Certification Vs. Experience for Medical Billers and Coders


Certification Vs. Experience for Medical Billers and CodersMedical billing and coding can be described as the procedure where a hospital caters to the needs of patients and submit the physicians’ bills to insurance companies for claims reimbursements. In order to receive the billed payments for the services doctors provided, it is necessary for the billing staff to submit accurately filled forms. It is thus, imperative for the medical coders and billers to keep a tab on the CPT changes for the treatment as well as insurance information of a patient.

Medical billers make sure that each superbill is reimbursed by the carriers on time. People capable of multitasking are apt for handling such jobs. Medical coders consist of people who are good at assessing, conversant with coding information, up-to-date with the latest healthcare reforms and changes, along with having an eye for detail while processing the bills.

Both, certification and experience are equally important for medical billers and coders. It is important and beneficial to have experience as a coder or biller for making a well-paying career; because only then you have the hands-on experience and the much required training in the said field. At the same time, CPC certification plays a big role for the applicant in acquiring good positions in the employment market.

Importance of Professional Experience

Most of the billers and coders acquire on-job training; however, it is advised to intern or be a part of the backend operations to learn the skills better, before getting employed as a full-fledged billing professional. It gives you the exposure to practical issues and the actual knowledge of interpreting and coding the medical terms.

The on-job trainers may also be able to provide you with the basic communication skills required for the profile so as to make sure that you handle both, the patients and the insurance companies well. The training program should include basic mathematics, documentation, using medical billing software and administrative duties.

Role of Certification in Employment

A certified professional coder or biller is strongly preferred and as much as 20 percent more than the non-certified ones because they are trained specialists in the domain. To get certified, the applicants should hold a high school diploma or an equivalent exam certificate. Two levels of certification are offered by AHIMA, viz. the entry level and the master level. For both the certifications, a three year work experience is recommended even though no educational requirements form prerequisite.

To hold a degree, a well rounded education is a must after which an associate`s degree should be earned. In order to receive certification, the applicant needs to file up work as a medical biller or coder for at least two years and also pass a written exam. The certified professionals need to renew their membership each year, which includes paying dues and completing the ongoing education for 36 hours. If someone wants to work for a professional high order level like an officer, an advanced bachelor’s or master’s degree can be acquired.

MedicalBillersandCoders.com brings together hundreds of billers and coders who have expertise in different specialties. MBC, a consortium of coders and billers are currently handling revenue cycle management of US physicians in all over the country.

This entry was posted in Practice Administration, Practice Management and tagged , , , , , , . Bookmark the permalink.


What are you looking for

4 Responses to Certification Vs. Experience for Medical Billers and Coders

  1. Oksana says:

    I am a certified in Physician Billing and Coding through college though I “majored” as a Medical Transcriptionist. Finding a job after two-years of medical courses and intense training is next to impossible. While I understand you would prefer someone with on the job or internship training, consider, a student has undergone two years of medical training and is current in knowledge. There are -many- people who never had an education in either field and employers hired them, trained on the job and these folks are experts now. They were given a “chance” which is more than most of the jobs nowadays.

  2. Dr.Rinki Srivastava says:

    Goodles and useful information! Please post more information like this on prospects of medical coding and billing…

  3. Janice Bachman says:

    I am in the exact opposite situation. I have 62 college credit hours but do not have my RHIT. I took a 16 month ICD-10 certification program and then it got delayed. I was previously in an LPN program that lost its’s accreditation and that’s where most of my credit hours came from. A double whammy! I have been working for 23 years with the past 8 in a hospital setting and the past 2 years coding outpatient for a doctor. The practice is fading away and I can’t even get a call back from all my applications. My facility requires a RHIT to become a clinical coder. So is there a happy medium with equal amounts of experience and schooling combined?

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>