Medical Billing & Coding Overview: Education & Job Outlook

The complete guide to medical billing and coding programs, certification, careers and advancement opportunities.
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Medical Billing Career Facts

Overview

The ever-increasing documentation required in the health care industry is becoming more complex than ever and has created a growing need for a Medical Records and Health Information Technology (HIT).

A patient going to an emergency room, hospital, a doctor’s office and other clinics are required to complete many pages of paperwork related to topics such as reason for visit, ailments, personal and family medical history, allergies, and many others that are part of a patients file.

A Health Information Technician processes this data and make sure they are current and meet government regulations and insurance requirements.

Two of the biggest job roles in the Health Information industry are Medical Billing and Coding as well as Medical Transcriptionist.

Required skills for these jobs are to organize, compile and process medical information data for hospitals, clinics and other health care facilities and all are in strong demand.

There are other specialized roles within the Health Information field such as Clinical Data Managers, Insurance Claims clerks, and Insurance Policy Processing clerks to name a few.

Medical transcriptionist and Medical Billing & Coding typically obtain a 2-year degree in Health Information but there are programs that offer certificates and diplomas from specialty schools in a shorter time period if the college associates degree is not for you.

Medical Data processing is a $15 billion industry today and expected to grow to be a $68 billion market within a decade.  The Bureau of Labor (BLS) predicts 23,100 new HIT jobs in the next 5 years growing at 11% from today’s workforce so the job prospects are excellent.

Medical Billing and Coding vs. Medical Transcriptionist

Both of these roles are considered to be Medical Data technologist, and both typically require an associate degree from an accredited college or trade school. There are some functions that these two roles have in common, but they are very different in practice.

A Medical Billing and Coding technician takes patient data and records them using a standard coding system in the U.S. You will need to decipher handwritten case studies and notes from physicians and billing information from hospitals, clinics, and other medical facilities and code them into a software system used by the industry.

A Medical transcription technician also uses patient data but primarily focuses on creating records as dictated by the patient’s doctor while diagnosing a patient. The Transcriptionist could be in the room or the doctor may even speak into a recorder as the doctor is diagnosing a patient. The Transcriptionist records this patient’s data into a system using specialized software.

States do not require licenses or certifications for Health Information technologists but to be competitive in the job market, many obtain a Registered Health Information Certification (RHIT) administered by American Information Management Association after obtaining your associate degree. Other common certifications to enhance your career are the Registered Medical Transcriptionist (RMT) and Certified Medical Transcriptionist (CMT). Entry level certifications are Certified Coding Associate (CCA) and Certified Coding Specialist (CCS). These require a high school education and 6 months experience.

Medical Billing & Coding Education: Degrees and Programs

A typical Healthcare Information Technologist college curriculum is 60 credit hours of school and have to maintain no less than a ‘C’ in each class. In 2019, there were 350 2-year colleges offering HIT programs.

The U.S. Department of Education recognizes the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) as the accreditation standard used by higher education. If choosing to go into the Medical Coding and Billing field, make sure you attend an accredited school.

Tuition costs will vary at different universities depending on factors such as living in state or out of state, public or private school and how long it takes you to finish.

One sample state college estimated taking 15 hours in one semester including tuition, books and supplies only (no room and board, transportation, and other miscellaneous fees) it would be about $4,000 for a local resident and a non-resident about $20,000 for the same semester. Technical schools that will only get you an entry level certification will typically be around $1,000 for an online program.

