Looking for an opportunity in the medical field that doesn’t involve actually administering medicine? Interested in an occupation where there is swiftly growing demand, and where you’ll find plenty of job openings in the future, and a great salary to top it all off? Medical billing and coding jobs are getting a lot of attention from job seekers and recruiters these days. The simple reason is that it’s hard to find a better bang for your buck when it comes to investing in your education and career path. With nothing more than an associate’s degree and a certification in medical billing or coding, you may be able to earn more than $40,000 a year. How many jobs are you going to find with that kind of opportunity? Not too many.
If you aren’t all that familiar with medical billing and coding or other auxiliary medical positions, then you probably want to learn more about them before you jump in. Medical billing and coding are usually grouped together as if they referred to a single job, but this is only because they are closely related. They actually are two different occupations, and most people choose to do one or the other and not both. So let’s break it down and talk about what medical coders do vs. what medical billers do, and how the two occupations are related. That way you can decide which job might be right for you.
What is Medical Coding?
The field of medicine is one which is highly complex, and it can be difficult to talk about medical conditions, procedures and treatments in plain language and be sure that everybody is on the same page. That’s why doctors have come up with a system of medical codes to communicate with each other, with other hospital and clinic personnel, and with insurance companies and government agencies. There are several different types of medical code classification systems, CPT® codes, ICD-9 codes and HCPCS codes. These codes are all alphanumeric in nature, and allow physicians and insurance companies to objectively discuss the situation with a particular patient. They can also help clinic administrators to figure out what is going on with hospital staffing and equipment needs. Just to give you an idea of how comprehensive these codes are, the ICD-9-CM coding system, which is the International Classification of Diseases, has more than 17,000 codes in it. Each code refers to a specific disease, injury, diagnostic method or treatment technique. There are also different variations of each, indicated by an extra digit in the code.
So for example, the numerical code 840 refers to an upper arm or shoulder strain or sprain. There are many different types of strains which can happen in that area of the body, though, which is why there are a number of different permutations of this particular code. 840.1 refers to a strained coracoclavicular ligament. 840.2, 840.3, 840.4 refer to different localized strains in the upper arm or shoulder, and so on. You can see how translating information through this system of codes would require specialized knowledge of an employee or contractor who focuses on medical coding and nothing else.
And ultimately, that is the job of a medical coder—to translate information in and out of these alphanumeric codes so that doctors, insurance companies, and other concerned parties can accurately, objectively, and swiftly communicate about a patient’s situation. This enables a hospital or clinic to run smoothly, a patient to receive safe, effective, and proper treatment, and for doctors and other health professionals to receive appropriate compensation for their work. Without the work of medical coders, none of this would be possible. That’s why it is such an important job.
What is Medical Billing?
Medical coding is used for many different purposes, but one of the main purposes is billing. Physicians, nurses, physician assistants, medical assistants, and all the other personnel in a hospital or clinic who treat patients all have to be paid for the work that they perform. That work is highly complex, which is why it has to be translated into those alphanumeric codes. That way no one can argue about what is going on with a patient and what treatments and tests were performed. If doctors were to try and request compensation for procedures without the help of coding, they would have a difficult time communicating about what exactly they had done.
Medical billers take those coded procedures and charge insurance companies, government programs, and patients as needed for treatments and tests performed. There are a number of different aspects to this process. Firstly, medical billers need to be able to understand the work of medical coders, which is why they receive training in medical code systems. Unlike medical coders, however, they do not need to have highly specialized knowledge of human anatomy. A more broad understanding may suffice, and billers can focus the rest of their educational time and effort learning about medical regulations and billing procedures.
A medical biller not only need to understand the charges on a bill, but also needs to be able to figure out who is financially responsible for a given bill. Sometimes this is an easy matter, while other times it can be quite complicated. It isn’t uncommon for a patient or an insurance company (or both) to contest the charges, saying that they are not responsible for the bill. Often times, both parties truly believe they are in the right, and it is the job of the biller to figure out exactly who owes money for the bill so that the doctors can be paid for their work.
