Are you looking for some immediate information regarding the training you’ll need to work as a medical biller and coder? This article will let you know just what you need to start working towards a career in medical billing and coding in a physician’s office, medical billing and coding in a hospital, and strictly medical billing.
Medical Billing and Coding in a Physician’s Office
If you want to work as a medical biller and coder in a physician’s office or other outpatient setting, you should:
- Strongly consider a certification from the American Association of Professional Coders (AAPC), which is a medical billing and coding professional organization specializing in outpatient coding.
- In particular, consider the Certified Professional Coder (CPC) credential from the AAPC, who states that this certification is "the gold standard for medical coding in physician office settings."
- Also consider the Certified Coding Specialist – Physician-Based (CCS-P) certification through the American Health Information Management Association (AHIMA). This credential specifically prepares you for work in a physician’s office.
Education and Training
Many colleges and universities offer medical billing and coding degree and certificate programs which can be completed in a traditional classroom or online. If you choose to pursue a degree, make sure the institution and/or program is accredited. You can do this by searching for either one in the U.S. Department of Education’s accreditation database or the Council for Higher Education Accreditation’s database. You can also take training courses directly through the AAPC. You have the option of taking these courses in a classroom or online.
Certification
To receive one of the aforementioned physician’s office medical billing and coding credentials, you must take and pass the respective examinations administered by the AAPC or the AHIMA. To maintain your AAPC certification, you’ll need to earn 36 continuing education units every two years. To maintain your AHIMA certification, you’ll need to earn 20 continuing education units every two years. Other certifications, such as one earned from a college, may have continuing education requirements as well.
Medical Billing and Coding in Hospitals
If you want to work as a medical biller and coder in a hospital or other inpatient setting, you should:
- Strongly consider an AHIMA certification, which is a medical billing and coding professional organization specializing in inpatient coding.
- In particular, consider the Certified Coding Specialist (CCS) credentials from AHIMA. The CCA certification is ideal for those new to the field, while the CCS certification is intended for those with more experience. AHIMA offers four other certifications that you may want to consider as well.
- Also consider the Certified Professional Coder – Hospital (CPC-H) credential from the AAPC. While this certification is listed as being for hospital outpatient coding, it offers the same real world skills you’ll need in an inpatient setting and is the closest the AAPC comes to a pure hospital coding credential.
Education and Training
Just like obtaining an education for medical billing and coding in an outpatient setting, you can complete a degree or certificate program through a college and university, which can be completed in a traditional classroom or online. Once again, if you choose to pursue a degree, make sure the institution and/or program is accredited by searching for either one in the U.S. Department of Education’s accreditation database or the Council for Higher Education Accreditation’s database.
The AHIMA recommends that students seeking their credentials apply to a program accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM), whose website features a program directory, through which you can search for programs according to state, program level, program name, and whether or not the program offers distance learning.
Certification
As with physician’s office-based medical billers and coders, you will need to pass the exam associated with the credentials you choose to pursue to get your certification. Also, to maintain your certification, you will need to earn the required number of continuing education units.
Strictly Medical Billing
If you want to work strictly as a medical biller, consider a certification from the American Medical Billing Association (AMBA), a professional organization devoted specifically to the needs of professional medical billers. They offer the Certified Medical Reimbursement Specialist (CMRS) certification, a nationally recognized credential which will prove your understanding of medical billing to potential employers.
Education and Training
You may choose to pursue a degree or certification in medical billing from a college or university, in which case, you should check the accreditation status of the institution and or program through the U.S. Department of Education’s accreditation database or the Council for Higher Education Accreditation’s database.
The AMBA offers training courses and certification as well. They provide comprehensive online courses in medical billing, doctor’s office billing, physical therapy billing, chiropractic billing, CMS 1500 form billing, and more. The AAPC also offers a medical billing course.
Certification
The requirements to become certified as a CMRS through AMBA involve successful completion of the CMRS exam. This is a 16-section, 800-question exam that you can complete online over the course of up to 45 days. AMBA sells a downloadable study guide for this exam for $199. Your certification will be valid for one year, after which you must complete 15 CEUs each year to renew your certification.
Medical Terminology and Anatomy
Regardless of where and how you work within the medical billing and coding industry, an understanding of medical terminology, physiology, and human anatomy is a must. Fortunately, educational resources pertaining to physiology, anatomy, and terminology are readily available from a number of sources.
In most cases, degree and certificate programs in medical billing and coding offered by colleges and universities will include courses covering medical terminology, physiology, and anatomy. You shouldn’t just assume that these courses will be part of the program, so you want to make sure they are before you enroll. Some programs are more limited in scope and instead choose to focus on code sets and billing procedures exclusively. If you want medical terminology, anatomy, and physiology training without completing a degree program, you have the option of going directly to a professional association. The AAPC, for example, offers online courses in anatomy and medical terminology. Each requires only a few weeks of study.
You can also do some terminology, physiology and anatomy studying on your own. Check out some recent books on these topics from your local library. Popular and highly affordable titles include Medical Terminology: A Short Course by Davi-Ellen Chabner and Human Body: An Illustrated Guide by Martyn Page.
About our expert. Jan Jacobs has worked in medical offices since the early 1980's. Ms. Jacobs has worked for M.D.'s and D.O.'s in primary care and specialty care. She is employed as a senior medical biller and has been at her current job for nearly 10 years, where she uses three different billing systems.
