Do you want to be a certified medical coder? If YES, here is a detailed guide / requirement on how to become a medical billing and coding specialist from home.

A medical billing and coding career can be lucrative for people interested in the healthcare industry. Medical and billing coding professionals process and code health insurance claims, manage patient bills, and track quality assessments. They work behind-the-scenes to provide assistance and help maintain the accuracy and integrity of the billing functions of healthcare providers.

These professionals make sure that health claims are processed and coded efficiently so that insurance companies and healthcare providers are reimbursed for the correct amount. It is their job to make sure that patients aren’t over-charged for routine appointments. This career allows for an independent work style as these professionals work within electronic databases to access medical bills and insurance claims.

To function efficiently in this career, you will need all the tools required to start processing claims on your own. However, supervisors are there to help if you have a problem. If independence is an ideal career trait, then this may be a good career path to consider.

According to industry reports, the medical billing and coding industry is expected to grow by 15 percent from 2014-2024. Note that this growth rate is faster than the average for all other jobs. Industry experts expect the baby boomer population to need more healthcare services as they age and grow more susceptible to illness. Therefore, the demand for more medical coding specialists to process claims and bills is predicted to grow.

To start, you will need a computer, telephone, high-speed internet, and a coding manual that will assist you when you look up codes. After you get a job offer, ask your employer if they allow specialists to work from home. Another benefit of this career is that it has a short training duration.

Steps on How to Become a Medical Billing and Coding Specialist from Home

The medical billing and coding specialist is at the very middle of the health care revenue cycle. By creating precise service and billing records, these specialists allow healthcare providers to focus more on caring for patients.

To effectively accomplish these objectives, the medical billing and coding specialist must keep detailed records of all healthcare services provided to the patient, maintain current files of the patient’s demographic, insurance, and account information. They will then have to translate all of these records into codes that reflect the patient’s medical history, diagnoses, tests, and treatments.

A medical billing and coding specialist will also have to use the coded data to create invoices or claims that accurately and confidentially report services provided and the patient’s conditions. Below are the steps to becoming a medical billing and coding specialist:

  1. Earn your high school diploma

High school students interested in medical billing and coding can increase their job prospects by taking classes in medical terminology, biology, anatomy and physiology, information technology, and office operations. After earning your high school diploma, some medical billing and coding specialists are able to train exclusively on-the-job.

One strategy is to get a clerical job in a physician or hospital billing office and work your way up. Another tip is to find a registered apprenticeship in medical coding. These yearlong training programs pay entry-level billing and coding professionals to learn on the job. You’ll also earn a certificate of completion that’s recognized around the country.

But have it in mind that you need a high school diploma or GED to be a medical biller. Some programs, such as AAPC, require an associate’s degree and a coursework in anatomy, physiology, or other related fields. Take your time to research and find out the type of medical billing you want to do. If you want to simply create medical bills, you can enrol in online programs such as AHIMA and AAPC.

But, if you would like to work in a variety of environments such as a hospital or doctor’s office, you will need more education that is also available from these organizations as well as local colleges and technical schools. Note that the more classes you take, the more it will cost you. Consider applying for what you can afford and boosting your education as you can afford it.

2. Register for a certificate program or obtain an associate degree

Although there are no formal educational requirements for this career, many employers will only consider job applicants with a postsecondary education. Certificate programs and associate degree programs are available, such as from an accredited community or technical college.

Coursework in biology, chemistry, computer science and math will strengthen a resume. Experts advice that you research the different program options including independent certification programs and recognized programs such as AAPC or AHIMA.

Each program has different education and certification requirements, but they are generally made up of the basic components of education and a certification examination. Review each program’s features to see which best suits your ideas and wishes for being a medical biller. Register for a certification program either at the AAPC or AHIMA websites.

These can also point you to affiliated programs in your area. Provide the information necessary to register, which will generally include your personal information, educational and professional background, and anything else that may be relevant to your desire to be a medical biller. You may also need to become a member of the certifying organization. Finally, pay any course fees required by the program.

3. Get certified

Just like we stated above, although certification is not required, most employers prefer candidates with certification. Becoming certified, while strictly voluntary, increases your likelihood of securing a higher paying position.

The American Academy of Professional Coders (AAPC), the American Health Information Management Association (AHIMA) and the American Medical Billing Association (AMBA) – among others – all offer recognized certification options for medical billers and coders. Note that immediately you’ve finished your education and pre-certification requirements, submit an application to your certifying organization to take the certification exam.

Check your organization’s website to get exact application requirements. Remember to schedule an exam date from the options in your area. You must attend an exam with a proctor at a physical location. Get any letters of recommendation and employer verification you need to take the exam.

After you must have applied to take the certification exam, you’ll need to take it to obtain your medical biller certification. You should study before the exam to improve your chances of passing on the first try. It’s advisable you meet with classmates or attend organizations’ local chapter meetings to meet people with whom you can study.

You may find you learn more by studying as a group than if you study alone. Don’t forget to use the most recent coding books to study for the exam. These resources are updated every year and not using the proper volume may limit your chances of passing. Ensure you study a variety of topics for your exam.

