Learn About Being a Medical Coder
What does a medical coder do?
Medical coders are responsible for completing, reviewing and processing medical claims from hospitals and doctors’ offices to help them get reimbursed by insurance companies for the services provided to patients. They use specialized medical classification software to assign diagnosis and procedure codes for insurance billing. They also review claims data for accuracy and completeness, ensuring that the assigned codes meet required insurance and legal rules and that the necessary signatures and authorizations are in place before submission. Other responsibilities include:
- Collaborating with the billing department to ensure all bills are satisfied on time
- Communicating with insurance companies regarding any coding errors and disputes
- Submitting statistical data for analysis and research by other departments
- Contacting physicians and other healthcare professionals with questions about diagnostic test and treatments given to patients, concerning coding procedures
Salaries vary for medical coder positions vary according to geographic location and experience. For the most up-to-date salary information from Indeed, click on the salary link.
- Common salary in the U.S.: $20.91 per hour
- Some salaries range from $7.25 to $44.40 per hour.
Medical coder requirements
There are several requirements to qualify for a medical coder position, including:
Medical coders must have a high school diploma or equivalent GED. Also, they are required to have a certificate or associate’s degree in medical coding, health information technology or another related field. Some of the coursework that medical coders complete in these programs include medical terminology, anatomy and physiology, computer data entry, medical law, privacy and ethics and basic and advance ICD-9-CM coding. Other advanced courses are also available that can be beneficial, including Healthcare Common Procedure Coding Systems (HCPCS) and Current Procedural Terminology (CPT).
Medical coders receive the majority of their necessary training through their medical coding program, whether that is an associate’s degree or a certificate program. Internships are also available, although typically require at least enrollment in a medical coding program. An internship, however, does provide additional on-the-job training under the direct supervision of an experienced medical coder.
There are several professional certifications offered through the American Academy of Professional Coders (AAPC). They include:
Certified Professional Coder (CPC)
Though not always required, it is preferred by physicians and non-physician practitioner services, indicating that you are qualified and competent in medical coding. The certification validates your proficiency in reviewing and assigning medical codes accurately for diagnoses, procedures and services that are performed by physicians and other healthcare providers.
Certified Outpatient Coding
This certification is the only standalone outpatient coding credential in the healthcare industry. It verifies your proficiency in assigning accurate medical codes for services, procedures and diagnoses in outpatient settings, such as emergency room visits, outpatient clinic visits, diagnostic testing, same-day surgeries and outpatient therapies.
Certified Risk Adjustment Coder:
This certification demonstrates your expertise in medical record review and that you have in-depth knowledge of the current rules, regulations and issues regarding medical coding, compliance and reimbursement.
Specialty Coding Certification
There are many specialty certifications available for coders, from general surgery to family practice to anesthesia and pain management. Designed for experienced coders, these certifications demonstrate advanced levels of expertise in the respective discipline. They are stand-alone certifications and don’t require the candidate to hold a CPC certification. They measure the candidate’s preparedness for real-world coding.
Many skills are essential for success as a medical coder.
Attention to detail
A strong attention to detail is pivotal in this role, as you must code and submit bills to insurance companies accurately. You must stay focused and keep a sharp mind to ensure that every detail is correct.
Organizational skills refer to your ability to stay focused on different tasks and use your mental capacity, physical space, time and energy efficiently and effectively. Organizational skills will allow you to stay on track with tight deadlines and work efficiently. These skills are particularly important for freelancers who are working with more than one medical center.
Even if you work from home, strong communication skills are important. Medical coders must be able to work with other professionals at hospitals and with insurance company representatives. You must also be able to communicate clearly through writing to ensure reports are clear and easily understood.
These include computer skills as well as a basic understanding of physiology. Most of the work performed in the role of medical coder will involve the use of a computer. You should be comfortable with basic word processing and spreadsheet software. You must also be able to use electronic health records and medical and coding software.
Typing skills, particularly the ability to type at a reasonable speed, are also integral to this role. Also, to convert information to the correct codes, you will need an in-depth understanding of medical terminology. This will require medical coders to have at least basic knowledge of human anatomy, physiology and common diseases.
Medical coder work environment
Medical coders typically work in hospitals, clinics and doctors’ offices with the following characteristics:
- Extended hours sitting at a desk
- Using computers, printers and other office equipment
- Collaborating with supervisors and physicians about patient procedures or billing issues
How to become a medical coder
These are the typical steps you can use to pursue a career as a medical coder.
1. Pursue an education.
Generally, a medical coder must have a minimum of a high school diploma or GED. You must also complete an associate’s degree or certificate program in medical coding, health information technology or another closely related discipline. Search for medical coder openings in your area and determine the basic level of education required for those positions. Obtain the basic required education.
2. Obtain a certification.
While not always required, a CPC certification or another professional certification is typically preferred by most employers. These certifications verify that you have the required skills to perform the job. At a minimum, you should consider obtaining your CPC certification to be more competitive as a candidate.
3. Update your resume.
Update your resume with your highest level of education, certifications, work history and skills. For each employment entry, include the name of the employer, your job title and the duties you performed within that role. Try to highlight the responsibilities or skills that can be transferred into a role as a medical coder.
4. Apply for jobs.
Perform a search within your geographic area for openings for medical coders. Identify which positions you are most qualified for based on your education and experience levels. You may want to consider also searching for internship opportunities–even paid opportunities–where you can obtain work experience. Apply for the positions you identify using your newly created resume and a cover letter that is customized for each role.
Medical coder job description example
Courtyard Health Center is seeking a medical coder to join its expanding healthcare organization. This person will be responsible for coding all medical services procedures, pharmaceutical supplies and patient diagnoses, symptoms, complaints and condition problems. They will be expected to ensure progress notes are coded accurately and to the maximum level of specificity following establishing coding guidelines while also maintaining patient confidentiality at all times. This role requires a strong understanding of medical coding, insurance reimbursement processes and medical terminology. The candidate must be proficient with the use of a computer and bilingual in English and Spanish. A coding certification and/or six months as a medical coder is required.