A typical associates degree program at an accredited college would be similar to the following:

Prerequisites (many high schools offer college equivalent)

  • Introduction to Anatomy and Physiology
  • Health Data Content and Structure
  • Essentials of Medical Terminology
  • Business Computer Applications

Semester I

  • Medical Terminology – Advanced
  • Legal and Ethical Aspects of Health Information
  • Pharmacology
  • English Composition I

Semester II

  • Health Care Delivery Systems
  • Introduction to Speech Communication
  • Pathophysiology
  • Coding and Classification Systems

Semester III

  • Clinical – Health Information/Medical Records/Technician
  • Coding and Insurance

Semester IV

  • Coding and Reimbursement Methodologies
  • Health Care Statistics
  • Health Information Systems
  • Ethics

Semester V

  • Clinical – Health Information/Medical Records/Technician
  • Health Information Organization and Supervision
  • Quality Assessment and Performance Improvement
  • Introduction to Psychology

Semester VI

  • Competency Review
  • Clinical – Health Information/Medical Records/Technician

Health Information Certifications

The information below shows some of the health information certification credentials and their descriptions. You can also see each certifications eligibility requirements to take the certification exam and types of work environments you can expect once certified.

Credential - Title Description

RHIA

Registered Health Information Administrator
Expert at managing patient health and medical records

RHIT

Registered Health Information Technician
Ensures quality fof medical records completeness and accuracy

CCA

Certified Coding Associate
Coding competencies specializing in Healthcare

CCS

Certified Coding Specialist
Expert at classifying medical data from patient records

CCS-P

Certified Coding Specialist - Physician
Expert at coding and managing records in physicians offices

CDIP

Certified Documentation Improvement Practitioner
Documentation integrity for auditing purposes

CHDA

Certified Documentation Improvement Practitioner
Documentation integrity for auditing purposes

CHPS

Certified in Healthcare Privacy and Security
Designs and Implements privacy and security protection programs
Credential - Eligibility for Exam Work Environment

RHIA

Bachelor or Master of Science in Health Information Management (HIM)
Typically works in Hospitals, physician clinic, nursing homes

RHIT

Associates Degree in Health Information Management (HIM)
Typically works in Hospitals, physician clinic, nursing homes

CCA

High School Diploma or equivalent
Typically works in Hospitals, physician clinic, nursing homes

CCS

Either RHIA, RHIT, CCS or 2 years experience
Works at Health Insurance companies, hospitals, government agencies

CCS-P

Either RHIA, RHIT, CCS or 2 years experience
Physician office, multi-specialty clinics

CDIP

Associates degree with 3 years experience. Or RHIA, RHIT, CCS, CCS-P, RN, MD with 2 yrs experience
Typically works in Hospitals, physician clinic, nursing homes

CHDA

RHIT plus 3 years experience or Bachelor plus 3 years experience or RHIA, or Masters HIM, or Masters and 1 year experience in health data
Typically works in Hospitals, physician clinic, nursing homes, government agencies

CHPS

Associates plus 6 years OR RHIT and 4 years OR Bachelor plus 4 years or Masters and 2 years in Healthcare privacy
Typically works in Hospitals, physician clinic, nursing homes, government agencies
Credential or Certification Eligibility Requirement for Exam Work Environment

RHIA

Registered Health Information Administrator

Expert at managing patient health and medical records
Bachelor or Master of Science in Health Information Management (HIM)
Typically works in Hospitals, physician clinic, nursing homes

RHIT

Registered Health Information Technician

Ensures quality fof medical records completeness and accuracy
Associates Degree in Health Information Management (HIM)
Typically works in Hospitals, physician clinic, nursing homes

CCA

Certified Coding Associate

Coding competencies specializing in Healthcare
High School Diploma or equivalent
Typically works in Hospitals, physician clinic, nursing homes

CCS

Certified Coding Specialist

Expert at classifying medical data from patient records
Either RHIA, RHIT, CCS or 2 years experience
Works at Health Insurance companies, hospitals, government agencies

CCS-P

Certified Coding Specialist - Physician

Expert at coding and managing records in physicians offices
Either RHIA, RHIT, CCS or 2 years experience
Physician office, multi-specialty clinics

