Coding and billing go hand in hand; however, they are separate processes. Coding generally involves taking the notes from a medical visit and encoding them into a short-hand that can be quickly assessed for billing and insurance purposes. Billers use the codes to create invoices for patients and insurance companies. Billing and coding is a combined function in some settings; however, they are generally separate functions. In fact, billing is often outsourced to companies that may have several medical offices as clients. Coding is outsourced to a lesser extent.
There are no state or federal laws regulating the certification or training needed to become a medical biller. Certification and training does; however, prove competency and increase likelihood of being hired. There are three major certifying bodies and numerous ways in which to receive training.
There are several ways to receive training. Many colleges and universities offer training either as continuing education credit or academic credit. Colleges may allow for students to apply for financial aid and even use military benefits to pay for coursework.
Course work is usually completed online. Drexel University, for example, offers its training entirely online program. The American Health Information Management Association (AHIMA) offers an online training course as well. In any case, you should be prepared to sit for the exam after your course work. Make sure to find out what the pass rate is for a training program prior to enrollment. Many programs are happy to take money from applicants; but, they may not always deliver what is expected.
One does not have to complete course work for billing and coding. One or the other will suffice; however, the additional education may be helpful. It is necessary to take both if for some settings though. For example, a hospital may require both.
Drexel University offers six courses to prepare students for certification. After the second level course is taken for any area of expertise, one may sit for the appropriate exam. This is useful for someone, for example, who may wish to complete billing coursework only and begin work as soon as possible rather than completing the entire program first.
There are three major certifying bodies. The American Medical Billing Association (AMBA) gives the Certified Medical Reimbursement Specialist (CMRS) designation to those who pass their exam. There credential is specifically for medical billers. The other two certifying bodies, the American Academy of Professional Coders (AAPC) and AHIMA, mostly focus on credentialing for coders; however, they also offer credentials for billing.
Most employers interviewed for this article stated that no certifying body’s credential is better than another. Only a few of them asked for a specific certification. Furthermore, none of the employers stated that one training program was better than another. While they did value training, and in some cases required it, no specific school, course, or format was deemed better than another. Experience and familiarity with medical terms and human anatomy were particularly valued.
Finally, you may or may not have to receive both billing and coding certifications. The setting and needs of the individual facility will determine whether or not both are needed. However, one certification is usually enough to find employment.
Below various employers and wages are listed in order to provide a sense of how much medical billers and coders earn. Many of the employers contacted were not available to answer questions and were not able to return calls by the time this article was published. Therefore, in order to provide more insight, several listings from www.usajobs.gov have been used. These jobs may include additional duties and require additional experience. Links to the job descriptions have been provided.
There does not appear to be a significant difference between salary for coders and billers using the following data.
Department Of Health And Human Services, Indian Health Service
Pharmaceutical Billing Technician (OA) Toppenish, WA $31,628.00 to $45,828.00 per year Get more information at: https://www.usajobs.gov/GetJob/ViewDetails/408915900
$37,540.00 to $48,804.00 per year
Get more information at: https://www.usajobs.gov/GetJob/ViewDetails/409266700
Billers and Coders
$15.00 per hour or more (depending on experience)
Physicians’ Choice, Inc. Cherry Hill, New Jersey Coders $15.00 per hour (with experience)
Medical Records Technician (Coder)
$31,944.00 to $51,437.00 per year
Get more information at: https://www.usajobs.gov/GetJob/ViewDetails/409592300
Medical Record Technician (Coder)
$43,823.00 to $56,974.00 per year
Get more information at: https://www.usajobs.gov/GetJob/ViewDetails/409843900
Medical Records Technician
Big Spring, TX
$35,609.00 to $46,294.00 per year
Get more information at: https://www.usajobs.gov/GetJob/ViewDetails/409513600