You’ve seen the ads. “Learn medical billing and coding and earn $50,000 a year in your own home!” There is some truth to the ads. Doctors are in desperate need of good billers and coders, and there is good money to be made, but don’t let the ads fool you. There is no shortcut to a successful career in medical billing or coding.
A practice’s financial health rests on the strength of its billing department. Not only do claims need to be coded and submitted to insurance companies correctly and in a timely manner, there are laws governing the proper methods for claims submissions. If these laws are broken, penalties range from steep fines to exclusion from federal and state programs such as Medicare to possible jail time. Physicians depend on the staff to be knowledgeable and to stay abreast of rapidly changing laws. Because of the potential consequences, most doctors are not willing to take a chance on someone with no experience and a “degree” from a diploma mill. So how do you get really get started in a medical billing or coding career?
The first thing to know is the difference between a biller and a coder. A medical coder reads medical charts and reports and assigns numeric codes to diagnoses and procedures. It requires an in-depth knowledge of anatomy and physiology, medical terminology and disease processes as well as knowledge of regulatory guidelines for the application of codes. Coders are in high demand and can work in hospitals,clinics, research facilities and insurance companies. There are two major coding certifications, the Certified Professional Coder and the Certified Coding Specialist. Most employers require at least one of the two major credentials. Some coders do work from home, but they usually have at least five years of experience.
A medical biller receives claims from the coder and files the claim with the correct insurance company. They are also responsible for posting any payments and investigating and resolving any claims that an insurance company has denied. An medical biller may also talk with patients about their bill and set up payment plans for those patients without insurance. Many billers eventually become certified coders.
The next step in a medical billing or coding career is to assess your educational options. Look into your local accredited community colleges. Many colleges offer certificates or degrees in medical billing and coding and offer placement assistance for their graduates. Most correspondence courses are not accredited and are not recognized by most employers. Ask your local community college for names of past graduates that may be willing to speak with you and the names of practices where they have placed past graduates. If you are unable to fit college classes into your schedule, there are some reputable colleges that offer distance education options. The American Health Information Management Association maintains a list of approved distance education courses.
If you choose to become a coder, certification is a must. The Certified Coding Specialist credential is offered by AHIMA and is awarded after a rigorous exam designed to test knowledge necessary for a career as an inpatient coder. The Certified Professional Coder is offered by American Association of Professional Coders. The exam is entry-level and is more suited to the beginning coder. It tests knowledge required for a career as an outpatient or physician coder. Both organizations require coders to abide by a code of ethics. Violation of the code can result in loss of credentials.
After you have your education and credentials you’re all set, right? Wrong. Just as important as education and credentials is experience. It’s a familiar catch-22: you can’t get hired without experience, but you can’t get experience until you get hired. How do you break through and get that first job? Consider registering with an employment agency. These agencies test your skills and check your references and are a low risk option for many medical practices. Even they may not be able to place you into your dream billing job, but may be able to place you in a job as a medical records clerk or front desk receptionist. Use these positions to gain practical experience in a medical practice and to make networking contacts that can lead to a billing job. Join your local chapter of the AAPC. Even if you are not a coder, people who make the hiring decisions for medical offices are often members and can help you land a job as a biller. If your area has a free health care clinic, volunteer your services. Most patients aren’t insured, but many of them participate in state and federal programs. You won’t get paid, but you will gain valuable experience.
Medical billing and coding is a worthwhile, satisfying and lucrative career, and it just takes the right education and persistence to succeed.