What is medical coding and billing?
This article covers questions pertaining to how much does medical billing and coding pay, and the factors which affect medical coding and billing salary, but before we get into that, it’s a good idea to get some insight into what this medical profession is all about.
Medical coding, also referred to as medical records, health information technicians, and classification is a field in healthcare which is primarily concerned with the maintenance and classification of proper records.
Coding involves taking physician and doctor’s notes, tests and lab results and applying a coding mechanism to make the information easily accessible and analyzable. It is a fundamental part of gaining an understanding about various ailments and conditions, via an analytic and statistical lens.
Other duties which a coder performs include reporting services to insurance companies for adequate reimbursement and aiding in different administrative roles. Therefore, even though this job has a medical setting, it won’t normally be about patient interaction.
It is a good way to work in the field of medicine without having to spend much time with patients, especially considering the overall competitive salary of medical coders.
Medical billing is a great career field if you’re looking to work in finance, healthcare and IT at the same time. Like medical coding, it is basically an amalgamation of the three fields. It goes without saying that you’ll need a diverse set of skills if you want to maximize your medical billing and coding pay.
This field will make you responsible for inputting patient information into a payment system from where proper billing information will be generated for insurers, state health programs and patients. It is an essential cog in the overall healthcare machine and the value of medical billers is immense.
Medical billing staff members may also have to follow up / research rejected claims in collaboration with medical coding staff. Since these professions are closely linked, students often train to work in both, which also gives them better job options and translates into better salary of medical billing and coding.
Medical coding and billing is a sound employment choice for a lot of people. For instance, medical coding positions are predicted to increase by 22% between 2012 and 2022 [Source].
Furthermore, the need for health services is likely to increase considerably as the ‘Baby boomer’ generation grows old and the demand for digitization of documents goes up in the years to come.
This rise in demand for these professions will probably be accompanied by better salary for medical coders and billers in general, but certified professionals are the ones who will reap the greatest benefit.
Medical coding and billing – what’s the outlook?
Let’s talk about the job outlook for these professions, now that we’ve answered the questions of what does a medical biller do and what does a medical coder do.
2012 saw medical coding technicians holding 186,300 jobs in the US. This number is expected to go as high as 227,400 by 2022. [Source]
For the greater part, these jobs will be in hospitals – at roughly 37%, so you can expect to become an integral part of a hospital community full of various other medical professionals.
Besides hospitals, there are other healthcare facilities which employ medical billing and coding professionals, for example:
- Nursing care facilities
- Doctor’s offices
- Federal government agencies
- Outpatient care centers
The majority of coding technicians are required to work full time. Weekend and evening shifts might also be needed on occasion, particularly if they work in a medical facility that remains open 24 hours a day.
The advantage of working as a medical coder is that because you won’t be dealing with patients directly, there isn’t a particularly large need to have your services on hand besides during regular hours. This lets you keep a more consistent schedule and is an excellent way to build a daily routine.
Coming to the question of how much does medical coding pay in the near future, as previously mentioned, because of the aging populace of the United States, more treatments, procedures and medical tests will be needed in the future.
This translates into a greater need for medical coding and billing technicians. It also implies a larger number of reimbursement claims from public and private insurance. It is a process which might strain resources as the workforce increases and tries to keep pace with the increased demand for resources. In spite of this, jobs will become available and there will be lots needed to be done.
Cancer registrars are also predicted to remain in high demand, especially since the spread of cancer continues to see a rise in frequency. Special purpose registrars will be needed since several different types of illnesses will be diagnosed and treated as patients grow old.
These jobs are expected to have a higher pay than the typical medical billing salary range, as do the ones in specialized facilities like those which treat cancer and so on, so you should keep an eye out for these if you want to secure a job with a better pay and benefits. It is quite clear that medical coding and billing careers can provide considerable salary, benefits, availability and growth for those who are seeking long term security.
How much does a medical biller make on average
Medical billing is one part of a bigger profession called medical records and health information technology. As per research conducted by the Labor Statistics Bureau, technicians in this profession earn an average of little over $35,000 per year.
