A medical code is an alpha-numeric “shorthand” for standard medical diagnoses, procedures, and services. Medical codes are used in billing and insurance claims to receive payment for healthcare services rendered.

Graduates with a medical coding education, also known as medical coders, medical billers, or medical records specialists, process and maintain confidential patient information in electronic health records (EHRs). They are active liaisons between patients and physicians.

Medical billing and coding (MBC) professionals function as reimbursement consultants — confirming that insurance companies cover their obligated costs, that healthcare providers are compensated for their services, and physician practices continue to operate smoothly.

Medical Coding Requirements

Are you wondering how to get into medical billing and coding or how to become a medical coder?

The field of medical billing and coding has five essential requirements to launch a career.

The typical education requirements to enroll in a medical coding program, are as follows:

• Medical billing and coding applicants must be at least 18 years of age.
• MBC applicants must have a high school diploma or GED.
• Medical billing and coding applicants must be able to pass a background check.
• MBC applicants must be comfortable with applicable medical billing and coding programs, and
• Medical billing and coding applicants must pass the CPC exam.

Although there are no firm education requirements to become a medical coder, achieving a medical billing and coding certificate can provide a solid foundation in the field and make you stand out to employers and among the stacks of other applicants.

According to the U.S. Bureau of Labor Statistics, most medical billing and coding employers seek candidates with at least a postsecondary certificate.

Medical Coding Class Requirements

Medical billers and coders are well-versed in anatomy and medical terminology. The behind-the-scenes healthcare professionals are also proficient in coding systems like the Current Procedural Terminology (CPT) and International Classification of Diseases, Tenth Revision (ICD-10).

Graduates of medical billing and coding programs, like the one offered at Goodwin University, complete a variety of medical billing and coding courses in human biology, medical law and ethics, medical office management, and more. Common medical coding course requirements include, but are not limited to:

• Medical Terminology
• Concepts in Human Biology
• Medical Insurance and Coding
• CPT ®-4 Coding I and II
• ICD-10-Coding
• Medical Law and Ethics

By the end of medical billing and coding certificate programs, graduates can:

• Accurately record coinsurance, copayments, deductibles, and risk withholds
• Adhere to HIPAA regulations
• Analyze medical reports, identifying all diagnoses and procedures, and
• Electronically and manually process medical insurance claims

Convenient and career-focused, Goodwin University offers medical billing and coding courses during the evening and entirely online.

With flexible class formatting, Goodwin medical billing and coding graduates can become trained, certified, and prepared for their profession in as few as 12 to 18 months — faster than any other medical billing and coding programs in Connecticut.

Medical Coder and Biller Certification Requirements

After completing a medical billing and coding program, alums are eligible to take the Certified Professional Coder (CPC) exam.

Once a student successfully passes the CPC exam, The American Academy of Professional Coders (AAPC) generally requires medical billers and coders to recertify their credentials every two years through continuing education credits.

To ensure medical billers and coders are upholding the latest credentials and best practices, continuing education credits can be earned by attending industry association meetings and educational programs, presenting published academic research, and more.

Further Credentials to Advance Your Career

With acquired experience in the field, medical billing and coding graduates also become eligible to obtain additional certifications in areas such as:

• Medical Billing and Coding Specification: Outpatient coding
  • Career Setting: Ambulatory centers, outpatient hospitals, urgent care clinics
• Medical Billing and Coding Specification: Inpatient coding
  • Career Setting: Inpatient facilities and hospitals
• Medical Billing and Coding Specification: Risk Adjustment coding
  • Career Setting: All healthcare agencies and insurance capacities

Career Settings for Success

Medical billing and coding professionals can also find fulfilling careers in:

• Corporate billing services
• Consulting firms
• Large medical groups
• Resident care
• Software companies, and
• State and Federal government agencies

Medical billers and coders improve patient experiences and contribute to vital research. The healthcare professionals maintain disease data, measure patient care, and track public health conditions in their everyday work.

The more credentials a medical biller and coder earns, the more likely they will be presented with advanced career opportunities and potential salary increases.

In 2021, medical records specialists nationally made a median annual wage of $46,660. In the same year, out of the 1,230 medical records specialists employed in Connecticut, the average yearly salary earned was $57,480.

From 2021 to 2031, the U.S. Bureau of Labor Statistics predicts that the medical records specialists field will grow seven percent, with 14,900 new openings each year over the decade.

Do you think a medical billing and coding career could be the right fit for you? Find out more about medical billing and coding!