Medical billing and coding are at the cornerstone of today’s health care revenue system, ensuring payers and patients reimburse providers for their services. As the industry continues to grow, rewarding careers in the health care sector are expected to rise. The U.S. Bureau of Labor Statistics (BLS) an employment growth of 8% for medical records and health information technicians between 2019 and 2029.
This page can help answer your questions about how to work in medical billing and coding, as well as give tips and resources on where to start in The Golden State.
What is Medical Billing and Coding
Medical billing and coding are key drivers behind the modern health care industry. Without either field, health professionals would not be able to transfer important data and get paid for their services. Although people use medical billing and coding together, they are still two separate jobs.
Medical coders translate written copy–such as a doctor’s diagnosis or patient prescriptions–into a numeric or alphanumeric code. For every medical case or injury, there is a corresponding code to match. Billing specialists then take the information from medical coders to make a bill or claim for the insurance company.
What Does a Medical Billing and Coding Worker Do?
Since medical billers and coders have two different job roles, they are usually found in various areas of a hospital, clinic, or doctor’s office. However, in a small setting, one person may perform both jobs.
Let’s take a closer look at what medical billing and coding experts do on their day-to-day schedule.
Professional coders typically start their day by reviewing medical charts, files or reports they have to code. Next, they examine each document and determine the patient’s diagnoses based on what was performed. Their job is fairly simple: a coder finds the best way to translate a doctor’s report into code.
For example, a record may show that a patient visited the doctor for lower back pain. But after physical examination and x-rays, the doctor discovered that the pain may be linked to a muscle strain in the affected area. With a positive diagnosis, the doctor prescribed Methocarbamol (or Robaxin), a muscle relaxant that treats back pain, followed by physical therapy for two weeks. The coder would read this report and use a coding manual, such as ICD-10, to identify the diagnosis and procedure. Coders must follow a special set of guidelines for each code, or it could result in a rejected claim by the biller.
As soon as a professional biller receives the code, it’s their job to create and submit a medical claim to the insurance company. It is also the biller’s responsibility to send out reminders and collect payments from each patient. While this process may seem easy to understand, it can be very complex. That said, a medical biller’s job duties include:
- Investigating and appealing rejected claims.
- Preparing patient payment plans and collection accounts.
- Reviewing patient bills for correct and complete information.
- Ensuring rate changes are up-to-date with billing software.
- Updating payment spreadsheets and running collection reports.
- Gathering referrals and pre-authorizations required for a doctor’s procedure(s).
- Checking every insurance payment for clarity and compliance with contract policies.
- Verifying eligibility and benefits for treatments, in-patient hospital stays, and other procedures.
- Answering all patient or insurance inquiries related to any assigned account, this can be done either by phone or email.
- Setting up, reviewing, and delivering patient claims using billing software, by either electronic or paper claim processing.
In addition to these tasks, an employer may ask a biller to perform other duties, depending on their certification and previous work experience.
Why Work in Medical Billing and Coding
Now is a good time to jumpstart your career in medical billing and coding. As a large number of health care workers enter retirement, the demand for certified professionals grows more and more each day. The Bureau of Labor Statistics projects there will be an upwards of 370,600 jobs nationwide for medical records and health information technicians by 2029.
But perhaps the best benefit of becoming a professional biller or coder is how quickly you can get started in the field. Many students earn their certificate online, which allows them to work part-time as they study.
Medical Records and Health Information Technician Salary
The median pay for medical records and health information technicians, of which medical billers and coders fall into, was $40,350 in May 2018, according to the BLS.
Best Cities to Work in Medical Records and Health Information Technician in California
Below is a table of California’s top-paying cities to work as a medical records and health information technician in California as of May 2018, which is what the BLS classifieds medical billers and coders as.
|Metropolitan area||Employment||Employment per thousand jobs||Hourly mean wage||Annual mean wage|
|San Jose-Sunnyvale-Santa Clara, CA||910||0.81||$28.82||$59,940|
|Yuba City, CA||50||1.21||$28.05||$58,350|
|Riverside-San Bernardino-Ontario, CA||2,010||1.35||$27.59||$57,390|
|San Francisco-Oakland-Hayward, CA||2,860||1.18||$26.37||$54,850|
How to Become a Medical Biller and Coder in California
Because the profession is in high demand, you’ll find plenty of schools offering medical billing and coding programs, including certificates, diplomas and associate degrees.
Follow these six steps to becoming a medical biller or coder, from getting certifications to landing a promising career in the field. There are some medical biller and coder requirements in California that may not apply outside the state.
Step 1: Choose A Medical Billing and Coding Training Program
There are hundreds of ways to land a dream job in medical billing and coding. Anyone considering a career in medical billing and coding must consider which educational program is right for them. For most, each student has to choose from three distinct areas: certificate, diploma or associate degree. These options require different courses and deliver different academic backgrounds, but all are beneficial options when looking to start this career.
Step 2: Complete Your Coursework
Regardless of how you choose to pursue your certificate or degree, the bulk of the coursework will cover four critical subjects: legal policies, health insurance, coding and the human body. Since each program has their own unique learning objectives, how these subjects are taught will vary. Still, it is important to complete each one before taking your CPC exam.
Step 3: Prepare For The CPC Certification Exam
Upon completing SJVC’s certificate or associate program, you’ll want to take the Certified Professional Coder exam given by the American Academy of Professional Coders (AAPC). This is a medical billing and coding certification. While certification is not always needed to work in this field, many employers list CPC as a preferred or required job qualification. Earning this credential can help you stand out in the job market as a preferred candidate.
