Medical Billing and Coding

In today’s world of increasing demand for healthcare insurance products, the medical biller and coder is more important than ever. A person who works in the medical billing and coding field is responsible for translating a doctor’s record of services performed for a patient into terminology that can be understood by the health insurance payer. It is also a field that is easy to enter if you enjoy working in an office environment. Plus, the pay tends to increase with experience.

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  • Named a Best for Vets school by the Military Times in 2014.
  • Has specialized in student-centered technology, business, criminal justice, health science, and culinary education for over 45 years.
  • Makes it possible for students to earn a bachelor’s degree in 2.5 years or an associate’s in 1.5 years by providing a year-round schedule.
  • Offers externships and clinical experience that help students prepare for life after they graduate.
  • Has 10 campuses across the mid-Atlantic, plus online degree programs.

Programs:

  • Health Information Management - Associate's
Locations: Newport NewsRoanokeRichmond

Kaplan University is focused on recognizing the achievements of military and veteran students and offers the flexibility of an online education. Eligible students can receive college credit for prior military experience and coursework—up to 75 percent of the credit needed for a Kaplan University undergraduate degree.*

Programs:

  • Medical Billing and Coding Certificate
  • BS in Health Information Management
  • Medical Office Administration
  • Grand Canyon University - Where a Quality Education and Faith Coexist
  • Recognized as offering some of the best online education programs in the nation.
  • We support students through their academic and spiritual journey.
  • GCU offers the convenience of online, on-campus, or evening programs.
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Programs:

  • M.B.A.: Health Systems Management
  • Available business concentrations include Accounting, Economics, General Management, Marketing, and Human Resource Management.
  • Ranked among the Best Online MBA and Online Graduate Business Programs in 2016 by U.S. News & World Report.
  • Programmatic accreditation provided by the Accreditation Council for Business Schools and Programs (ACBSP).
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Programs:

  • Master of Business Administration - Healthcare Management
  • Online MBA program ranked 6th in the USA by CEO magazine.
  • In a university-sponsored survey, 4 out of 5 alumni reported being satisfied with their experience.
  • #1 Online School for military veterans according to Military Times.
  • 75,000+ graduates across all industries offer extensive networking opportunities.
  • My Unique Student Experience (M.U.S.E.) lets students watch, view, read, or hear content.
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Programs:

  • Master of Business Administration - Health Care Management

Liberty University provides a world-class education with a solid Christian foundation, equipping men and women with the values, knowledge, and skills essential for success in every aspect of life.

A liberal arts institution with 16 colleges and schools, Liberty offers programs in fields such as medicine, religion, law, aviation, cinematic arts, psychology, business, and more. Part of the Big South Conference, Liberty fields 20 NCAA Division I athletic teams and 32 Club Sports teams, offering fans an unparalleled college sports experience.

Programs:

  • Doctor of Business Administration: Healthcare Management

At Kaplan University, we offer over 180 degree and certificate programs. With three different ways to learn, you can choose the format that works best for you:

  • Study wherever you have an Internet connection, because almost all of our courses are 100% online, or
  • Take campus-based classes(with day and evening options available), or
  • Combine campus learning with online classes (blended).

Programs:

  • Medical Billing and Coding Certificate
  • Medical Office Administration
  • Associate of Applied Science:Office Management
Locations: Hagerstown

Miller-Motte Technical College (MMTC) has a history of helping students succeed through hands-on education and career training. Our faculty and staff work to ensure that when you've completed your program, you're truly ready to begin your career.

Programs:

  • Electronic Health Records - Associate of Occupational Science
Locations: Lynchburg
Give your career a boost with an education from Southern New Hampshire University. We offer certificates, bachelor's, master's, and doctoral degrees in over 100 programs in a wide variety of subjects.

Programs:

  • IMBA - Healthcare Informatics

Located in the heart of Washington, D.C., the Milken Institute School of Public Health at the George Washington University is dedicated to advancing the health of local, national and global communities. Established in 1997, the Milken Institute SPH brings together the fields of medicine, business and education to develop professionals with the skills and knowledge to tackle complex global health challenges. 

You need to have a Bachelor’s degree to be qualified for this school.

Programs:

  • Executive Master of Health Administration

At a Glance

Medical Billing and Coding TrainingOther Job Titles: Medical Coding & Billing Specialist, Medical Billing Clerk, Billing Coordinator
Salary Range*: $20,800-$49,920; Average $31,000; Median $33,000
Education/Training Required: High school to bachelors degree however employers prefer those with associate’s degree and medical billing and coding certificate
Desired Skills/Aptitude: attention to detail and working with health information systems (computers)
Certification/Licensing: Certification available through AAPC
Locations with Best Opportunities: Texas, Arizona, Nevada, New Mexico
Employment Outlook: Faster than average through 2018
Opportunities for Advancement: Experience, cross-training, moving into management

What is Involved in Medical Billing and Coding?

Medical billing and coding is sometimes separated into two distinct jobs. Medical coders are responsible for taking incoming documentation from a healthcare provider facility and “coding” it so that it can be processed for payment by a health insurance company.

The coder uses a set of standards for translating documents from a healthcare provider into a claim that the insurance payer can understand. There are three main standards or guidelines:

  • Current Procedural Terminology (CPT)
  • Healthcare Common Procedure Coding System (HCPCS)
  • International Statistical Classes of Diseases (ICD)

CPT codes are defined and maintained by the American Medical Association (AMA). The publication assigns codes to all procedures used by medical practitioners on patients. For example, an office visit has a CPT code of 99201. HCPCS codes are based on CPT codes except used for billing to Medicare and Medicaid which are the government healthcare payers for those living on financial assistance or social security.

ICD codes can be thought of as the diagnosis for a condition when the patient visits a healthcare provider. This code set was created by the World Health Organization and is intended to form a standard way for classifying diseases or other ailments. ICD codes are complex and the U.S. is currently on ICD-10 however there are some organizations still using ICD-9.

Medical billers are the thread between entities of patient, insurance companies, and healthcare providers. Their responsibility is to send healthcare claims to the appropriate payer which will be an insurance company or government-funded healthcare assistance program such as Medicare and Medicaid.

The Workplace

Medical billers and coders can work in just about any healthcare provider or insurance facility there is. These include:

  • Doctor’s offices
  • Health insurance administration centers
  • Hospitals
  • Dental offices
  • Nursing homes
  • Pharmacies

At these locations, medical coders are responsible for assigning the right codes for procedures performed before sending the claim documentation to the insurance payer.

Education and Certification

Employers prefer those with at least an associate’s degree and a certificate awarded through an approved medical billing and coding program. Some seeking to enter this field will get an associate’s degree in any discipline and then augment it with a medical billing and coding certificate. There are also associate degree programs for this field.

Although not specifically required, employers also desire certification of its billers and coders. The most widely-known provider of certification is the AAPC (American Academy of Professional Coders). They offer several certifications all related to coding but with specialties. For example, for physician’s offices there is the Certified Professional Coder or CPC and for hospitals and outpatient facilities there is the Certified Professional Coder-Hospital Outpatient or CPC-H.

Salary Source: Bureau of Labor Statistics, May 2012.