How to Become a Medical Coding Specialist: Job Description & Requirements

Oct 20, 2021

Medical Billing and Coding Job Description

Those wondering 'what is a medical coding specialist?' and 'what do they do?' should know that medical coders or coding specialists are a kind of health information technician who work in the medical field doing essential work to keep the hospital systems that many people rely on running smoothly and efficiently at all times. These professionals are primarily responsible for organizing, managing, and ensuring the accuracy of health information data, often on a large scale and for systems that impact people dealing with many different medical issues. Doctors, nurses, and other medical professionals rely on the work of medical billers and coders in order to do their jobs and access relevant information on a day-to-day basis. Medical coders typically work to guarantee the proper coding of health information, most commonly for billing purposes, but also for other organizational purposes. Other medical coding job duties may include:

  • Coding patient information for preexisting conditions, both in general and for individuals
  • Selecting the correct procedure codes for patient care and transmitting that information to doctors
  • Noting proper diagnosis codes and keeping them up to date at all times
  • Working with healthcare providers, insurance agencies, and billing services to make sure payment is dispensed in good time
  • Managing other medical facility records and digitizing old records as needed
  • Organizing medical reports and transmitting them to the relevant individuals
  • Consolidating data from various sources to create overarching health data systems
  • Working with interstate or international health organizations in order to update patients' medical information

Personality Requirements

In order to become a successful medical coder, it is necessary to consider one's personality and strengths to find out if this is the right job for you. Medical coders need to have excellent focus and attention to detail at all times during their work. They need to have exemplary writing and proofreading skills in order to catch mistakes and communicate clearly. They need to exercise discretion when working with sensitive medical information and patient files. Their telephone manner needs to be clear, professional, and friendly. They need a wide knowledge base on many different topics, including the financial aspects of medicine for medical billers in particular. Medical coders may require significant patience when working to optimize outdated systems or when requesting information from different establishments.

They need to solve problems creatively and often need good design skills in order to create strong user interfaces for a variety of different systems that will be accessed by many medical professionals and sometimes by patients. Medical coders need to be able to work fast in order to disseminate important information, particularly in times of medical crisis. They need to make all healthcare systems unambiguous and easily navigable, so they also need to have excellent digital communication skills. An understanding of accessibility in web design, particularly when creating resources for patients, is an excellent asset. Medical billers need to understand the insurance system and have a strong understanding of a variety of socioeconomic challenges facing their clients in order to be of help when creating payment plans and insurance claims.

Many of these are learned skills rather than intrinsic ones, so don't worry if you feel like you don't fit this description yet. The most important thing is a readiness to learn and some background knowledge that will help pave the way to becoming a successful medical coder in a particular healthcare establishment or clinic.

Medical Coding Job Description

Because medical coders work in different medical contexts, both within their own workplaces and throughout their careers, there is no one specific job description that fits all medical coders. One of the main traits of the job is an ability to work in different systems and to solve problems creatively while keeping up with the day to day requirements of their own workplace.

What Does A Medical Coder Do On A Daily Basis?

A medical coding description will depend on the specific environment a medical coder works in. Working for a hospital will differ from working for a clinic, and responsibilities will be different again in nursing homes. Some coders will have to do more work with and for patients whose medical records come from other areas, and some will specialize on integrating health systems in a city or state. Generally speaking, however, medical coders spend their days working with online and paper organizational systems, updating patient records, liaising with patients and medical insurance organizations, and working to update and organize their workplaces' medical filing systems so that doctors always have easy access to relevant information. Medical coder responsibilities are of the utmost importance to the health and safety of people accessing medical care because they impact the safety and care of the patients in the medical system, all of whom rely on the proper and efficient functioning of medical information systems.

Medical Billing Job Description

Although they are often listed together, medical billing is actually a different job from medical coding. Both are important in creating efficient healthcare systems for all concerned.

How Does a Medical Coder Differ from a Medical Biller?

A medical biller holds a similar position to a medical coder, but with more of an emphasis on the financial aspect of the work. Medical billers liaise specifically with clients and with insurance providers in order to ensure that all payments and insurance claims are handled smoothly. They often assist patients in submitting insurance claims and help patients navigate possible payment options for a variety of services. Medical billers also communicate with hospitals, drug companies, and other service distributors in order to ensure that their clinic or other workplace has sufficient stocks of medication, access to medical devices, and more. In some cases, they also work to provide effective payment for specialists and other part-time medical personnel in clinics and nursing homes. Medical billing job duties are similar to those of medical coders, but they are more limited to a single area of the medical field instead of encompassing all aspects of the medical systems database. Medical billers spend more time on the phone and are less concerned with the functioning of overall systems. In many ways, the work of medical coders assists medical billers by giving them clear access to relevant financial and medical information.

Can Medical Billing and Coding Be Performed Separately?

In some cases, medical billers are hired solely to work on finances. More commonly, however, medical coders also perform the function of medical billers, especially in smaller clinics. In hospitals and other large medical establishments, the distinction between medical coding and medical billing is more clear. Some medical billers go on to take on more medical coding responsibilities based on the needs of their place of work, and for some people the careers blend into one another entirely. Medical billers and coders, especially at smaller clinics, may also do other administrative and secretarial work, including scheduling and cancelling appointments and assisting with expert referrals.