This is a comparatively large salary, when you take into account the fact that medical billing needs just two years of education to begin. You may also opt for a Bachelor’s or Master’s degree, if you wish to earn more money in this field. In many cases, by acquiring your Associate’s degree and starting work as a medical biller, you might be able to get your Bachelor’s degree’s costs covered by your employer.
The upper 10% in this profession make an average of $54,430 per year, and you may also use medical billing as a cornerstone for a higher-end career in health administration or health informatics, where you might be able to earn a six figure salary!
Can you work from home?
Each day, hundreds, even thousands, of smart Americans fall for work at home medical coding and billing jobs, mostly because the economy has forced the average educated person to look for alternatives which supplement or create revenue streams to counter the financial crisis.
Indeed, the work from home industry has opened a number of paths for some individuals to earn extra bucks every month, and when the ads make it seem like you’d be able to make $40K the very first year, who would refuse such a lucrative offer?
Thinking about this logically though, a medical billing / coding job means you have to perform the many different functions of medical coding for a given period of time, for a specific amount of cash, in the confines of your employer’s office.
If you employer has a setup which allows for remote working, you might be able to perform your duty from home, after you have proven yourself to be a trustworthy employee (this can take anywhere from six months to a year). Your medical billing from home salary, then, would be the same (or comparable) as if you were working from your office.
This is the only way you can work from home as a medical biller or coder – there is no quick fix as the ads would have you believe.
The ads you see scattered all over websites and in newspapers are just ‘opportunities’ and nearly all will mislead you since they give the impression that you’ll work for them from home as a fully employed medical biller.
In truth, these vendors aim only to sell you a home based medical billing business model, some tools for running your business, a completely useless listing of physicians who, according to them, desperately require your medical billing / coding services. If you’re extremely lucky, you might be able to get this to work and find an employer who will teach you a thing or two about the job, after they’ve hired you.
Three reasons as to why you should seriously consider medical billing and coding as a career choice:
- They yearly earning of certified medical coders in the United States ranges from $34,000 to $57,000. Particular specialties such as neuropsychiatry coding can pay as much as $62,000 annually!
- How much do medical billers and coders make in an hour can be anywhere between $16 and $29 depending on experience, certification and location. In the event that they have to do overtime, how much does medical billing and coding make depends on the number of hours they’ve worked, and varies between $14 and $35 per hour.
- Benefits such as a 401(k) program and health insurance are included in the job description for fully employed professionals.
Factors that Affect Medical Billing Salary
The answer to the question of how much do medical billing and coding make is dependent on a number of factors. If you want to increase your medical coder biller salary, it is certainly a realistic desire, for which all you need to do is find the right path, based on the following factors:
- Level of education
- Level of experience
- Employer type
- Employer size
Location is a primary factor affecting medical coder and biller salary so you’ll need to ensure that you’re ready to relocate in order to be in the perfect spot to earn well in this field. According to financial reports, top medical billing coding salary can be earned in New Jersey, DC, Maryland, Massachusetts and Hawaii.
Although these locales may have a higher cost of living, overall the payoff is good enough to offset this and then some, mainly due to the plethora of opportunities you’ll have there to enhance your career further.
Additionally, you might also be able work from home as a medical biller or coder in certain cases (refer to the previous section). Even if you’ve got to take maternity leave, or have to leave town or attend to any other unforeseen situation, if you employer has trust in you, you’ll be able to perform your tasks remotely.
This means you’ll be able to earn a medical biller and coder salary anywhere in the world. The rapid growth of this profession has led to both high billing and coding salary, and enhanced flexibility, making it a field to keep an interest in, especially if you want a promising career.
Here’s a breakdown of medical billing and coding salary per hour and per year, according to various factors that determine it i.e. state, employer type, and location. It will give you better insight into how much do medical billing and coding make exactly.
