How Do I Become Certified?

If medical billing and coding interests you, or you want to advance in your current medical billing and coding career, consider your options for certification. Those with certified status enjoy many benefits over their counterparts without certification, such as increased salary and job prospects. Certification programs differ depending on the level of education you want to reach, the amount of time you plan to invest in your education, and your budgetary needs.

Medical coding and billing advancement options can include a certificate, diploma, degree, or training course. In addition, you may consider an alternative route to the traditional education experience and prepare for your medical billing and coding certification online.

Path 1: Certificate or Diploma Program

Medical coding and billing certificate and diploma programs begin the postsecondary education available for students interested in working in this industry. However, these two programs differ. Certificate programs require less time to complete, with slightly more restrictive curricula than diploma programs.

Certificate programs benefit career-focused students who aim to get out into the workforce as quickly as possible. Students looking for a more well-rounded curriculum may opt for the longer diploma program.

  • Time to Complete: 4-12 months
  • Cost: $800-$4,500
  • Subjects Covered: Students study medical coding, medical billing, clinical terminology, electronic medical records practices, laws, ethics, confidentiality, anatomy, physiology, and managed care.
  • Program Outcome: Students earning a medical coding and billing certificate learn how to submit claims to insurance companies for reimbursement, process bills, navigate billing software, and navigate insurance plans. Students explore the basics of medical coding. Graduates can enter careers as medical coders, medical records coordinators, and health information clerks.

Path 2: Associate Degree Program

Associate programs make up another path toward obtaining your medical billing and coding certification. Often more expensive than the certificate or diploma path, earning an associate degree also takes more time but may bring about more career options. Many employers prefer job candidates with an associate degree in medical billing and coding over their counterparts with certificates or diplomas. In addition, some professional certifications require an associate degree, such as the Registered Health Information Technician exam and the certified professional biller certification.

Graduates with associate degrees have the option of continuing their education and applying their credits toward a bachelor’s degree.

  • Time to Complete: Two years
  • Cost: $6,000-$13,000
  • Subjects Covered: In addition to the basic courses covered in the diploma and certificate programs, associate degrees usually require students to take general education courses, such as English, math, and natural and social sciences.
  • Program Outcome: Graduates of these associate degrees gain familiarity with medical billing and coding procedure and can assign accurate medical codes for various healthcare services. These professionals qualify to work in medical clinics and for insurance companies.

Path 3: BA Program

A bachelor’s degree can serve as an additional qualification for those pursuing a career in medical billing and coding. Students usually obtain their bachelor’s degrees in health information management or healthcare administration. Earning a four-year degree provides the comprehensive education and training that prepares graduates to enter their careers.

Bachelor’s degrees generally take about four years to complete and often come at a higher cost than an associate degree or certificate/diploma program. However, bachelor’s degrees provide the in-depth training that employers often seek in candidates. Graduates may be qualified for more lucrative levels of employment, such as management positions.

  • Time to Complete: Four years
  • Cost: $36,000-$120,000
  • Subjects Covered: Bachelor’s programs for students in this field generally study health informatics and management. Students learn the basics of collecting, processing, and protecting patient healthcare data, while studying the administrative procedures involved in healthcare settings.
  • Program Outcome: Graduates from a bachelor’s program in health information management or healthcare administration may work as medical service managers and health information technicians.

Path 4: Training Courses

Certain credentialing organizations, such as AAPC, offer prep courses for many medical billing and coding certification exams. AAPC’s training courses prepare students who plan to become a certified professional coder (CPC), certified outpatient coder (COC), or certified inpatient coder (CIC). AAPC medical coding classes take place entirely online and can be completed in four months or less. Students who prefer learning in a formal classroom setting may be able to find an AAPC course in their area. These classes benefit students with a strong knowledge of topics, such as anatomy and medical terminology.

AAPC recommends that students who have taken both the preparation course and passed the certification exam to become CPCs find employment. Later, they may earn an associate or bachelor’s degree through an accredited program, if they choose to pursue additional education.

Medical Billing and Coding Online Programs

Many programs for medical billing and coding are available online. Prospective students often find that the online learning environment gives them the tools needed to integrate their education into their busy lives. Whether preparing for your medical billing and coding certification with a certificate, diploma, degree, or professional training course, you can pursue your education through distance learning.

Online courses offer flexibility and convenience that traditional programs cannot. Distance learners generally access and complete course material when it best fits their schedules. This allows students to fit in schoolwork around their existing time commitments, such as work and family life. In addition, most online students enjoy the freedom to work on their degrees from home, as opposed to relocating and/or commuting to campus.

If you decide to pursue your medical billing and coding education or training online, be wary of programs that offer a much shorter duration than industry standard. Programs that promise you the ability to work from home without any experience may also be suspect. When searching options, make sure to check each program’s accreditation.