Day-to-Day Experience of Medical Coders

What does a day in the life of a medical coder look like? As with the job description for this position, daily duties are highly variable. Medical coders generally work standard hours, though in some cases, particularly in terms of information system breakdowns or medical emergencies, overtime or weekend work may be required. Some medical coders work from home while others work directly within clinics and hospitals. Most of a medical coder's work is done via computer, as few medical establishments retain paper copies of most of their information. When working within a medical establishment, medical coders must follow health and safety protocols common to all medical staff. They may also have increased contact with patients if they work in such establishments, particularly if they are consolidating patient records. Medical billers are far more likely to work within medical offices, as they are required to liaise directly with patients more frequently. Medical billing and coding are not usually physically demanding jobs, but they do require significant facility with digital technology and excellent typing and editing skills. Mistakes made by medical coders can be disastrous if they harm patients' access to care.

Benefits and Challenges

There are numerous benefits for those who work as medical coders. Working within the medical system can in itself be rewarding, as it involves helping people to recover from serious illnesses and live their lives to the fullest. For those who enjoy solving problems and creating systems, medical coding can also be a very interesting job. The job can be challenging when crises arise or when systems require massive overhauls, particularly when it comes to integrating different kinds of health systems into one umbrella system. Medical mistakes at any level can and do cost lives, which puts pressure on medical coders to be exceedingly careful in their work even when under time pressure. For medical billers, working with patients who are struggling financially or who lack health insurance can be very challenging and demoralizing, but making successful insurance claims and assisting those who would not be able to handle their medical finances alone can be a reward of the job. Medical coding can be very interesting for those wishing to learn about medicine without making a career out of becoming a nurse or physician. It can also impact the medical and financial choices that coders and billers make for themselves and for their loved ones due to their increased understanding of the benefits and pitfalls of a particular system.

Medical Coding Specialist Requirements

In order to become a medical coding specialist, students typically need to obtain a certificate or associate's degree in the field of medical coding, along with professional certification. Previous administrative experience is also likely to be very helpful for those looking to obtain work as medical coders. There are several different certificate and Associate of Applied Science (AAS) degree programs available in medical coding, as well as certificate and associate's degree programs available in medical billing and coding for those wishing to become a medical billing clerk and other related medical billing and coding job options.

Many certificate and associate's degree programs in the field of medical coding are available in online formats, though others are hosted in person. Some of these certificate programs can be completed in as little as 10 months, while associate's degree programs typically take two years to complete. Online programs tend to be more self-directed and may be completed in more or less time according to students' schedules and levels of engagement with the material. Students in a medical coding program are likely to take courses in topics like:

  • Medical terminology
  • Medical billing
  • Healthcare systems
  • Diagnostic coding
  • Procedural codes
  • Medical ethics
  • Administration

Medical Coding Specialist Certification

After completing a postsecondary program, most medical coders need to obtain professional certification in the field to demonstrate their expertise. General health information technician certifications are available through several organizations, such as the Registered Health Information Technician (RHIT) certification, but medical coders may pursue more specific certification, like the Certified Professional Coder (CPC) certification. Which certification to choose will depend on the type of work that coders want to perform and the specific requirements of medical establishments in their area for medical coders and billers.

The CPC certification is offered through the American Academy of Professional Coders (AAPC). To earn the prestigious credential, students must take the CPC exam and pass with a score of 70% or higher. The exam takes 5 hours and 40 minutes, and prospective applicants often study for a number of weeks before attempting the exam. Study guides and other information are available through the AAPC website, as well as options for exam preparation courses, supplementary courses, and practice exams to help students feel as prepared as possible for their examinations.

Medical Coding Specialist Advancement

Some medical coders may go on to earn a bachelor's or master's degree to advance their career. Often with an advanced degree, work experience, and the correct certifications, health information technicians can move into supervisory positions, such as a career as a medical or health services manager. A bachelor's degree in information management, business administration, or even biology can be helpful in giving medical coders more information on medicine and on administrative techniques. For those working full time, bachelor's degrees are available online or through evening classes from a number of universities. Continued work experience with a single clinic or medical establishment can also lead to career advancement through increased familiarity with the establishment's systems and needs.

How Long Does It Take?

Becoming a medical coding specialist can take less than a year after high school graduation, but in many cases it takes longer, especially when prospective medical coders get a bachelor's or master's degree. However, because these degrees can be obtained later in a medical coder's career, this job is relatively accessible. Certificates often take 10 months or less, and associate's degrees generally take around two years. The path to becoming a medical coder is different for everyone, and prospective medical coders should be prepared to be flexible and to take opportunities that arise in order to learn as much as possible and get involved in the medical community.

The desk setup of a medical coding specialist

Medical Coding Salary

According to PayScale.com, medical coders made a median hourly wage of $18.06 in September 2019. This equated to a median annual salary of $41,545. PayScale.com did note that wages were likely to vary based on factors such as employer, bonuses, location, skills, and experience. For example, medical coders with 10 to 19 years of work experience reported an hourly wage of $21.33, while those with 20 years or more of work experience reported an hourly wage of $22.97. Compared to other medical professions, this is a relatively low wage, but as previously stated there may be opportunities for advancement within the system, particularly in cases where system overhauls are needed or digitization is not yet up to speed. Integration of new technologies as they arise may also be an area in which medical coders can expand their understanding and increase their salaries.

Medical Coder Outlook

While the U.S. Bureau of Labor Statistics (BLS) did not report the job outlook specifically for medical coders and billers, it did report a job outlook of 8% growth for medical records and health information technicians from 2019 to 2029. This job growth projection is much faster than the national average, meaning that there will be significant demand for medical coders in the coming decade. This growth in the field may be attributed to the growing need for healthcare services as the American population ages, and in turn, the need for managing more healthcare information and data. Making sure that digitization and large-scale integration of various systems is done effectively may also increase the need for medical billers and coders in the coming years. Health crises like the COVID-19 pandemic have unfortunately already necessitated vastly increased medical information coordination efforts, many of which have been spearheaded by medical coders and those in other medical information positions.

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