Medical billers also have the job of collecting that money in situations where a simple one-time payment isn’t sufficient. Sometimes a patient owes a bill which he or she cannot afford to pay all at once. In these situations, a biller can do one of two things. Either the biller can set up a payment plan with the patient to collect the money gradually over time (usually this is the best option), or the biller can send the bill to a collections agency. It is up to the medical biller to do all the follow-up with the patient and determine the best course of action for the hospital to be paid in a timely fashion.
One of the best things about becoming a medical biller is that you have a chance to work one-on-one with patients to resolve financial issues. While that may sound like a tedious process, and sometimes it can be a hassle, it also gives you a chance to make a real difference. Many patients are not only struggling with their health, but also with their finances, and the medical biller has the opportunity to find a way to make medical care more accessible to the patient. While you cannot lower prices as a biller, you can set up affordable plans which allow patients to continue receiving care.
In the future, the job of medical billers will likely become more complex, owing to the changing face of modern medicine. With Obamacare starting in 2014, there are going to be a lot of new regulations to learn, and the ways in which clinics interact with insurance companies and government agencies is going to change. The government itself is probably going to need a lot more medical billers and coders on its staff for this reason, which could lead to even more opportunity in the coming years.
How Much Opportunity Is There?
The best source of information about job growth is the U.S. Bureau of Labor Statistics (BLS), which is the government agency that conducts research on the demand for various professions. The BLS classifies medical billers and coders as health information technicians, a field which it states is growing at a rate of 21%. This is faster than the nationwide average for other occupations, and represents an employment change between 2010 and 2020 of 37,700 new job openings. That’s a pretty substantial amount, and odds are it will only continue to grow after 2020. We have an aging population with a lot of maladies which need treatment. That means a growing need for medical professionals and auxiliary staff members like billers and coders.
Should You Become a Coder or a Biller?
Is one of these two professions “better” than the other? Not really. Earnings in either field are going to be comparable. Most people choose one or the other to focus on, but some professionals may seek certification in both so that they can perform a combination of functions at a small clinic or a go into business on their own, offering dual services to their various clients. The vast majority however will become medical billers or medical coders, but not both.
Ideal Attributes for a Medical Coder
- Attention to detail and amazing organizational skills. You need to be able to sort through thousands of codes in order to correctly translate different conditions and treatments through the alphanumeric system. If you cannot keep track of huge amounts of information in a computer system, this job is not for you. If however you have great attention to detail and you love to organize, then you may be a perfect candidate.
- Interest in anatomy. If you like biology, you may prefer to be a coder instead of a biller, because anatomy plays a larger part in your job. You’ll get to learn a lot about the human body while you are studying for your coding exam, and that knowledge will play a regular part in your profession once you begin working as a medical coder.
- Independence. As a coder, a lot of your work will involve going through medical codes in a computer database on your own. You need to be able to efficiently work on your own to do this job. But you also need to be good at teamwork, since you will be working with other hospital personnel.
Ideal Attributes for a Medical Biller
- Attention to detail and amazing organizational skills. This aspect of work is just as important for a medical biller as it is for a medical coder. You will not only need to know about medical codes, but also healthcare regulations. Like medical coders, you will be working with a large amount of data, and you will need to be able to organize that information for quick access.
- Good customer service skills. Coders do not usually interact with members of the public, but as a biller, you will regularly talk to customers and insurance companies on the phone so that you can work out billing problems and resolve disagreements in a timely fashion. If you do not enjoy working with customers, this is not a good job for you. If you are polite, friendly, helpful and informative however, you may love being a medical biller.
- A desire to help others. This is an important part of medical billing because you will not only be dealing with members of the public, but also will be responsible for resolving billing issues to everyone’s mutual satisfaction. If a customer cannot pay immediately, you have the option of providing a payment plan. This is not only good for your organization, but also may mean that a patient can afford medical care instead of losing access to that care. If you want to help others, being helpful and amenable as a medical biller is a great way to do it.
Where Can I Learn More?
Excited to become a medical coder or biller? You’ll find a number of other articles and resources right here on our website to help get you started on your path to becoming a medical biller or coder. Another great source of information is the AAPC. If you decide to pursue an occupation in this field, you’re going to be spending a lot of time on their website. The AAPC site is where you go to learn about the exam requirements, and it’s a great starting point for selecting an educational program.