Step 4: Create A Resume & Apply For Jobs
Resumes are your golden opportunity to draw in employers for an interview. A good resume for a medical biller or coder will contain three things: education or training, work experience, and technical skills. You can also include additional information, such as references or a professional summary.
Step 5: Start Your New Medical Billing And Coding Career
The medical billing and coding field has many openings for qualified experts with professional skills, knowledge and experience. SJVC is a great place to begin your training and education for a number of reasons:
- Convenient and flexible online courses
- Helps prepare students for the CPC exam
- Choice of certificate or associate degree
- Offers an extensive array of career services, networking opportunities, and other job resources
How Long is a Medical Billing and Coding Program?
A Medical Coding and Billing Program at SJVC can be completed with a certificate online in as few as 7 months or an Associate of Science Degree in as few as 15 months. Other program lengths may vary depending on the institution and the type of degree awarded.
Can I Study Medical Billing and Coding Online?
Yes, medical billing and coding schools and courses are available online. Many programs allow students to explore similar career paths or continue their education in other courses, with a range of affordable and flexible hours.
For more information about what we offer, check out SJVC’s programs and courses.
How to Find Medical Billing and Coding Jobs in California
After passing your Certified Professional Coders (CPC) exam, it’s time to hit the job market. Many health care specialists find jobs on third-party sites such as LookSharp, Indeed and LinkedIn. But some of the great places for finding new jobs are at professional organizations or health care centers.
Here’s a list of top resources in and around California.
- Adventist Health
- Huntington Hospital
- Garfield Medical Center
- St. Jude Medical Center
- Santa Rosa Memorial Hospital
- Desert Regional Medical Center
- The American Association of Professional Coders (AAPC)
- The American Health Information Management Association (AHIMA)
Find Your Path in Medical Billing and Coding
SJVC is committed to hands-on training in the skills you need as a medical biller and coder. Learn more about our program and exciting opportunities.
What to Look for in a Medical Billing and Coding Program
Before enrolling in a college campus or online program, be sure to consider several options like your preferred learning environment, program delivery, course length, cost and class size. Depending on your schedule, an online course may fit better into a student’s lifestyle than a traditional, in person program.
The following information will help you navigate your choices and further explain how to pick a medical billing and coding certificate or degree program that works best for you.
Medical Billing and Coding Certificate vs Associate Degree
When considering a medical billing and coding career, you have two main choices: a certificate or an associate degree. In California, several colleges offer both programs. Before deciding on a certificate or degree, be sure to weigh the pros and cons of each to see what best fits your needs.
If you have a specific career in mind and don’t want to dedicate two years to getting a degree, then a certificate program may be your best option. In some instances, knowledge and comprehension is just as important as the career your training leads to.
One of the best advantages of earning a college degree is that your education will explore a broad range of topics. A medical billing and coding degree will give you a broader understanding of the world around you. However, you will need to dedicate time, resources and money to your studies.
What Will I Learn in SJVC Medical Billing and Coding Programs?
Sample classes from catalog
- MOP 110: Medical Insurance Principles – This course focuses on the requirements of a billing and coding specialist as well as insurance terminology, legislation and regulations that affect billing and coding. Students will perform fundamental administrative and communication skills needed to work in a medical facility. Students will practice the basics of CPT and ICD coding as well as complete insurance claim forms. Students will be trained in CPR/BLS-HCP and first aid. Keyboarding skills are also emphasized in this course.
- MOP 120: CPT/HCPCS Coding – The course examines coding concepts associated with the Current Procedural Terminology manual and the HCPCS code book. The Evaluation and Management, Anesthesia, Surgery, Radiology, Pathology/Laboratory and Medicine sections are covered with emphasis on section guidelines and proper code selection. Keyboarding skills are also emphasized in this course.
Benefits of an Online Medical Billing and Coding Program
Enrolling in an online medical billing and coding program can help prepare students for a specific role in the health care sector. In turn, they also provide a variety of benefits compared to traditional education, including:
- Added flexibility
- Customized learning environment
- Unlimited access to career resources
- Increase self-discipline and responsibilities
- Better work-school-life balance
- Better opportunities to concentrate and focus
How Does Online Learning Compare to Traditional On-Campus Programs?
Traditional on-campus programs are limited by the availability of their faculty, whether it’s through specific classes or time slots. But with online courses, professors can work from anywhere at any time. Some schools hire adjunct faculty to teach online classes, giving students a wide array of options that’s not limited by the number of staff members.
They also allow students to complete assignments at their own convenience. This makes earning a college degree or certificate feasible for people with children, full-time jobs or active duty military. Online programs are an affordable alternative to traditional methods as they save on extra costs such as room and board, meal plans, transportation, parking, and daycare fees.
Kickstart Your Career in Medical Billing and Coding
Small class sizes, individual attention, and hands-on training in the skills you need. Learn more about how to become a medical biller or medical coder with SJVC.
Start Preparing For Your Medical Billing and Coding Career with SJVC
Want to take the next step towards a new career? Start by applying at SJVC’s online Medical Billing and Coding program. Students earn a certificate in as little as 7-9 months or an Associate of Science degree in as few as 15 months. Our online programs are convenient and flexible for any lifestyle.
Request more information on either program or contact our office to speak with an admissions advisor today.
Visit https://www.sjvc.edu/admissions/consumer-information/ for important information about program outcomes.
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