Medical Coders and Billers

Career summary

Medical coders and billers assign codes to illnesses, injuries, and medical procedures based on doctor's and nurse's notes. They enter these codes on insurance forms.

Medical coders and billers match letter and number codes to medical treatments, diagnoses, and medications. Every time a patient receives professional health care, the providers assign a code and create an insurance claim. This ensures that the health care providers are paid for their services.

Medical coders check medical records for doctors' and nurses' notes, lab tests, and x-rays that explain what treatments the patients received.

They know insurance plans, regulations, codes, and guidelines. They use this knowledge to assign correct codes for procedures and supplies used to treat the patient and maintain patients' privacy.

Medical billers make certain that all insurance forms are completed and signed. They also make sure that all the correct information is entered into their computers. Medical billers prepare billing invoices. They might also collect payments, interpret benefits, handle denied claims, and process appeals.

Medical coders and billers work in every type of health care facility, including doctor's offices, surgery centers, and hospitals. Some coders have their own freelance businesses. They work from home and bill for their services on an hourly basis.

Related careers

This career is part of the Health Science cluster of careers.

Related careers include:

Education and training

Educational programs

The programs of study listed below will help you prepare for the occupation or career cluster you are exploring.

Programs of study directly related to this occupation

Other programs of study to consider

Training

To work as a medical coder or biller, you typically need to:

have a high school diploma or equivalent; and
graduate from a medical coding and billing program.

Education after high school

You must complete a training program to become a medical coder or biller. A training program in medical coding and billing usually takes six months to two years of full-time study. Some programs offer training in either medical coding or medical billing. Other programs combine coding and billing into one training program. Many community colleges and proprietary schools offer such programs. Medical coding and billing courses are also available online.

As a medical coding and billing student, you take courses in anatomy and physiology, medical terminology, and statistics. You become familiar with various diseases and disorders. You also learn about procedures that doctors perform and drugs they prescribe. Finally, you study how health information is coded.

Upon completion of a training program you receive a certificate of completion or an associate degree.

Many vocational schools and online programs offer training in medical coding and billing. Be cautious when enrolling in programs in this area. The quality of these programs varies widely. You should investigate the schools you are interested in.

On-the-job training

Some hospitals and clinics offer on-the-job training. Training usually lasts two to three months.

Helpful high school courses

You should take a general high school curriculum that meets the state's graduation requirements. You will be required to take both math and science classes to graduate.

Helpful electives to take in high school that prepare you for this career include:

Anatomy and Physiology
Business and Applied English
Business Math
Health Education
Medical and Clerical Assisting
Medical Office

The courses listed above are meant to help you create your high school plan. If you have not already done so, talk to a school counselor or parent about the courses you are considering taking.

You should also check with a teacher or counselor to see if work-based learning opportunities are available in your school and community. These might include field trips, job shadowing, internships, and actual work experience. The goal of these activities is to help you connect your school experiences with real-life work.

Join some groups, try some hobbies, or volunteer with an organization that interests you. By participating in activities you can have fun, make new friends, and learn about yourself. Maybe one of them will help direct you to a future career. Here are examples of activities and groups (PDF file) that may be available in your high school or community.

Things to know

Volunteer experience in a health care environment is valuable.
According to the American Association of Professional Coders (AAPC), certified coders earn a higher salary than non-certified coders.
Medical coders and billers need to type well and understand the laws that safeguard information about patients.
Depending on where you work, you may learn how a medical office operates. You may learn about the various business functions and the computer software used.
Medical office technology changes constantly. Expect to take classes throughout your career to keep your skills up to date.
Medical coders and billers have little or no direct contact with patients. They work at computers for long periods of time.
Medical coders and billers need patience, problem-solving skills, and the ability to focus on details. A medical coding error can delay payment for services. It helps to be good with numbers and memorization.
Medical coding and billing positions are increasing rapidly in private physicians' offices.

Licensing/certification

Medical coding and billing certification is optional. Many employers prefer to hire certified medical coders and billers. Several national organizations offer certification. For more information, contact:

The American Health Information Management Association (external link)