Accredited Medical Billing and Coding Online Programs

Often, medical billing and coding licensing and certification requirements state that credits earned must come from an accredited program in order to qualify. In addition, some financial aid organizations mandate that aid recipients enroll in accredited programs to ensure a high quality education and employability after graduation. As such, many employers verify that a job applicant has attained their certificate, diploma, degree, or training credentials from an accredited program before offering them employment.

Primary accrediting bodies for medical billing and coding programs include the American Health Information Management Association, the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM), and AAPC. CAHIIM provides a searchable database of accredited health information management and health informatics degrees.

Which Medical Billing and Coding Certification Is Right for Me?

Which credential you pursue in medical billing and coding depends on the type of work you prefer. Certain professionals, such as the certified professional coder and certified outpatient coder, perform medical coding, the latter of the two specifically in outpatient settings. Certified professional billers handle billing operations, such as submitting and following through with insurance claims. Medical auditors, practice managers, and compliance officers ensure physicians’ offices work efficiently and profitably within governmental regulations for coding and billing.

Certified Professional Coder (CPC): According to the AAPC, the CPC certification is the most recognized medical coding certification in the healthcare industry, also making it the most common. CPCs demonstrate a thorough understanding of all code sets and can assign the proper codes for healthcare services doctors and other providers perform in medical settings. These professionals understand healthcare administration and the ethics and regulatory practices involved in medical insurance claims and reimbursement.

Certified Outpatient Coder (COC): COC certification affirms that the coder understands medical terminology, anatomy, and coding guidelines. Students must also demonstrate comprehension of payment methodologies, regulatory compliance, and the use of several different code sets for outpatient settings. Certified outpatient coders often work in ambulatory surgical centers and hospital outpatient billing and coding departments. These professionals demonstrate proficiency in evaluation and management, surgical services, radiology, pathology, anesthesia, and medicine.

Certified Professional Biller (CPB): CPBs understand all areas of the revenue cycle. Healthcare providers and patients rely on them to submit medical claims to insurance providers and process payments and reimbursements. CPBs must comply with governmental regulations and private payer policies. Acting as liaison between doctors and insurance companies becomes vital, as the process of building and submitting a claim, resolving claim denials, and issuing appeals may prove complex and time consuming.

Certified Professional Medical Auditor (CPMA): CPMA certification ensures that professionals understand medical record standards and documentation guidelines, coding and documentation compliance guidelines, coding and reimbursement concepts, scope and statistical sampling methodologies, medical record auditing abstraction, and category risk analysis and communication. This knowledge allows CPMAs to work in a variety of healthcare settings to ensure the compliance and profitability of physician practices.

Certified Physician Practice Manager (CPPM): CPPM certification benefits those with experience in other areas of healthcare interested in physician practice management. This role involves an understanding of all facets of medical office administration. CPPMs must demonstrate proficiency in compliance regulations, the revenue cycle, health information, human resources, and general business processes. The certification exam covers health care reform, medical office accounting, and physician reimbursement.

Certified Professional Compliance Officer (CPCO): A CPCO designs, implements, and maintains a healthcare compliance program for a physician’s practice. This process involves many steps, such as internal compliance reviews, risk assessments, audits, and staff training and education. Physician offices require compliance programs in order to manage Medicare and Medicaid fraud and abuse.

Medical Billing and Coding Certification FAQS

How Long Does it Take to Become a Medical Coder?

The time commitment necessary to become a medical coder varies depending on the level of education and training you choose to complete. Earning a certificate takes as little as four months, while a diploma program may last 12 months on average. If you wish to earn a degree, you will find that an associate program requires a two-year commitment, while a bachelor’s degree requires about four years. Training courses through AAPC typically take four months to complete.

How Much Does a Medical Coder Make a Year?

Working professionals with medical coding and billing certification earn varied salaries that depend on several factors. Generally, the education level you choose to complete impacts your earning potential. Those with associate and bachelor’s degrees often command higher salaries. AAPC salary surveys found that credentials also affect salaries. Those with several medical billing and coding certifications received higher salaries than their counterparts with fewer credentials. In addition, coders with more experience earned more money. Surveys also confirmed that working in hospitals and larger group settings, and living in higher populated areas, demand higher salaries.

How Do I Maintain My Medical Billing and Coding Certification?

Medical coding and billing certification remains valid for two years after awarded. In order to maintain valid certification status, billers and coders must complete a specified number of continuing education units every two years. To keep one credential active, you must complete 36 continuing education units in each two-year period. Different credentials require continuing education in various areas. Continuing education units must come from AAPC-approved vendors. Visit AAPC’s requirements and policies for more information on maintaining your medical coding and billing certification.