The medical field is a booming industry. It is strong; it is mighty; and it stands to grow even stronger as the population worldwide ages. But even this new mammoth requires an effective system – and this is where medical billing and coding comes in. Medical billing and coding jobs are considered medical administration jobs, and they keep the healthcare system in shape.
Come economic boom or doom, medical billing services will still be relevant and will remain in high demand even during slumps. The sprouting of medical billing companies gives rise to a myriad of changes and chances for medical billers and coders. In fact, the Bureau of Labor statistics (BLS) predicts that there will be 207,600 job openings by 2022!
What is Medical Billing and Coding?
Medical billing and coding involves the submission of a patient’s paperwork for reimbursement and following-up on claims to insurance companies to receive payment for services provided by a healthcare provider. Healthcare providers typically refer to hospitals, clinics and the like. But wait – is there a difference between medical billers and medical coders? As a matter of fact, there is; and the main one is the difference in the responsibilities they shoulder.
- Medical biller: A medical biller handles all the documents required by an insurance provider for the reimbursement of healthcare services provided to a patient. The method of documentation used must be correct and legitimate in order for the application to be processed. A medical billing specialist is an expert in his or her field and excels at memory, accuracy and performance under stress. People who specialize in medical billing from home usually have at least 5 years of experience.
- Medical coder: A medical coder computes appropriate medical codes – of which there are thousands – into insurance claim documents and final reports for patients. But it’s not really as simple as it sounds: a medical coder must have a strong grasp of human anatomy and comprehension skills in order to tag the numerous numeric codes to parts of the human body.
Although it has two terms for two inter-related yet different tasks, bear in mind that they can be done by the same group of people; this reduces the risk of domino-effect miscommunication en route to the final destination: either an insurance company or the body of a final report.
What Are They Expected To Do?
In short, those in the medical billing and coding department have to:
- Be very, very accurate when coding documents and reports
- Guide patients on how to apply for reimbursement on claims to their insurance provider
- Explain to patients about insurance procedures as well as the advantages and compensations of insurance plans
- Essentially, keep their mouths shut: the confidentiality of the patients must be kept
Medical billers and coders can, but not necessarily do, work in several places that may or may not deal directly with patients, such as hospitals, ambulatory surgical centers and medical research and development centers. Of course, there are other workplaces that can use your skills as a medical biller or coder, so you should always try looking in places where people don’t usually look – like healthcare R&D institutions, for starters.
What You Can Expect from the Job:
- A 40-hour work week
- Ability to understand, memorize and apply details
- A fast-paced working job with strict deadlines and work pressures
- Possibility of making it a work-from-home job (medical billing from home)
The Digital Touch to Medical Billing and Coding
The digital world has revolutionized how medical billing and coding is done. Accuracy is still of the utmost importance, but electronic software applications have made the job much simpler. Medical billing software has evolved to fit the bill.
Medical billing software applications used in healthcare are primarily divided into two types: Electronic Health Records (EHR) and Electronic Medical Records (EMR). Both of them are used for the same purpose – maintaining databases, inserting the right codes and so forth while more sophisticated software can even include X-ray and scanning storages – but EHR is more commonly used for smaller-scale organisations while EMR is more suitable for large-scale organizations.
Why Pursue It as a Career?
- Higher chance of securing a job due to ever-increasing demand as populations worldwide age
- Comparatively lower educational prerequisites for admission into the course
- Flexibility in terms of working environment – and location and time, if you freelance
- Ability to either freelance or get permanently employed…or you can do both if you think you’re up to it.
What’s the Pay Like?
The average medical billing and coding salary varies based on a number of factors; not everything is based on the level of your academic qualification. Your experience matters, too, as does the location, size and scope of the company you work for; your previous training; and your skill set.
According to the Bureau of Labor Statistics (BLS), the median annual salary for a medical biller in May 2018 is $42,350. A fresh, inexperienced employee can expect an average of $31,240 – calculated with numbers from the lowest ten percentile – while an experienced one can stand to earn an average of $73,430. All in all, the average medical billing and coding salary is approximately 10% higher than the average LVN salary.
Even the figures on the low end of the salary spectrum are enough to live comfortably by, if not lavishly. And in trying times like these, a satisfactory salary in a high-demand profession is good insurance against unemployment.
How to Become a Medical Biller or Coder?
So maybe you’ve decided to give medical billing and coding a shot, but you don’t know where to start. You don’t need a license. Technically, you don’t even need formal education in order to ply your trade – though it might be best to keep this as a theoretical assumption unless you are really sure you can self-train. Either way, you can up your chances of snagging a better job in this industry if you’ve been certified.
This doesn’t mean you have to earn a degree; a professional certification like CPC or CPC-H is what you need. Employers want more than diplomas and degrees. They want professionals. And they want proof that you are the professional you claim to be. They want to see your professional certification.
Education first; certification later. You’ll want to receive adequate guidance and tutelage to help you be certified. If you’ve decided to self-learn, then you’ll need to find all the reliable sources you can get. But this move requires great dedication and you might not have enough of it to pull through. So what’s left?
The simplest answer: go back to school. Except that we now call it college or university, but that is not the point. How do you go about doing this?
First you should know – or at least hazard a guess – at what area you’d like to specialize in. There are three different coding systems used in the healthcare sector, so this will be one of the times when you’ll need to be sure about what you want to do without being able to test the waters first.
How Should You Choose A Medical Billing School?
Medical billing schools are not all the same. They differ in syllabi, staff, branding (the strength of their name, to be precise), fees and location. A more recent development is the availability of online courses, which breaches the physical limitations of traditional schools and allows students to learn medical billing from home; location no longer matters so long as you’re facing your computer at set times. So which fits your needs better: online or offline schooling?
Online vs Offline Dilemma
Medical billing and coding schools can be taken either online with help from the Internet, or offline in traditional brick-and-mortar institutions. Here are some pros and cons of both options.
- Offline school: has a set duration of study; promotes face-to-face interaction; and offers you a chance to build rapport with future co-workers (and rivals) and experienced professionals, such as your lecturers and tutors.
- Online school: allows you to set the pace so that you can complete the course much sooner if you think you can absorb essential knowledge fast enough; gives you the freedom of location as long as you are facing your computer screen at the stipulated times.
- Offline school: has a slower pace of studies and thus later graduation; might be more costly than an online education because relative costs increase.
- Online school: offers no face-to-face interactions (video lectures, live or otherwise, don’t count); harder to build rapport with fellow students and possible co-workers.
Regardless of which option you choose, remember to do your homework and choose an accredited college or university: it will help you strengthen your chances with potential employers, and you stand a higher (though not definite) chance of getting better lecturers and a better-rounded syllabus.
Make sure you will be well-grounded when it comes to theoretical and practical knowledge; medical billing software, engineered by companies such as Lytec and Medisoft, which will be relevant later when you start working; and, hopefully, you will find a way to foster relationships with those in the same course and industry as you.
As with your medical billing course, certification can be done both online and offline. The official websites of national agencies like AAPC.com will show you the variety of certifications you can pursue and how to pursue them.
Medical Billing Services
Once you are certified, there are a few ways for you to offer your medical billing services. The first would be to work for a hospital or some other healthcare institution. The next would be to work for medical billing services companies who provide a means of outsourcing for healthcare organizations which are already stretched too thin. Another possibility is to be your own master and offer your services as a freelancer.