12 Billing and Coding Certifications To Boost Your Career

By Indeed Editorial Team

July 13, 2021

A billing and coding certification is a great way to earn a competitive edge in the job market. Certification verifies that you have the skills and knowledge to successfully perform a job and can help to boost your career. Identifying the certification that you're most interested in obtaining can take some time and research. In this article, we explore 12 different billing and coding certifications that you may want to consider.

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What is a billing and coding specialist?

Coding specialists create coded data used by hospitals and medical providers to obtain reimbursement from insurance companies or government programs, such as Medicare and Medicaid. Medical billers then use that coded information to correctly prepare and send invoices to patients and insurance providers.

Related: How To Become a Medical Billing and Coder

What is a billing and coding certification?

A billing and coding certification is a professional recognition of the expertise, judgment and achievement of medical coders. While these certifications may not always be required, they are required in some states. Since many employers prefer candidates who have been certified, having one or more certifications may give you an advantage.

Related: Differences Between Medical Billing and Coding

12 in-demand billing and coding certifications

Here is an in-depth look at some top billing and coding certifications:

Please note that no company or entity mentioned in this article is affiliated with Indeed.

1. Certified Billing and Coding Specialist (CBCS)

Offered by the National Healthcareer Association (NHA), this exam verifies skills to support the coding and billing process, assign codes for diagnoses and procedures, prevent fraud by auditing billing and submit claims for reimbursement.

Prerequisites include:

  • High school diploma or equivalent, plus completion of a medical billing and coding training or education program within the last five years

Or

  • High school diploma or equivalent, plus one year of supervised work experience in the medical billing and coding field within the last three years.

Test topics include regulatory compliance, claims processing, front-end duties, payment adjudication and applied coding knowledge. The cost is $109 and includes study materials. Certification renewal requires 10 continuing education units (CEUs) and a recertification fee every two years.

2. Certified Coding Associate (CCA)

This certification is offered by the American Health Information Management Association (AHIMA) for entry-level coders in hospital and physician office settings. It is a nationally recognized standard of achievement in the health information management (HIM) field.

Prerequisites include:

  • High school diploma or equivalent

  • At least six months of professional coding experience (recommended, but not required)

  • Completion of an AHIMA-approved coding program (recommended, but not required)

  • Completion of a coding training program that includes anatomy and physiology, medical terminology, basic International Classification of Diseases (ICD) diagnostic/procedural and basic Current Procedural Terminology (CPT) coding (recommended, but not required)

The computer-based exam has 90 to 115 total test items. Candidates have two hours to complete the test covering reimbursement methodologies, classification systems and other essential areas of coding. They must bring a current codebook to the test center. The cost is $199 for AHIMA members and $299 for non-members. Certification renewal requires 20 CEUs every two years and a $218 recertification fee.

3. Certified Coding Specialist (CCS)

This certification verifies higher-level skills in classifying medical data from patient records, usually in a hospital setting. It is offered by the AHIMA.

Candidates must have at least one of the following:

  • Diploma or degree from a medical coding training program

  • At least two years of medical coding experience

  • An existing medical coding certification plus one year of coding experience

  • A Certified Coding Specialist - Physician-based (CCS-P), Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) credential

The computer-based exam has a multiple-choice section and a medical scenario section. Candidates have a total time of four hours to complete it. Candidates must bring a current codebook to the test center. The cost is $299 for AHIMA members and $399 for non-members. Twenty CEU hours and a $218 recertification fee are required every two years.

4. Certified Coding Specialist - Physician-based (CCS-P)

The CCS-P certification verifies coding specialization in physician-based settings like doctor's offices, group practices, specialty centers and multi-specialty clinics. The master-level credential is offered by the AHIMA.

Candidates must have at least one of the following:

  • Diploma or degree from a medical coding training program, plus a year of coding experience

  • At least two years of medical coding experience

  • Hold a CCA credential, plus a year of coding experience

  • An existing medical coding certification, plus one year of coding experience

  • Hold a CCS, RHIT or RHIA credential

The computer-based exam has 97 to 121 total items, including multiple-choice and medical scenario settings. Candidates have a total time of four hours to complete it. They must bring a current codebook to the test center. The cost is $199 for AHIMA members and $299 for non-members. Twenty hours of CEU and a $218 recertification fee are required every two years.

5. Certified Inpatient Coder (CIC)

Candidates with this certification have verified expertise in assigning medical codes for diagnoses and procedures performed in an inpatient setting. It is offered by the American Academy of Professional Coders (AAPC).