Many exams will have questions on the following fields: anatomy, medical terminology, information technology and computers, coding, insurance, fraud and abuse, compliance and health laws. In most cases, you will take the exam at a designated location, but some programs may allow you to take the certification examination online.

After scheduling the exam date and preparing yourself, sit the exam at a time you feel comfortable. Make sure you pay any fees up front so that you can enter the job market as quickly as possible.

Always remember to verify any examination information you receive from the certification organization. Make sure to note the name of your proctor and phone number to verify examination information. Get your exam results between 7-10 days after you sit the exam. Results are generally available online and by mail.

4. Train on the job as well

Most employers provide on-the-job training, but the employee must prove his or her mastery of nationally recognized billing and coding standards. Also have it in mind that some of the programs may require practical experience as a part of their education program.

If yours doesn’t, consider doing an internship or working in a medical office to gain practical experience that can boost your education and help you pass the certification exam. In addition, an internship may open to the door for you to future employment.

Consider speaking to a career counsellor, local doctor’s office, or draw on a professional network about getting practical experience. Ask about the best types of work for your specific education and certification goals. Also note that many organizations consider two years experience as a medical biller necessary to pass the certification exam.

5. Leverage opportunities for your career to evolve

It’s very crucial to state that most successful medical billing specialists begin their professional career at the front desk, sharing reception and coding responsibilities. After gaining some experience, the specialists are promoted to positions of higher responsibility, where invoicing and key operations of the office or agency take place.

Note that with additional education and experience, a specialist can attain further advancement to the role of office manager, billing administrator or supervisor. As a certified medical biller, you have the option of working in different professional environments.

Consider sending letters of intent to local employers about your interest in working for them. For example, contact local hospitals and inquire if they are looking for someone with your certification and skills. Don’t be shy to ask fellow medical billers in your local area if they know of any job opportunities.

Also check the websites of professional organizations such as AMBA, AAPC, and AHIMA for job listing. Register yourself with a head-hunter or placement agency to help find opportunities as a medical biller. If you’re recently certified and looking for a job, consider volunteering during your down time.

Try to see volunteering as a way to gain valuable practical experience and make inroads in the medical billing profession. Remember that it will also look good on your resume. Try also to network with other billing professionals.

Meeting other medical billers can expand your knowledge of the profession and help you find work. Attend workshops, local chapter meetings, and national conferences whenever you get the chance. Join local and national medical biller organizations such as AMBA, AAPC, and AHIMA. These organizations have local chapters, regular meetings, national conferences, and events where you can meet other certified medical billers.

Helpful Resources for Medical Billing and Coding Specialist

As a medical billing and coding specialist, have it in mind that trade groups and industry associations offer education, training and certification opportunities. You don’t have be a working coder to visit these groups. They can help you gain new skills, pursue specializations or simply learn more about the profession.

Whether you’re a long-time coder who wants to brush up on your skills or a prospective student looking for the educational program that’s just the right fit, you’re not alone. There are plenty of groups, organizations, academies and career services designed specifically for coders or those hoping to pursue careers in the field.

  1. American Association of Professional Coders

The AAPC is the world’s largest healthcare training and credentialing agency with over 175,000 members. It provides its members the widely recognized Certified Professional Coder (CPC) certification across at least 10 of the most popular specialties. It also provides training for those certifications, which the organization claims can double a candidate’s chances of passing the CPC exam.

  1. American Health Information Management Association

The AHIMA has several resources both for industry professionals and those who are considering a career or just starting their education. This association provides a variety of certifications, as well as educational materials, training and tutorials regarding those certifications.

It also maintains a special section just for students. Note that prospective coders can find details on how to finance their education, the difference between degrees and certifications, and how to find the right program.

  1. Healthcare Billing and Management Association

With 25 years of history, HBMA is a non-profit trade association that offers education, certification, collaboration and advocacy for health care billing and coding professionals.

  1. Medical Group Management Association

This association provides certification and other marks of educational success, benchmarking data and statistics. It also organizes industry events, provides networking opportunities and develops informational materials for industry professionals.

  1. The Professional Association of Healthcare Coding Specialists

The PAHCS is Best known as a network gathering place for coding specialists, and its stated mission is to enhance documentation, compliance and reimbursement capabilities. The network offers certification in nearly 20 different areas.

  1. American Academy of Professional Coders

The AAPC focus solely on physician-based medical coders. You will have to visit their website to learn about continuing education, training, networking and certification opportunities.

  1. American Association of Clinical Coders & Auditors

The AACCA provides certification and training crafted to keep professional coders in compliance with government-mandated regulations and up to date with health care industry standards.

8. Billing-Coding.com

This forum opens up discussions on a range of topics, including career advice, coding from home, schools and colleges, and general advice.

  • Conclusion

Statistics has it that the demand for coders will grow by a full 16 percent between 2016 and 2026. That’s much higher than the projected growth in the general job market. But have it in mind that this business is not all rosy, as it will take dedication and computer skills to succeed in this business.

A medical billing and coding specialist must be able to explain charges and invoices to patients and their families, often under stressful conditions. You’re expected to have high ethical standards due to the confidential nature of patient information and also have the ability to work well independently and with others.

Ajaero Tony Martins