The demand for certified medical coders and billers is poised to maintain an uptrend, as Covid-19 continues to put a serious strain on the US public health system. The industry was already grappling with staffing shortages and workers approaching retirement before the pandemic. Over  r plan to leave or retire by 2027. Rebuilding a resilient workforce is a critical task for the government now, which is investing billions of dollars in recruitment and training programs. Moreover, as telemedicine gains traction, there will be a need for skilled coders and billers to handle the revenue cycles of institutions in a complex business model.


Employment of medical records and health information specialists is forecasted to grow by   All this makes medical billing and coding a lucrative option if you are interested in a career in the US healthcare industry. On average, certified medical coders and billers made Different states within the US have different pay scales for billers and coders.


Another advantage is that you don’t need to spend years in a medical or nursing school to begin your career. So, how long does it take to become a medical coder and biller? The answer depends on the medical billing and coding programs you choose to enroll in. Before we get onto that, let’s understand what is medical billing and coding.


Medical Coding Versus Medical Billing

There is a difference between what a medical coder and medical biller does. The role of a medical coder is to assign billable codes to the list of diagnoses, treatments, procedures, and other services availed by a patient in a healthcare facility. There are numerous standard codes used in this process, including ICD-10 diagnoses codes, HCPC-Level II codes, CPT, facility codes, and so on. A coder, thus, needs to have extensive knowledge of these codes and their applications in various complex procedures. They need to work in close association with physicians, billers, insurance providers, clinical staff, and others to ensure that the undertaken procedures are coded accurately. Based on these codes, patients are billed by the facility and reimbursed by insurance companies.


A biller’s job is to decipher these codes and prepare claims to be submitted to the patients’ insurance providers. They have to capture correct patient data and prepare a payment plan for accurate reimbursement. This includes staying in sync with a hospital’s or a clinic’s payment guidelines and following up with patients on any outstanding amount. Billers work closely with insurance providers, investigating the causes of claim rejections. They also need to submit appeals, follow up on claim statuses, and make post-payment adjustments.


Together billers and coders maintain the revenue cycle of a facility and ensure that patients are being charged correctly under various healthcare plans. They play a critical role in ensuring healthcare companies can avoid litigation, payment fraud, and fines levied by regulatory authorities.


For these reasons, employers hire certified coders and billers, who have the knowledge and skills to ensure smooth and accurate execution.


How Long Does it Take to Become a Certified Medical Coder?

This depends on the path you take to become a coder. You don’t need an associate’s degree to enroll in a certification program. So, you can start looking for jobs right after your high school diploma. Many medical billing and coding programs will allow you to finish coursework at your own pace.


If you have sufficient coding experience or enroll in a program to become a medical coder, you can apply for the CPC (Certified Professional Coder) test.  It is not necessary to show these proofs right away to appear for the exam. But unless you provide them, you will be designated as an apprentice, which means your certificate will have a CPC-A® credential.


AAPC’s CPC credential is a highly sought-after certification among coders to pursue a career in a hospital or clinician’s facility setting. It is the industry standard to demonstrate expertise in reading medical charts and assigning proper codes, knowledge in healthcare regulations, medical terminologies, human anatomy, and physiology.


Most candidates complete the coursework and pass the test within 12 months. It could take you somewhere between 12 to 18 months to become a certified medical coder.


You can also pursue other certifications like the COC® (Certified Outpatient Coder) and CIC® (Certified Inpatient Coder), which have similar requirements and time of completion.


In contrast, some certifications like Registered Health Information Technician (RHIT®) by the American Health Information Management Association (AHIMA) is an academic program that can take   The Registered Health Information Administrator (RHIA®) from AHIMA needs 4 years to complete. If you wish to pursue a course of shorter duration from the AHIMA, you could choose Certified Coding Associate (CCA®), which needs 6 months of coding experience.


How Long Does It Take to Become a Certified Medical Biller?

Certified medical billers with a CPB® (Certified Professional Billers) credential earned a median salary of  , one of the highest in the sector. AAPC’s CPBs are recognized by the industry to demonstrate extensive knowledge of various insurance plans, coding guidelines, healthcare laws and regulations, payers’ policies, and expertise in how to improve an institution’s revenue cycle.


You don’t need to have an associate degree or prior billing experience to pursue this certification. This online medical billing course is designed for completion within 4 months, though some students require up to 6 months to finish the 80 hours of course work. After successful course completion, you will be eligible to appear for the CPB exam. Passing this exam will open doors for you to multiple opportunities in the industry.


What Other Skills Do Medical Coders and Billers Need to Succeed?

Medical billing and coding programs can provide the necessary knowledge and skills to work in a real-world environment. However, to advance your career along, you also need skills like communication, problem-solving, critical thinking, and reasoning. One of the major differences between a medical coder and a biller is patient interaction. As a biller, you might need to interact with patients and their families, which requires social skills, cultural awareness, negotiation skills, and empathy. Coders typically do not interact with patients, but they do communicate extensively with healthcare and insurance professionals.

The US healthcare industry continues to face challenges in the aftermath due to the pandemic, which continues to take up critical resources of healthcare systems. Hospitals and other healthcare facilities need to be proactive, swiftly scaling their virtual services for patients. This will continue to reshape how and what work is performed by their workforce. Various partnerships are also being forged for supplies, vaccinations, and treatments. In this complex and rapidly changing environment, the need for medical billing and coding expertise remains critical to ensure that institutions continue to comply with regulations and do so profitably. If you are looking for a career with high growth potential and opportunities for remote work, you can weigh your options between medical coding versus medical billing.

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