Despite a slow economic recovery out of the recession, the healthcare industry continues to expand. As the baby boomer generation ages, there will be a growing need to train and hire new professionals to work in a variety of clinical environments, from maternity care to hospice care in clinics, hospitals, homes, and care facilities.
Also known as health information technicians or medical records specialists, billers and coders transcribe the information contained in medical records and other healthcare documentation (like doctor’s notes and laboratory results) into a number of systems of codes. These codes are used universally throughout the healthcare industry, and maintain a standard that lets insurance agencies, hospitals, and other organizations classify medical procedures and bill for services. Billers and coders maintain this standardized system of classification, which is crucial for accurately billing for services rendered and tracking patient health information.
Understand the Difference Between Medical Billing and Coding Jobs
Coders are tasked with organizing and managing health information data by converting written or verbal language into codes that classify and describe medical procedures and services. They categorize patient information in preparation for billing and maintenance of patients’ medical histories. Coders carry out the following responsibilities:
- Review patient information for pre-existing conditions
- Retrieve patient records for medical personnel
- Serve as a liaison between the health clinicians providing patient care and billing offices tasked with securing payment for services rendered
Billers are certified by the American Academy of Professional Coders, which grants the certification of CPB (Certified Professional Biller.) CPBs must:
- Understand the difference between types of insurance plans and how billing strategies differ between them
- Apply payer policy, Local Coverage Determinations (LCD,) and National Coverage Determinations (NCD) for the successful submission of claims
- Know CPT, ICD-9-CM, and HCPCS coding guidelines
- Understand the complex rules and regulations that apply to the healthcare industry, including HIPAA, the False Claims Act, the Stark law, and the Fair Debt Collections Act
- Understand the procedures of filing a medical billing claim
- Follow up on claims and denials that are issued by insurance companies
How Much Does a Medical Coder Make?
For entry-level occupations, these positions still offer relatively high wages because coders and billers must demonstrate accuracy and consistency. In 2012, junior medical billers and coders made $34,200 a year, which is about $16.42 an hour. However, medical billers and coders who have earned more experience on the job, demonstrated success, and continued their education by completing certification programs can earn over $50,000 per year. The most senior medical billers and coders, at the top ten percent of their field, can expect to earn an average of $27.02 an hour. With rapidly expanding healthcare markets in certain states where projected industry growth outstrips the supply of qualified workers, billers and coders may enjoy even higher wages and benefits. Take, for example, the state of California. The highest salary recorded in the Golden State was over $65,000 a year.
How much does a medical biller make with certification and experience?
Medical records and health information technicians can find entry-level jobs without formal certification or training by having work experience that demonstrates their proficiency in carrying out this highly detailed work. However, there are opportunities for advancement with job-specific training, education, and professional certification.
While a high school diploma or GED is a basic requirement for medical billing and coding jobs, those who have completed a two-year associate’s degree earn, on average, $1.00 more per hour than those without an associate’s degree. Medical records and health information technicians who obtain further certification can make as much as $4.00 more per hour than their colleagues.
Because of the data-rich subtleties associated with medical billing and coding, technicians who stick with their jobs and accrue experience enjoy higher salaries. Those with ten or more years of experience can earn a medical coding salary of $40,000 a year.
A combination of certification, on-the-job experience, and aptitude can lead to supervisory and leadership positions within records departments. You’ll also enjoy more flexibility in the workplace and mobility within the industry, where your skills will be marketable in a hospital, doctor’s office, insurance company, or health information research setting. Within health organizations, coders who demonstrate fluency and expertise find opportunities to advance as registrars, who check claims for accuracy and manage databases.
Become a CPB by taking the AAPC examination
The CPB exam is a professional certification that recognizes expertise and knowledge in medical billing. It’s an intensive test consisting of 200 multiple-choice questions. The exam is an open-book test that, in part, simulates common billing procedures in hospitals and clinics. You can use your manual to look up codes, but you’ll need to study rigorously to pass the exam.
The exam will ask you questions regarding the correct application of CPT, HCPCS procedure and supply codes, and ICD-9 diagnosis codes used for billing specific insurance programs for services. You’ll learn about these classification systems (that is, about different kinds of codes and when they are used) as you prepare for the exam.
Explore how pay varies according to work location and environment
Medical billers and coders work in a variety of settings, such as public and private, large hospitals, small clinics, insurance companies, and in research. Their salaries vary according to their work environment and the amount of responsibility they take on. The following is list of the workplaces that employed the most medical records and health technicians in 2010:
- 39% worked in public, private, state, and local hospitals
- 23% worked in physicians’ offices
- 7% worked in nursing care facilities
- 3% worked in home healthcare services
Medical billers and coders can find work in places that don’t necessarily require specialization or that have established billing mechanisms in place. These employers include hospitals, physicians’ offices, nursing homes, assisted living facilities, hospice care agencies, and outpatient facilities. These jobs offer an entry-level salary between $26,000 and $35,000 per year.
Geography is another key factor that determines the salary of billers and coders. According to the Bureau of Labor Statistics, in 2012 New Jersey reported that medical records and health information technicians enjoyed the highest salaries in the nation, with an average salary of $55,130 a year. The District of Columbia had the second-highest salary at $45,500, while technicians in Alaska earn $40,740 a year. The salaries for health information technicians is also robust in Bay Area cities in California, where the cities of San Francisco and San Jose reported annual salaries of nearly $50,000 a year.
There are other environments, however, where medical billers and coders can earn more. Technicians working in branches of the federal government, veteran’s hospitals, and military installations can earn a salary closer to $43,000 a year. They also enjoy military work benefits, which include subsidized travel and continuing education support.
What’s the highest medical coding and billing salary?
Although rare, positions in pharmaceutical and medicine manufacturing offer health information technicians the highest wages. Below are some of the other highest medical billing and coding salaries, organized by industry:
|Industry||Hourly average wage||Annual average wage|
|Pharmaceutical and Medicine Manufacturing||$31.76||$66,060|
|Insurance and Employee Benefit Funds||$24.92||$51,840|
|Scientific Research and Development Services||$23.11||$48,060|
|Grant Making and Giving Services||$22.52||$46,840|
|Federal Executive Branch||$22.25||$46,280|
Career Outlook for Medical Billing and Coding Specialists
Medical records and information specialists will find only more opportunities for career advancement and mobility as the demand for their skills increases within the healthcare industry. You can expect to see 7,370 new positions opening up by the end of the decade. That’s nearly a 21% increase in job opportunities by 2020. This growth is faster than average for all other positions inside and outside of healthcare.
Part of this demand can be attributed to the anticipated increase in care for an aging U.S. population. This generation of older adults will need more medical tests, treatments, and procedures that need to be classified and billed. This means more claims for reimbursement will be issued to private and public insurance organizations.
The increased collection of medical records, as well as the use of this electronic health data by all kinds of healthcare providers, will require more technicians to manage this information. This projection applies to all areas of the healthcare industry.
This aging population will require billers and coders to specialize in certain areas, as many types of illnesses are detected and treated later in life. Cancer registrars in particular are expected to continue to be in high demand. They review patient records and pathology reports for completeness and accuracy, assign classification codes to represent the diagnosis and treatment of cancers and tumors, and analyze and compile patient information for cancer research purposes.
Prospects remain the most promising for technicians with a certificate in health information. As electronic health record (EHR) systems become more commonplace, technicians with moderate to advanced computer skills will have an advantage. If you learn these skills, you’ll be more prepared to learn how to use the software, follow EHR security and privacy practices, and analyze electronic data to improve healthcare information as more providers and hospitals digitize their records.