Educational Requirements for Medical Billing and Coding Specialists

A medical billing and coding specialist must wear many hats and be able to thrive in a fast-paced, high-demand work environment. If you want to become a medical billing and coding specialist, then you must meet certain educational requirements. This is what you can expect when it comes to training to be a medical billing and coding specialist:

Required Coursework. The functions of a medical billing and coding specialist are far-reaching, and require a knowledge of both medical terminology and office procedure. Therefore, a training program in medical billing and coding must include a broad range of subjects, and each subject will include some coverage of medical terminology:

• Health Insurance and Managed Care Systems. There are many different types of medical insurance programs, and a medical billing and coding specialist needs to be familiar with all of them, including Health Maintenance Organizations (HMOs). You must know how to interpret patient charts and physician’s notes in order to use coding that correctly corresponds to the appropriate insurance program.
• Government Programs. These include Medicare, Medicaid, and TRICARE.
• Computer Claims Systems. This encompasses processing electronic data interchange through an outside data clearinghouse, and using a variety of different computer claims programs.
• Medical Documentation. This course teaches you how to evaluate and manage medical documentation, from invoicing to collections.
  Claim forms. You must have a thorough knowledge of the different types of insurance claims forms, including how to fill them out, submit them, and follow-up on them.
• Hands-On Experience. Any good medical billing and coding program should offer extensive hands-on training, in the form of either externships or internships. An externship or internship is also a way to gain valuable work experience while still training, and also to build some contacts in the field in order to gain a one-up when it comes to finding a job after you’ve completed your coursework.

School Options. You have a few choices when it comes to finding a program to train to be a medical billing and coding specialist. Just make sure that whatever program you choose is recognized by a legitimate accrediting body. If you do not complete training through an accredited program, then you will not be able to sit for a certification examination, and having a professional certification is your key to finding employment as a medical billing and coding specialist. Research the following schooling options, and remember to ask about accreditation:

• Colleges. Many community colleges and universities offer two-year, associate degree programs that prepare you to take the certification examinations.
• Online training programs. Online, or distance learning, programs are a great way to pursue your education while also maintaining a current job. Some online institutions specialize in medical billing and coding training, and deliver a certificate upon completion of the coursework. Other online schools are actually colleges that can provide you with a degree. Not all online programs are created equal, so be sure to do your research before committing.
• Technical/Vocational Schools. You may choose to get a diploma or certificate from a technical or vocational school that offers training in medical billing and coding.

Certification. Once you complete an accredited medical billing and coding training program, you will need to sit for a certification examination in order to receive a designation as a certified medical billing and coding specialist. There are several different accrediting bodies and each offers its own professional designation. Any designation from an accredited certifying body, however, will be recognized by potential employers as proof of your knowledge and aptitude as a medical billing and coding specialist. Here are some certifications to look for:

• Certified Professional Coder (CPC), offered by the American Academy of Professional Coders (AAPC).
• Certified Billing and Coding Specialist (CBCS), offered by the National Healthcare Association (NHA).
• Certified Coding Specialist (CCS), offered by the American Health Information Management Association (AHIMA).

As you can see, the proper training is of utmost importance when it comes to pursuing your dream of becoming a medical billing and coding specialist. You can expect to spend anywhere from nine months to two years in training, depending on the type of program you choose, but if you put the time and hard work into getting your certification, you will reap the benefits. You can look forward to a high salary, flexible hours, and job security when you become a medical billing and coding specialist. So crack open those books and good luck!


By: Ceete Sheekels