Claiming Your Success With UMBS

While medical billing and coding are different careers, they’re often talked about in the same breath. Both jobs are tied to a healthcare organization’s revenue cycle and how providers are paid for their care. Despite these similarities, their roles and responsibilities differ significantly.

Medical billers submit claims that include a procedure or service’s corresponding codes. Subsequently, medical insurance companies process the claims and reimburse providers according to a patient’s plan or coverage. Throughout this process, billers often correspond with insurance companies and patients to ensure providers can continue offering care.

Moreover, correct coding and billing impact patients directly. According to Garcia, accurate coding can mean the difference between a minimal copay and patients footing an entire bill

No, you do not need a postsecondary degree to work as a medical biller or coder—though a degree can help pave the way to some positions.

Moreover, medical billers often do not require higher education or training; in many cases, healthcare organizations provide necessary training on the job. Additionally, some people begin work as billers, work on a certification or degree in the meantime, and then transition to another healthcare job.

For medical coders, having a degree can lead to one of two designations: registered health information technician (RHIT) with an associate degree or registered health information administrator (RHIA) with a bachelor’s degree. Notably, these designations require coders to pass a rigorous exam in addition to graduating from a medical coder program.

According to Garcia, “You’ll likely need a higher degree if you want to be in a supervisory, educator, or managerial role.” Otherwise, he suggests, “start with a medical coding certificate,” or begin work as a medical biller without investing the years needed for a higher degree.

Medical billing requires fewer specialized skills and can have fewer barriers to begin a career," she adds. Moreover, you can leverage experience working in an entry-level billing position to demonstrate familiarity with the billing and coding process. Alternatively, starting in medical records, transcriptions, or prior authorizations can serve as an initial step, allowing you to get your foot in the door before transitioning to another position.

Similar to many fields, the competition for openings can be fierce. According to Garcia, "Sometimes people get discouraged when applying for jobs, but it all depends on how persistent you are." Therefore, don't give up, and stay determined in your job search.

Succeeding as a medical biller or coder demands dedication, attention to detail, and excellent communication. According to Nancy Szwydek, MPH, RN, RHIA, CRAT, CMAC, assistant dean for accreditation at Purdue University Global, "There is a big misconception that this field is easy: that they can just punch codes into a computer and things will be good. It requires a lot of work and practice."

Moreover, self-motivated learning is essential for medical billers and coders. As Garcia highlights, "Codes change every year, and you need to be resourceful to answer your questions on the job." This underscores the dynamic nature of the field, emphasizing the continuous need for skill enhancement and adaptability.