree programs. The objective of diploma programs is to provide students with a thorough education that prepares them for an entry-level position as a medical coder in a variety of healthcare settings such as a hospital or physician’s office. Unlike the certificate, diploma programs generally require at least 12 months of study to complete and offer a better-rounded curriculum.
The curriculum not only covers the foundational subjects in the field, but more advanced topics such as healthcare systems and operations, health information management or insurance claims adjudication. Some online college programs may require students to complete an internship or research project prior to graduation. The objectives of diploma programs are closely aligned to the certificate – after finishing their studies, diploma holders should be able to do the following:
The associate degree is the longest, most comprehensive educational option available to prospective medical billers or medical coders. The naming convention varies by college or program, with some granting an Associate of Science and others issuing an Associate of Applied Science. The titles vary as well, ranging from Associate of Science in Insurance Billing and Coding to Associate of Applied Science in Medical Billing and Coding. These programs offer students the opportunity to complete their professional training through an online, self-paced format. Associate programs are designed to be completed in approximately 24 months of study, requiring between 60 and 64 credit hours to graduate.
Curriculum is divided between general education classes (e.g. humanities, mathematics, English, social sciences) and required coding and billing courses. Example topics of study include diagnosis coding, procedure coding, pathophysiology, pharmacology, coding ethics, medical terminology and insurance claims processing. Like the diploma, some colleges may require students to complete a research project or internship to develop real-world, applicable skills. The goals of associate degree programs are two-fold: 1) to prepare graduates for entry-level billing and coding positions and 2) set the foundation for a transition to bachelor’s degree programs.
Enhancing existing and developing new knowledge and skill sets are the major goals of online medical billing and coding training programs. However, because of the diverse array of educational options available, it is important for prospective students to review the each potential program to assess how it fits with their future professional and personal goals. The first, and most important, factor for students to consider is the reputation of their target institution, ensuring it is respected within the larger healthcare industry. Other factors prospective students may want to consider before deciding on an institution:
The American Health Information Management Association maintains a list of approved certificate programs, while the Commission on Accreditation for Health Informatics and Information Management Education enforces accreditation of associate and bachelor’s degree programs in the field. Accreditation indicates the training program adheres to industry and educational standards and, in turn, its overall quality. Additionally, some certifications may require students to complete an AHIMA or CAHIIM-approved program of study to be eligible for the examination.
In general, each certificate, diploma and associate program qualifies students to sit for a range of credential and certification examinations. However, that is not always the case. Students should review both the curriculum and program standards to ensure their target educational program does allow them to sit for professional credential examinations.
Because of their highly specific nature, both medical billing and medical billing require an additional level of specialized training. The American Academy of Professional Coders (AAPC) is the leading organization for credentials in the field, serving as the national standard bearer for professional credentials in both fields. The American Health Information Management Association (AHIMA) also offers several certification options for graduates of online medical billing and coding programs. Earning medical coding credentials demonstrates the candidate’s expert knowledge of the coding industry, spanning coding assignments and application of ICD-9 and ICD-10. For the medical biller, professional credentials confirm and support a candidate’s knowledge of the healthcare business and the particular nuances of medical billing.
The AAPC offers five different types of medical coding examinations and credentials: CPC, COC, CIC, CRC and CPC-P. Below is an overview of each certification:
Other types of AAPC coding credentials include the Certified Professional Coding Professional (CPC-I), Certified Professional Compliance Officer (CPCO), Certified Professional Medical Auditor (CPMA) and Certified Physician Practice Manager (CPPM).
Like AAPC, AHIMA offers three core certifications and credentials for medical coding professionals:
Certified Coding Association (CCA) Launched in 2002, the CCA designation is one of three coding credentials recognized and accredited by the National Commission for Certifying Agencies (NCCA). The CCA demonstrates a candidate’s experience and expertise in coding practices across healthcare settings.
In addition to its five core credentials, AAPC also offers a range of specialty credentials designed to demonstrate a coder’s expertise in specialized disciplines. Specialty examinations measure a candidate’s real-world skills and preparedness in areas such as coding, compliance and regulation. There are 22 specialty coding credential options, spanning specific areas of medical care, from cardiology to gastroenterology, hematology to pediatrics. Below is the list of available specialty credential options from AAPC:
The AAPC also offers billing professionals an industry-recognized credential: the Certified Professional Biller (CPB). Individuals who earn CPB certification demonstrate they have an advanced understanding of the complexities of the U.S. health care’s complex business and revenue cycles, including:
Each year the American Academy of Professional Coders conducts a healthcare business salary survey, which examines earnings by experience, educational attainment and qualifications. There is a major takeaway for prospective medical billers and coders: credentials and certifications influence earning power. The 2014 survey revealed experience, credentials and area of practice all impact the earnings of medical billing and coding specialists.
Below is a list of billing and coder salaries by healthcare settings in 2014:
|Health System Workers||$54,186|
|Large Group Practice||$49,342|
|Medium-Sized Group Practice||$46,762|
|Solo Practice/Small Group||$45,851|
At the credential level, the core coding credentials earned an average salary of approximately $54,600 in 2014. The best salaries were for individuals in management and auditing positions. Below is a list of 2014 salaries by credential area:
Kristin N. of Santa Fe, New Mexico is a stay-at-home mother of two children who has recently enrolled in an online certificate program with a desire to become a Certified Professional Coder. AffordableCollegesOnline recently interviewed her about her professional background, why she chose medical billing and coding and her advice for preparing to undertake a certification program online.
Why did you choose to pursue a career in medical coding?
Prior to having children, I was an elementary school teacher for nine years. My husband and I have had multiple discussions about me transitioning back into the workforce. I discovered I no longer wanted to teach, but wanted a flexible career opportunity so I could continue to focus on raising my children. After much research, I discovered medical coding.
Why did you choose an online certificate program?
Again, the flexibility was the primary factor. Being able to study online and complete classes on my time is a big bonus. The second factor was cost. I didn’t want to pay thousands and thousands of dollars for an associate or bachelor’s degree. I wanted a career-oriented training program. The third factor was time. My online program will be finished in seven months, which is manageable when you’re a full-time mother.
What advice would you give to students thinking about going into the field?
Well, I’m relatively new to the industry. But, I have two points of advice: I’d tell students to choose an accredited program that is recognized by professional organizations and I’d also recommend they research the coding job market in their area to make sure there are local career opportunities prior to starting a training program.
What’s been the most challenging part of your program to-date?
Everything! My background in education is in another galaxy than healthcare. Coding is completely foreign to me and learning about medical terminology can be extremely difficult. But, my instructors are very supportive and my husband has been wonderful arranging time for me to study without dealing with the kids. So, those are to two biggest challenges: my unfamiliarity with coding and the pressure of being both a mom and a student.