Medical billing and coding specialists play a vital role in healthcare administration, translating medical services into standardized codes for insurance claims processing. With increasing demand due to aging populations and health reforms, this career promises stability and growth. However, succeeding requires specialized expertise and communication skills.
This overview provides actionable tips for those exploring medical billing and coding, drawn from the real-world perspective of working professionals.
Career in Medical Billing and Coding – 5 Tips to Consider
If you are considering a career in medical billing and coding, here are 5 essential tips:
1. Find an Accredited Program
There are many medical billing and coding training programs, but it is crucial to verify proper accreditation. Check that a certificate or diploma course is accredited by a recognized healthcare education body. Academic programs approved by the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) ensure you gain industry-relevant skills.
Vocational programs offered by community colleges also provide robust medical billing and coding education. A combination of theoretical coursework and practical training through internships gives well-rounded preparation for healthcare administration roles. When comparing programs, check course syllabi and instructor credentials too. Programs affiliated to the Registered Apprenticeship program for Medical Billers and Coders are also a good choice.
2. Learn the Industry Codes
A strong working knowledge of medical coding systems is vital for billing and coding jobs. Two essential categories of codes are:
ICD-10-CM Codes – The ICD-10-CM or International Classification of Diseases, 10th revision is used to code medical diagnoses and inpatient procedures. There are over 70,000 ICD-10 codes used to precisely document details like illness, injury, symptoms and the cause of these conditions. Proper ICD-10 coding drives reimbursement amounts for providers.
CPT Codes – The Current Procedural Terminology or CPT codes represent medical services like clinical tests, surgical procedures, medical equipment and healthcare administration activities. These 5-digit alphanumeric CPT codes describe exact services and treatment methods on claim forms. There are over 8,000 codes which are updated annually.
Resources like Med Genius provide an online ICD-10-CM and CPT code lookup to clarify definitions. Getting very comfortable using these coding systems is key before you start working. We’ll cover the other tips in the next response.
3. Sharp Communication Skills
Excellent communication abilities, both oral and written are essential for medical billing and coding jobs. You need to correspond clearly with healthcare providers to obtain accurate clinical documentation and claim forms. Strong phone skills are vital to contact insurance companies and follow-up on unpaid claims.
Writing coherent emails and letters to convey coding guidelines and queries is also important. Having an analytical mindset helps assess clinical details thoroughly and seek additional information if diagnosis notes seem unclear.
4. Stay Updated on Healthcare Policies
Healthcare rules and regulations evolve regularly so staying current is imperative. Seek information on changes to coding guidelines, reimbursement policies, HIPAA protocols and reforms in Medicaid, Medicare and private insurance.
Joining local AHIMA chapters and AAPC networks to exchange industry news is advisable. You could also pursue advanced certifications like the Certified Professional Coder (CPC) credential to cement expertise in the latest standards and compliance needs.
5. Get Certified
While certification is rarely mandatory, getting certified demonstrates your proficiency to employers. Entry-level certified coding associate programs are a good starting point for basics of medical records and insurance claim processing.
After gaining some experience, you can take certification exams to become a Certified Coding Specialist (CCS) or Certified Coding Expert (CCE) in focused areas like cardiology, neurology or orthopedics. Maintaining credentials via continuing education also provides career advancement opportunities in related health information roles.
Choosing the Right Work Environment
Medical coding and billing job roles are available in diverse healthcare settings, so consider which work environment matches your interests and skills. Some options to explore:
1. Physician Practices and Clinics
Doctor’s offices and multi-specialty clinics have openings for medical billers and coders working closely with small provider teams. You support clinical documentation and claim submission for a limited set of procedures. Prefer this if you like having a close-knit team.
2. Hospitals and Health Systems
Larger hospitals have specialized departments focused on coding insurance claims spanning diverse specialties and treatment complexity levels. You have access to on-site training programs to advance coding skills. Choose this for job stability and room to grow.
3. Coding Contract Agencies
Third-party medical coding vendors hire contractors and remote coders to work on outsourced physician records and insurance claims. Offers work schedule flexibility but usually pays per piece. Opt for this if you prefer telecommuting jobs.
4. Insurance Providers
Medical billing and coding experts are also employed within health insurance providers to review claim submissions, analyze billing discrepancies, and coordinate audits. Great for analytical roles.
Expanding Responsibilities
With above average industry growth projected in coming years, experienced medical coding and billing professionals can progress into supervisory and management roles within their departments.
Other opportunities to leverage your healthcare administration experience exist across related domains like health data analytics, clinical documentation improvement (CDI), and population health management. Pursuing relevant advanced training helps open doors as healthcare systems emphasize tech integration.
Building Your Professional Network
As in any career, having a strong professional network in medical billing and coding opens up more job opportunities and growth avenues. Consider the following networking strategies:
1. Local Chapters and Conferences
Actively participate in regional chapters of leading industry associations like AHIMA and AAPC. These conduct regular meetings, workshops and annual conferences that facilitate networking with fellow billing and coding professionals in your city. Getting involved in planning committees also widens your connections.
2. Online Forums and Groups
In today’s digital world, having an online presence and engaging actively with relevant social media groups builds connections. Follow leading forums and communities of medical coders on platforms like Reddit, Facebook and LinkedIn to exchange sector trends, job openings and career advice.
3. Volunteer Initiatives
Contributing time to coding and billing volunteer programs is worthwhile to gain experience and connections. For instance, organizations like Code4Free work with low-income community health centers and need volunteers to support insurance claim processing. Similarly, university health systems have pro bono programs.
4. Informational Interviews
If new to the billing and coding arena, set up exploratory meetings with professionals working in settings of interest to better understand roles, skills and daily responsibilities. Insights from informational interviews help assess culture fit and career paths.
Conclusion
Pursuing a career in the high-demand field of medical billing and coding requires strategic planning and preparation but offers excellent prospects. Finding an accredited training program lays the right foundations in healthcare coding expertise, regulatory policies and practical experience.