Prerequisites include:

  • An associate’s degree (recommended, not but required)

  • Current AAPC membership

Candidates are allowed five hours and 40 minutes to complete 60 multiple-choice questions as well as 10 inpatient cases with fill-in-the-blank responses. Topics cover the correct application of ICD-PCS procedure codes and ICD-10-CM diagnosis codes. The cost is $325 for AAPC students and $399 for all others. One free retake is allowed. Renewal requires annual AAPC membership and 36 CEU every two years.

6. Certified Medical Coder (CMC)

The CMC certification recognizes advanced training in medical coding guidelines for outpatient claims. It is offered by the Practice Management Institute (PMI).

Prerequisites include:

  • At least one year of experience in medical coding or completion of foundational training courses.

The exam has about 133 questions. Candidates assess coding scenarios and fill in the blanks accordingly. The exam is offered in a six-hour proctored setting. The cost for training and the exam is $1,250. Twelve CEU are required each year for certification renewal.

7. Certified Outpatient Coding (COC)

The COC certification, previously known as the Certified Professional Coder-Hospital (CPC-H), shows proficiency in assigning medical codes for procedures and services performed in hospital groups, outpatient surgical centers and hospital billing and coding departments. It is offered by the AAPC.

Prerequisites include:

  • An associate's degree (recommended, but not required)

  • At least two years of medical coding experience

  • Current AAPC membership

The exam has 150 multiple-choice questions and allows candidates five hours and 40 minutes to complete. The cost is $325 for AAPC students and $399 for all others. One free retake is allowed. Renewal requires annual AAPC membership and 36 CEU every two years.

8. Certified Professional Biller (CPB)

This certification, offered by AAPC, verifies medical billers have the skills to maintain all aspects of the revenue cycle. It ensures they have an understanding of various types of insurance plans, experience in applying payer policy, local coverage determinations (LCDs) and national coverage determinations (NCDs).

Prerequisites include:

  • An associate’s degree (recommended, not but required)

  • Current AAPC membership

This exam has 200 multiple-choice questions and allows five hours and 40 minutes to complete it. The cost is $325 for AAPC students and $399 for all others. One free retake is allowed. Renewal requires annual AAPC membership and 36 CEU every two years.

9. Certified Professional Coder (CPC)

Offered by the AAPC, the CPC certification is the most popular in the medical coding field. It covers multiple aspects of the profession, including procedure codes for coding and billing for medical claims in a physician’s office.

Prerequisites include:

  • Associate’s degree in medical billing and coding (recommended, but not required)

  • At least two years of experience in the medical coding field

  • Current member of the AAPC

The CPC exam has 105 questions divided into 12 sections. Topics include ICD-10-CM, HCPCS, medical terminology, anesthesia, radiology, pathology, evaluation and management. Those without experience may earn a Certified Professional Coder-Apprentice (CPC-A) certification.

The cost is $299. At least 36 hours of CEUs are required every two years for certification renewal.

10. Certified Professional Coder-Payer (CPC-P)

This CPC-P specialty certification offered by the AAPC verifies a coder’s aptitude, proficiency and knowledge of coding guidelines and reimbursement methods for services from the payer’s perspective. It demonstrates basic knowledge of coding-related payer functions with an emphasis on how those functions differ from provider coding.

Prerequisites include:

  • A least two years of coding experience (recommended, but not required)

  • Current AAPC membership

The CPC-P exam has 105 questions. The cost is $299. At least 36 hours of CEUs are required every two years for certification renewal.

11. Certified Professional Medical Auditor (CPMA)

The CPMA certification demonstrates a professional’s proven knowledge of coding and documentation guidelines to improve the revenue cycle of health care practices. It verifies a clear understanding of noncompliance risks for practices. It is offered by the AAPC.

Prerequisites include:

  • At least two years of experience in medical auditing (recommended, but not required)

  • Current AAPC membership

The proctored exam has 150 multiple-choice questions and candidates have five hours and 40 minutes to complete it. It is a high-level exam not meant for those with little, limited or no audit experience. The cost is $399. At least 36 hours of CEUs are required every two years for certification renewal.

12. Certified Risk Adjustment Coder (CRC)

The CRC certification offered by the AAPC verifies proficiency in reviewing and assigning accurate medical codes for diagnoses performed by physicians and other qualified health care providers in an office or facility setting. It also shows a professional’s understanding of the audit process for risk adjustment models and the anatomy, pathophysiology and medical terminology necessary to code diagnoses.

Prerequisites include:

  • An associate’s degree (recommended, but not required)

  • At least two years of experience in risk adjustment coding or a risk adjustment coding course (recommended, but not required)

  • Current AAPC membership

The exam consists of 150 multiple-choice questions and candidates have five hours and 40 minutes to complete it. The cost is $399. At least 36 hours of CEUs are required every two years for certification renewal.

Related: Learn About Being a Billing Specialist

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