What Is a Medical Coder?

Written by Coursera • Updated on

Learn about medical coders, what they do, the job requirements, and how much you could earn in this popular career.

[Featured Image]:  A male medical coder wearing a white uniform, is sitting at his desk,  in front of his desktop computer.

A medical coder is someone who translates details from a patient’s medical documents, such as physician's notes, lab reports, procedures, and diagnosis into universal medical codes for the purpose of maintaining accurate medical records. Health care providers and insurance companies use these codes for billing and record-keeping.

This is an administrative position within the health care industry. This means a large part of the medical coder role includes working with the documentation and transcription of essential medical documentation within a health care setting. 

What is medical coding?

Medical coding is the process of taking a patient’s health care information like medical procedures, diagnosis, necessary medical equipment, and medical services information from the physician's notes. A medical coder transforms this information into universal medical alphanumeric codes. 

There are generally three types of universally known medical alphanumeric codes: 

  • International Classification of Diseases (ICD) 11th revision (ICD-11): The World Health Organization (WHO) created and manages this internationally used code. The classification system is largely used for the purpose of health recording and data collection, among other uses. These codes can classify symptoms, disease, illness, and cause of death. 

  • Current Procedural Terminology (CPT): CPT codes identify medical, surgical, and diagnostic procedures and services within the US. The American Medical Association (AMA) developed this system, which breaks down into three categories: procedures and contemporary medical practices, clinical labs, and emerging technologies. 

  • Healthcare Common Procedure Coding (HCPCS): The Centers for Medicare and Medicaid Services (CMS) developed this coding system intended to help with the processing of insurance claims processed through Medicare or other providers. Coders use them to note medical procedures, products, supplies, and services. 

Medical coding's primary use is to ensure medical billing and insurance carriers pay and process claims correctly, but the system is also valuable for research purposes and basic medical record-keeping for patients.

Each code tells insurance companies, researchers, or other physicians in health care, the exact diagnosis, procedure, and/or medical service provided. In short, these codes act as a universal way to quantify health care visits and make physician’s notes less abstract for insurance carriers and anyone who has access to your medical records. 

Roles and responsibilities of medical coding jobs

One of the core responsibilities of a medical coder is to ensure the accuracy of the medical records you transcribe and the codes you use. Other medical coder job requirements include proficiency in a variety of medical codes and an adherence to medical coding code of ethics.

  Some of the day-to-day responsibilities of medical coding jobs include:

  • Transcribing patient information into appropriate medical codes 

  • Examining medical documents and records for missing information 

  • Conducting chart audits 

  • Collecting, researching, and filing patient medical information

  • Ensuring all documents are grammatically correct 

  • Complying to medical coding guidelines and policies 

Medical coding vs. medical billing   

Medical coding differs from medical billing in that medical billing deals solely with financial transactions between insurance carriers and health care providers. A medical biller is in charge of processing insurance claims, generating bills, and managing balances and payments for health care providers.

Medical coding, on the other hand, only pulls billing information and details from a patient’s record to translate into medical coding. So, while both professions deal with medical records, they are in fact entirely different jobs. 

Medical coding vs. medical billing   

Medical coding differs from medical billing in that medical billing deals solely with financial transactions between insurance carriers and health care providers. A medical biller is in charge of processing insurance claims, generating bills, and managing balances and payments for health care providers.

Medical coding, on the other hand, only pulls billing information and details from a patient’s record to translate into medical coding. So, while both professions deal with medical records, they are in fact entirely different jobs. 

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Certification for medical coders

You can become a medical coder by completing a medical billing and coding certification program or by earning your associate degree in medical coding. A medical coding certification is a credential in health care coding and billing. It shows you've learned a specific medical coding system, or systems, along with the basics of how to translate patient medical data into codes.

If you choose to earn a medical coding certification, you have many options. You may obtain a certification in general coding or a specialty medical coding certification. You can also earn multiple certifications.

The most important thing to remember when choosing your certification is to choose an accredited program such as the Practice Management Institute (PMI), the American Health Information Management Association (AHIMA), or the American Academy of Professional Coders (AAPC). Each one of these accrediting organizations has its own set of certifications, each with variations in the medical coding system taught and the application (i.e., type of health care facility).

You can earn general coding certifications like a Certified Medical Coder (CMC) certificate or a Certified Professional Coder (CPC-A) certificate, or one of many specialty coding certifications that range from urology to pediatric care. The certification you choose can help you to get on your ideal career path for medical coding jobs or boost your income. 

Though certification is optional in many cases, a study conducted by the American Academy of Professional Coders (AAPC) found that certified medical coders earned 27 percent more than medical coders without certification[1]

You can complete a certification program at any time throughout your career in medical coding. Some people earn their certificate to get a medical coding job while others earn certifications after completing their associate degree. Some people earn their bachelor’s degree, but it’s not typically a requirement.  Each employer will have its own specific training requirements. 

Important skills and personality traits for medical coding jobs

Insurance carriers, health care providers, and patients all rely on the accuracy of medical records. Therefore attention to detail is a must, as is proficiency in the coding systems you will be using at your particular health care facility. 

