Nature of the Workplace

As with all sectors of the healthcare industry, demand for medical billing and coding professionals is projected to rise considerably in coming years. The Bureau of Labor Statistics reports that trained billers and coders can expect a 21% increase in job growth by 2020. Explosive advancements in medical know-how have created new treatments and medications for our rapidly aging baby boomer population, which in turn have increased the need for knowledgeable coding professionals.

Medical billing and coding specialists generally end up in one of four working environments: a hospital or other large medical facility, a physician’s office, a health insurance company, or a home office. Each has its pros and cons; depending on your tastes and work style, you may find one area to be the more suitable than the others.


The majority of certified billing and coding specialists are employed at hospitals; in 2010, 39% were employed by state, local or private hospital facilities. If you’re employed at a hospital, odds are you’ll be working in a busy environment. Hospitals are open 24 hours a day; while it’s rare, some coders may work outside of normal business hours. In any large facility, it’s likely that billing and coding functions as an independent department, so you should not be expected to perform other administrative support duties.

Your role is to ensure all claims are billed and coded so that the hospital receives payments without delay. Because billing and coding is a “back of the house” administrative support role, you will not work directly with patients. You will, however, work as part of a team, and frequently contact physicians and other healthcare professionals to clarify billing issues.

In-patient admissions coordinator Ashly Stone shares her thoughts on working in a hospital:

“I thought of it as behind the scenes of nursing and healthcare…It’s always giving me something different, a new challenge. Everybody’s got a different history, and I like that.”

Physician Practices

After hospitals, doctors’ offices are the second largest employer of medical coding and billing specialists. Because a physician’s office can range from one doctor in independent practice to a large group of practitioners covering several specialties, the duties of a coder are usually relative to the size of the practice. In a smaller practice, a certified coder may split time between billing and coding with other tasks such as answering the phone, checking patients in and out, or scheduling appointments. In this instance, you might experience direct patient contact in an administrative capacity.

Most often, your title in a position like this could be office manager, billing manager, clinical documentation specialist, or physician process coordinator. Regardless of title, the smaller the office is, the more likely it will be for the coding specialist to wear many hats during the course of a workday. Many coders and billers maintain that gaining experience in a smaller office is valuable because it allows the opportunity to monitor an entire claim cycle. Experienced coders who earn their stripes in a smaller office often transition into management positions quite easily.

A member of the American Academy of Professional Coders (AAPC) had this to say about her job in a physician’s office:

“Most of us are cross-trained to cover other positions within the business office. I am the only certified coder and the only other person allowed to code is our manager. However, I am also responsible for depleting charts as I code them, help manage the medical record room, cover front desk and scheduling as needed, answer patient billing phone calls, submit claims electronically and on paper. I am currently responsible for coordinating the credentialing of physicians at our facility.”

Insurance Companies

Coding and billing specialists who are employed by insurance companies are commonly called coding analysts. These positions require more education and experience; insurers commonly look for candidates with a bachelor’s degree, certification in coding and billing, and at least three years of work experience.

Coding analysts work typical office hours in a corporate office environment. They’re on the receiving end of claims sent by coders and billers in hospitals and physician offices, which they process and analyze to ensure accuracy. If a claim contains poor or mislabeled coding, these analysts will work directly with the doctor’s office or hospital to correct the claim. Coding analysts must pay scrupulous attention to detail and stay aware of legislative changes that affect insurance companies. Travel is often a job requirement.

One coding analyst had to say about his new position:

“We are a company that provides a Medicare advantage (replacement) policy. I review medical charts daily to assure proper diagnostic coding is submitted to our company for claims. I travel throughout Iowa for about 6 months of the year, the rest of the time, I work via the internet. I travel throughout the state of Iowa and often into other adjoining states, going to practices to review records on site. This does mean that I live out of a suitcase at times, but it’s not that bad.”

Working at Home

The merits of allowing employees to work from home is a constant debate in the business world. Many feel the sense of camaraderie and idea-sharing is lost when employees work remotely. Others, however, argue saving money in office maintenance costs will mitigate the risk of productivity loss. While not a common practice, some companies hire at-home billing and coders, called remote coders.

Among legitimate third-party companies who hire remote coders, scams are reportedly in the mix, so research the company you’re interested in very carefully. Most remote coders need at least three years of office or hospital experience to be hired. Some companies require potential coders to pass a challenging coding test before receiving assignments.

Remote coding requires discipline and independence, as you’ll have very little contact with patients or healthcare professionals. Many remote coders find their productivity increases without the constant distraction of phone calls, conversations with co-workers, or other administrative duties. Positions are usually awarded on a contract basis, and may be full-time or part-time. Remote coders generally have a quota of case files they must complete during a certain time frame.

As one remote coder stated,

“It was difficult at first to complete at least 150 charts a week … but I hit my required 95% correct coding average within a month. Now the company has me coding for 2 hospitals in two different states. I have never had such job security.”

Healthcare professionals enjoy a benefit that few other industries offer: the promise of continued expansion and soaring job growth. Medical coding and billing professionals are also lucky enough to have a choice of working environments, whether in a corporate office, busy hospital, or neighborhood doctor’s office. If this career is appealing to you, check out other aspects of this field and consider professional certification.