CDIP

Certified Documentation Improvement Practitioner

Documentatation integrity for auditing purposes
Associates degree with 3 years experience. Or RHIA, RHIT, CCS, CCS-P, RN, MD with 2 yrs experience
Typically works in Hospitals, physician clinic, nursing homes

CHDA

Certified Health Data Analyst

Expert at health data analysis and big picture strategy
RHIT plus 3 years experience or Bachelor plus 3 years experience or RHIA, or Masters HIM, or Masters and 1 year experience in health data
Typically works in Hospitals, physician clinic, nursing homes, government agencies

CHPS

Certified in Healthcare Privacy and Security

Designs and Implements privacy and security protection programs
Associates plus 6 years OR RHIT and 4 years OR Bachelor plus 4 years or Masters and 2 years in Healthcare privacy
Typically works in Hospitals, physician clinic, nursing homes, government agencies

Medical Billing & Coding Salaries

The Bureau of Labor Statistics (BLS) has detailed statistics on role which vary state by state but the median average salary for Medical Records and Health Information technicians is $40,350 per year.

Several factors determine the final salary or wage of a Medical Billing & Coding professional including specialization within a field, experience, and geography to name a few. The areas with a higher cost of living tend to pay above average.

The top five top paying states for medical billing and coding according to the BLS:

  • New Jersey
  • District of Columbia
  • California
  • Connecticut
  • Hawaii
Quick Facts: Medical Records and Health Information Technologists
2018 Median Pay

$40,350 per year

$19.40 per hour

Typical Entry-Level EducationPost-secondary non degree award
On-the-job TrainingNone
Number of Jobs, 2018215,500
Job Outlook, 2018-2811% (Much faster than average)
Employment Change, 2018-2823,100

Source: Bureau of Labor Statistics

Health Information Job Growth

The future is very bright for Billing and Coding Technicians and Transcription Technician job growth. According to BLS, they predict employment to grow 11% from now through 2028. This is a much faster than average growth occupation in the Allied Health industry in terms of jobs. The BLS predicts 23,100 Medical Billing and Coding and Transcription technicians’ jobs will be added between 2018 and 2028.

Job growth for Health Information industry is growing as favorable laws recently passed in the U.S. are increasing the demand for patients and more strict documentation is required.

The need for Health Information technicians is in every state but some areas have more need and are willing to pay more to start.

The top five states with the most jobs according to BLS are:

  1. California
  2. Texas
  3. Florida
  4. New York
  5. Ohio

Medical Billing and Coding Duties

These specialist jobs primarily code and bill for in-office procedures, payment posting, and reimbursement from insurance. Some accounting and patient statement balance knowledge is helpful.

A typical job description for a Medical Billing and Coding specialist is:

Medical Coding Duties

  • Reviews all documentation to ensure coding quality by the provider
  • Apply coding rules on patient and use of CPT and ICD codes
  • Assist in educating physicians and staff in requirements of documentation for reimbursement.
  • Review and recommends updates on coding changes.
  • Assist with annual bill review and update with codes.
  • Assist in conducting internal audits of patient charges

Medical Billing Duties

  • Submit claims daily.
  • Check for data errors.
  • Determine and resolve problems that resulted in a rejected claim.
  • Resubmit/refile and appeal rejected claims if necessary.
  • Check coding and post charges.
  • Submit claims
  • Run daily updates and insurance exception reports.
  • Review and correct, re-scrub rejected claims.

Medical Billing & Coding Personality Traits

Medical transcriptionists and medical billing and coders play a critical role in aiding the physician and patients to make sure the practice is compliant, documented, and insurance claims and payments are properly handled.

Here are some personality traits that can help HIT professionals succeed:

  • Excellent communication skills
  • Ability to read and interpret physician diagnosis
  • Pay close attention to detail
  • Dependable
  • Tech Savvy
  • Excel at research
  • Self-starter and ability to work without supervision

If you love working in an office or from home and are passionate about the health industry, then a Medical Information Technician career maybe the most fulfilling for you.

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