Consider these key skills and personality traits needed for medical coding jobs: 

  • Attentive to detail

  • Efficient with time management

  • High ethical standards

  • Organizational skills 

  • Patience  

  • Strong communication skills 

Medical coder experience requirements

You do not need any previous experience in medical coding to become a medical coder; however, many of the medical coding certification programs, even the entry-level certifications, require at least one year of professional experience. If you need to gain professional experience prior to certification, consider applying for positions as a billing assistant where you’ll learn more about the medical coding process.  

How to get started in a medical coding career

Getting started in medical coding requires just a few steps. Here’s how you can start today:  

1. Meet the basic prerequisites.

The basic prerequisites for getting a medical coding job are to complete medical coding training. This can be done in the form of an associate degree program in medical coding, a certificate in medical coding from an accredited organization, or on-the-job in-house training by an employer. To be eligible for training, you’ll need your high school diploma or GED. 

2. Complete medical coding training.

If you are choosing to earn your associate degree in medical coding, look for a reputable program offered at a community college or vocational school. There are in-person and online options. If you would rather earn a certificate in medical coding, think about where you’d like to work. Then try to gain professional experience in that particular health care field as many certificate programs require some prior experience in medical coding and/or an associate degree. And if you are working with a company that provides on-the-job training, then focus on completing that required training and look into adding a professional certificate afterward. 

3. Obtain your medical coding certification. 

You can obtain your medical coding certification after completing an associate degree in medical coding or with no degree at all. Entry-level certifications can help you get a medical coding job. At any time in your career as a medical coder, you can obtain speciality medical coding certifications. A complete list of all medical coding certifications is available through the three major national accrediting organizations: PMI, AHIMA, or AAPC. Most certification programs include a final exam that you must pass to earn your certificate.  

4. Brush up on in-demand medical coding skills.

Once completing training or obtaining medical coding certification, take time to brush up on the top in-demand skills you’ll need as a medical coder. For example, you can enroll in a course on medical software or reimbursement models like those offered on Coursera. You can also request additional training materials from your employer specific to its needs as a health care provider. 

5. Find a job. 

When the time has come to find a job, ask yourself what health care industry you’d enjoy and what you're qualified for. Is there a specialty like pediatrics that interests you? Do you want to apply for jobs in your area to get some professional experience? Keep in mind you may also find remote medical coding jobs.

Medical coding salary expectations

A medical coder working in the US makes an average of $46,660  a year, or $22.43 an hour [2] as of May 2021. This salary average includes all medical records and health information specialists. You may earn more than this average depending on where you work, the certifications you hold, your level of professional experience, and the hours and/or shifts you work. 

If you want to earn certifications to boost your income, the American Academy of Professional Coders (AAPC) releases an annual medical coding and billing salaries report that lists credentials with the expected salary. 

How long does it take to become a medical coder?

It takes about two years to become a medical coder if you choose to earn your associate degree. It may take anywhere from nine to twenty months to become a medical coder if you choose to enroll in a certification program. You may see variations in program formatting and requirements that affect the duration of your training to become a medical coder. 

Is there a high demand for medical coders/ job outlook?

Medical coders are in relatively high demand. According to the US Bureau of Labor Statistics, the profession can expect to see a 7 percent growth rate, which is considered average growth. The BLS also predicts an additional 12,300  jobs will be added between 2021 to 2031 [2].

Where do medical coders work?

Medical coders may work in physicians’ offices or other health care facilities like outpatient care centers, surgical centers, or government-owned medical facilities. They may work in offices or remotely. 

Consulting services: A medical coding consultant may work in a variety of health care offices, and they may travel or work remotely. Their job is to check the accuracy of medical records. They may also train other medical coders. 

Government agencies: The federal government is a major employer of medical coders. They may employ medical coders for federal agencies such as the Army National Guard, US Air Force, and the Department of Veterans Affairs. 

Hospitals and clinics: Hospitals and clinics are among the most common places for a medical coder to work. They typically have multiple billing departments that require many medical coders. 

Insurance companies: Insurance companies may hire medical coders to check for the accuracy and verification of medical claims that come in from health care providers. Medical coders working in these environments should be quite proficient in medical coding. 

Nursing homes and assisted living facilities: Nursing home medical coders work in assisted living facilities, hospice care centers, residential nursing homes, and other facilities that serve senior citizens. They may work with different types of medical codes specific to senior services. 

Remote work: Medical coding is a service some health care providers outsource. Some medical coders are able to work remotely. Requirements include proper training, access to the internet, and a reliable computer. Some remote medical coders are full- or part-time employees, while others work as contractors or freelancers. An employer should have HIPAA privacy and security requirements since you will access people’s medical records.

Ready to take the next step in your career?

Medical coding is a highly accessible career with room to grow. Enroll in a medical coding program and get your certification to begin. Online and in-person programs are available and earning a certificate online is easy. Get started today in this in-demand career. 

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Article sources

1

AAPC. 2022 Medical Coding and Billing Salary Report, https://www.aapc.com/resources/research/medical-coding-salary-survey/". Accessed September 14, 2022.

Written by Coursera • Updated on

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