Medical billing and coding salary range
|U.S. National Average||$18,190||$35,080||$88,330(+)|
|Medical Coder Salary||$22,700||$37,710||$57,320|
|Medical Billing Salary||$23,750||$34,940||$47,930|
Highest medical coder and biller salary specialist salary
Medical biller and coder salary has a wide range depending on the career that you are working in:
|Career||Hourly Rate||Annual Salary|
|Medical and Surgical Hospitals||$16.78||$34,890|
|Medical and Diagnostic Lab||$16.73||$34,800|
|Other Health Practitioners||$15.78||$32,820|
|Career||Hourly Rate||Annual Salary|
|Pharmaceutical and Medicine Manufacturing||$25.41||$52,850|
|Drugs and Druggists' Sundries Merchant Wholesalers||$23.49||$48,860|
|General Medical and Surgical Hospitals||$19.28||$40,100|
Medical biller and medical coder salary by state
Medical billing and coding salary has a diverse range depending on which state you work in.
Medical Billing Salaries:
|State||Hourly Rate||Annual Salary|
|District of Columbia||$22.89||$47,610|
Medical Coding Specialist Salary:
|State||Hourly Rate||Annual Salary|
As it can be seen, the medical billing and coding salary in NJ is quite diverse, being the highest in the latter and least in the former. The average medical billing and coding salary in NY is $37,000 a year.
However, the mean medical billing and coding salary in PA is just a meager $29,000 a year, which goes to show that location play a huge role in determining the amount you’ll earn in this field. Bear in mind that these statistics are likely to change in the next decade as the population of the US ages, so you’ll have higher medical biller and medical coder average salary in the future.
The skills required to be a successful medical coder
Now that you’re aware of the medical billing salaries and medical coding salaries you might earn based on various factors, and if you’ve resolved to become one, it is time to learn what will be expected of you:
Insurance companies require medical codes to know what a patient must be charged and how much must be paid to hospitals, doctors and other medical facilities. All things from private insurance to Medicare require employees with degrees in medical billing / coding to learn and enter appropriate codes.
Medical coders are also expected to assimilate patients’ health information such as history, exams, lab results, symptoms, treatments, imaging tests and all other healthcare related services.
Other requisite skills for being a successful medical biller / coder are:
- Data entry
- Spreadsheet programs
- Specialized billing and coding computer software
With medical facilities switching over to electronic health records (EHR), medical billers and coders with these skills will be in higher demand and will thus have a chance to earn better medical coding / medical billing salary. These professionals will also be required to perform secure data transfer from paper to digital records and also between electronic databases.
Medical coding / medical billing specialist salary is higher than the average because they have to learn how to code patient details for reimbursement from Medicare, Medicaid and insurance. Depending on the exact degree they pursue, they may be taught a number of coding systems such as long term, ambulatory and physician.
Why and how to get certified?
Reasons to Become a Certified Medical Billing and Coding Professional
- Certified medical coders salary is on an average $7K greater than that of those who aren’t certified.
- Both the CCS and CPC (explained below) coding certifications are accredited qualifications which are nationally recognized.
- Employers in the US have a greater likelihood of hiring candidates who possess one or both of these certifications.
- Both CCS and CPC certifications will allow you to forge a career and earn above average medical billing and coding salaries in a highly competitive employment market.
- If you’re a certified medical coder, you’ve got a greater chance of being allowed to work from home with a flexible work schedule.
Checklist for Seeking an Accredited Medical Coding Degree Program
For a field requiring as much concentration and attention to details ad medical coding and billing, the majority of employers are seeking an individual with a certification or a degree from an accredited institute of higher education.
There are several such institutions in the country, which can make it a bit difficult to decide which one is best for you. Here are some of the important traits to look out for in a medical billing / coding certification program:
- Provides a recognized certificate: Well recognized document certifications for medical billing and coding specialists include the Certified Tumor Registrar (CTR) certificate and the Registered Health Information Technician (RHIT) certificate.
- Accredited: Simply put, if your degree is not from an accredited program, it will not receive any credence from most employers, and will be worth nothing in the market, let alone earn you a decent medical coding billing salary.
- Balanced pricing: Since certification classes are an essential requirement for many professionals of the medical coding / billing field, some institutes believe they can charge high fees with question. Make sure that you do your research online, or talk to a professional who already has a degree, to ascertain a fair price for an associate’s certification in the field, so that you aren’t swindled into paying more than you have to.
