Medical Billing and Coding

The Medical Billing and Coding program offered by ACH is designed to provide graduates with the skills necessary to qualify for entry-level positions in the insurance billing & coding field. Students will learn medical terminology, medical office management & billing/coding. Work-site learning in a medical facility is a component of this course.

Medical coders are essential to medical record keeping. Medical coders assign alphanumeric codes to specific injuries, illnesses and medical procedures, using a system of medical coding consistent across the health care system. Doctors and hospitals use the codes for planning and internal data collection, while public agencies and insurance companies require codes to reimburse health care providers.

What is Medical Billing and Insurance Coding?

General Overview

A Medical Billing & Coding program at the American College of Healthcare (ACH) prepares individuals to effectively and efficiently maintain a patient’s medical record and other health and medical information.Medical Billing & Coding is an important behind-the-scenes part of our health care system. Certified Medical Billers & Coders communicate between medical offices, patients & insurance companies. By assigning letters & numbers to diseases & conditions, injuries & medical procedures, they speed up the process of payment.

Responsibilities

Medical billing and coding professionals require an ability to focus on details, and should have patience. Problem-solving skills are also useful and essential, as coders are required to determine which part of each medical report is relevant to bill / code for.Medical coders should have knowledge in the following areas:

  • Blue Cross and Blue Shield Plans
  • Completing CMS-1500 and Commercial Claims
  • CPT Coding
  • ICD-9-CM Coding
  • Insurance Claim and Regulatory Considerations
  • Medicaid
  • Medicare
  • Tricare and Workers’ Compensation

Duties performed by a billing & coding specialist may include any combination of the following:

  • Appropriately filling out and filing medical insurance forms
  • Assigning a code to each diagnosis and procedure

AAPC License

The American Academy of Professional Coders (AAPC) offers several types of medical billing and coding certifications:

    • Certified Professional Coder (CPC): To become a CPC, an individual must pass a coding certification examination sponsored by the AAPC. The examination consists of questions regarding the correct application of CPT codes, ICD-9-CD diagnosis codes, and HCPCS procedure and supply codes used for billing professional medical services to insurance companies. To sit for the exam, an individual must have at least two years of coding experience and is required to maintain yearly renewal and CEU (continuing education) requirements.

 

    • Certified Professional Coder – Hospital (CPC-H): To become a CPC-H, an individual must pass a coding certification examination sponsored by the AAPC. The examination consists of questions regarding the correct application of CPT codes, ICD-9-CM diagnoses, and procedure codes used for billing facility services to insurance companies. To sit for the exam, an individual must have at least two years of coding experience and is required to maintain yearly renewal and CEU requirements.

 

  • Certified Professional Coder – Payer (CPC-P): To become a CPC-P, an individual must demonstrate that he or she has the skills and knowledge to arbitrate provider claims effectively. The CPC-P certification demonstrates the payer coder’s proficiency, aptitude and knowledge within the payer environment. To sit for the exam, an individual must have at least two years of coding experience and is required to maintain the appropriate amount of yearly CEU requirements.

AHIMA & NHA Licenses

AHIMA Certificates

The American Health Information Management Association (AHIMA) offers the following credentials:

    • Certified Coding Associate (CCA): Even without much job experience, a new coder can earn the CCA immediately in order to demonstrate competency in the field.

 

  • Certified Coding Specialist (CCS): Certified Coding Specialists are professionals skilled in classifying medial data from patient records, generally in the hospital setting. To become a CCS, an individual must possess expertise in the ICD-9-CM coding system, as well as the surgery section within the CPT coding system. Additionally, the CCS should be knowledgeable of disease processes, medical terminology, and pharmacology.

 

NHA Certificates

The National Healthcare Association (NHA) offers the following credential:

  • Certified Billing & Coding Specialist (CBCS): To become aCBCS, an individual must pass a coding certification examination sponsored by the NHA. The examination consists of questions surrounding administrative procedures for medical billing and insurance claim processing, as well as submitting, tracing, transmitting, and appealing billing claims for a full range of health plans.

Job Outlook

The U.S. Bureau of Labor Statistics states that medical billing and coding is one of the ten fastest growing allied health occupations. Employment for Medical Records and Health Information technicians is expected to increase by 21% between 2010 and 2020, according to Bureau of Labor Statistics.

Medical billing & coding training provides an opportunity for graduates to benefit from the expanding health care job market. As demand for medical procedures continues to grow, medical coding is increasingly crucial to a facility’s smooth and successful operation.

Once hired, medical coders and billers hold secure jobs, with good futures. Supervisors often spend weeks or months directly training medical billers and coders. Once they are properly trained and have gained experience by participating in the daily office routine, there is a strong possibility that their positions will be long term.

Graduates of ACH’s Medical Billing & Coding program can choose to work in a variety of locations, including (but not limited to):

  • Group practices
  • Hospitals
  • Insurance companies
  • Multispecialty clinics
  • Nursing care facilities
  • Pharmacies
  • Physician offices
  • Rehabilitation / Specialty centers
  • Working from home

In California, Medical Billing & Coding Specialists earn a mean wage of $34,160 to $42,270, according to Bureau of Labor Statistics, U.S. Department of Labor, May 2012.

Prerequisites

High-school diploma, a recognized equivalency diploma or passing an ability-to-benefit (ATB) test & satisfactory completion & passing of a nationally recognized, standardized capacity-to-benefit (CTB) test, qualification questionnaire & personal interview with administration.

Get Started On Your New Career

Call 1-888-430-4224 or contact us today to get started in your new career as a Medical Billing and Coding specialist!