- Updated: Data storage and computer technology are undergoing such rapid changes that the software used for the storage and retrieval of medical data this year may have dramatically changed in the next few years. Ensure that the program you pick teaches you not just the programs presently being used, but also the basic skills needed to adapt to changing technologies in this profession. This is the only way you can survive in an evolving landscape and keep earning a competitive salary for medical coding and billing.
Locating and applying to a good medical billing/coding program might take you some time, but it won’t be difficult if you are systematic in your search. Do research beforehand, send in your applications to the candidates you’ve shortlisted, and do not delay replaying to official communication from the medical billing and coding schools you have applied to.
The sooner you acquire a certificate or degree, the sooner you’ll be able to get a secure job with great pay and benefits which are applicable to this profession.
Guidelines for starters with no experience:
AHIMA’S CCS and AAPC’s CPC Certifications – The essential credentials for medical coders in the US
AAPC is the acronym for American Association of Professional Coders (established in 1988), whereas AHIMA is the acronym for American Health Information Management Association (established in 1928).
Both are the most influential associations in their domains in the medical coding and billing industry, and their certifications are held in esteem by hospitals, health care providers and employers all over the US.
AAPC’s certification is known as the Certified Professional Coder (CPC), whereas AHIMA’s certification is known as the Certified Coding Specialist-Physician (CCS or CCS-P). Both of these certifications are based on examinations for which you can prepare using suggested study guides, and once ready, send your application forms 4 to 6 weeks before the date of the exam.
Both these organizations have many local chapters with exam centers all over the US, and some even in foreign countries.
Bear in mind that if you wish to have a serious career in this field (even if it is home based) you’ll have to have a certification from at least one of these organizations. Remember that the salary for medical billing and coding for those who bear a certification from these organizations is $7000 more than that for non-certified individuals.
CPC, CPC-A or CCA Certification for Medical Coders without prior experience:
CCA and CPC-A are a couple of other designation certificates for those who aspire to be in the medical coding professional and have little or no experience / formal training in a medical billing and coding program.
The Certified Coding Associate (CCA) is an AHIMA certification whereas the Certified Professional Coder-Apprentice (CPC-A) is an AAPC certification. Which one should you go for?
We’d recommend you to just prepare for the CPC exam, which is the same as preparing for the CPC-A designation. After you’ve cleared the CPC exam with a minimum score of 70%, you’ll get one of the following:
- CPC designation if you’ve got two years of experience (including externships) OR one year of experience alongside 80 contact hours in a course for medical coding.
- CPC-A designation if you haven’t got any past experience, and have not been a part of any coding course.
Keep in mind that the study materials and books needed for preparing the CPC-A are the same those for the CPC.
CPC is far more popular with most employers in the US and around the globe as a job-ready professional certification. And if you’ve got a CPC-A designation, it will be much easier to transition to full CPC designation.
AHIMA also has a certificate known as the CCS-P which is comparable to the CPC for physician coding, but it can be a lot more difficult because of its varied test format. The CCS-P/CCS exam format is composed of multiple select, multiple choice and fill in the blanks sections related to medical records cases.
Moreover, the CCS-P/CCS exam has a 4 hour length as compared to the 5 hours and 40 minutes time you get for sitting the CPC exam from AAPC.
Those who opt for an entry-level CCA from AHIMA are also likely to go for the CCS-P or the CCS certification from AHIMA. You can also mix up these certifications to provide a boost to your profile which will translate in to better medical coding / medical billing pay.
This will be a safe bet since dual qualifications will give you an edge over your competition regardless of the preference of your potential employer for one organization or the other.
- AAPC is the biggest organization for medical coding certificates and the credentials it provides (CPC, CPC-H, CPC-P, CPC-A, CIRCC and Specialty) are the preferred choices for both aspiring and current medical coders in the US.
- AHIMA certifications, by contrast, are recommended for establishing your expertise in advanced domains of medical coding (e.g. specialty hospital coding), and are therefore suitable after you’ve accumulated a minimum of 5 years of work experience and wish to start earning a medical coding / billing specialist salary.
For other careers in the medical profession check our our ultimate guide to becoming a Phlebotomist located here.