How to Become a Medical Coder – Education & Experience

Are you interested in how to become a medical coder? Healthcare organizations receive and organize large amounts of data, from patient records to insurance billing requests. Medical coders are the professionals who conduct the behind-the-scenes work to handle all this information. They make sure patient data is logged into electronic health records accurately. They also ensure that patients are billed accurately for healthcare services.

Medical coding is a stable job and potentially lucrative industry. Let’s look at how to become a medical coder in detail.

Article Navigation: What is a Medical Coder? | How to Become a Medical Coder | Education | Licensing/Certification for Medical Coding | Medical Coder Career Information | Medical Coding FAQs

What is a Medical Coder?

A medical coder is a computer billing and information categorizing specialist. They take information from healthcare organizations to make sure it is categorized and easy to retrieve. Then, they apply the data to finance-related tasks. They handle all the medical billing and coding necessary to ensure that bills flow smoothly from healthcare provider to patient insurance provider and back.

What Does a Medical Coder Do?

The many duties and responsibilities of medical coders include:

• Organize financial data for easy retrieval
• Use data to bill patients for medications & healthcare services
• Contact insurance companies as needed
• Record medical transactions according to healthcare codes
• Ensure that insurance companies reimburse healthcare providers

How to Become a Medical Coder

1. Step 1 – Earn a medical coding certificate
2. (Optional) Step 1a – Earn a healthcare information management degree
3. Step 2 – Pass the CPC exam
4. Next, Step 3 – Acquire state licensure
5. Step 4 – Apply to positions
6. Step 5 – Get experience
7. Lastly, Step 6 – Continue your education or career

Education

To become a medical coder, applicants must meet specific educational requirements. Generally, a college degree is not necessary. That said, some medical coding positions require an associate’s degree or higher credential depending on specifications, job responsibilities, etc.

However, most medical coding positions only require applicants to earn a medical coding certificate. Coding certificate programs are not the same thing as a college degree. But many college degrees in medical coding or billing include classes in qualifying students to take certification exams.

In summary, students have two pathways to acquiring educational credentials and becoming a medical coder:

• Take a certification course in medical coding/billing and receive a certificate
• Pursue a medical coding or billing degree program and earn a certificate over the program’s course

Admission Requirements

Aspiring medical coders must meet admission requirements for a medical coder certification course or program. These requirements are generally:

• Have a high school diploma
• Meet a minimum GPA threshold, usually 2.0 or above

Because admission requirements are so basic, almost anyone may choose to become a medical coder. However, medical coder program requirements get more strict as one pursues higher degree programs.

For example, a bachelor’s degree in medical coding, billing, or medical terminology usually requires a high school diploma plus a higher GPA minimum. Some programs, particularly graduate programs, require students to take prerequisite classes or programs before admittance.

Before applying, students should carefully study the admission requirements for their chosen certificate program or college degree program.

Types of Online Programs

Aspiring medical coders can take various medical coding and billing online programs. However, these online programs are usually not in medical coding or billing. Online degrees to become a medical coder may be labeled as degrees in healthcare administration or health information management.

There are advantages to taking a college program rather than a certificate program. A college program in health administration or similar subjects provides students with a well-rounded education in liberal arts. It also gives students the knowledge they need to succeed in medical coding and billing.

Furthermore, such a program may qualify future medical coders to take on advanced positions in healthcare organizations.

Associate’s

Associate programs are available online in both part-time and full-time contexts. Healthcare administration, health information management, and related subjects are perfect associate’s degrees for aspiring medical coders.

That’s because they frequently take two years or less to complete. Furthermore, such programs are usually very affordable. They often include medical billing classes that are similar to those one might take in a certificate program. Therefore, associate degree program graduates can acquire medical coding certification in at least one area (see more below).

After graduating, students can transfer most or all of their credits toward a bachelor’s degree program.

Bachelor’s

Bachelor’s programs in health information management or healthcare administration are also available for online students. These are not necessary to become a medical coder. Still, they can provide much of the foundational knowledge required to succeed in this field.

More importantly, bachelor’s programs may qualify graduates to succeed in higher-paid, higher responsibility medical billing positions. For example, graduates can take on managerial or supervisory roles in healthcare organizations.

Most online bachelor’s programs in healthcare administration include courses on subjects such as:

• Human resources
• Data analytics
• Medical project management
• Health policy
• Legislative compliance
• And more

On average, bachelor’s degrees take four years, whether online or in person. Ultimately, bachelor’s degrees are attractive to prospective medical coders because they improve a candidate’s likelihood of being hired. Suppose you’re choosing between candidates with a certificate vs. candidates with a certificate and bachelor’s degree. Then the latter candidate is almost always the top choice of a healthcare organization.

Master’s

Some medical billing or coding specialists may pursue master’s degrees in healthcare administration. However, this is only appropriate if one wants to proceed into this industry’s administrative or supervisory track.

A master’s in healthcare administration is usually considered an overqualification for a medical billing position. That said, many medical coders and billing professionals pursue part-time online graduate programs while holding down a job. Hence, they can progress their careers over time and earn more money in the long run.

Certificate Programs

Certificate programs are the only real educational necessity to become a medical coder. There are four core certification programs and certificates students can pursue:

• First, a Certified Professional Coder or CPC. It qualifies certificate program graduates to work in medical practices.
• Next is the Certified Outpatient Coder or COC certification. This credential qualifies the graduate to work at outpatient hospitals, ambulatory surgery centers, and urgent care facilities.
• Certified Inpatient Coder or CIC. CIC qualifies the graduate to work at inpatient hospitals and facilities.
• Lastly, Certified Risk Assessment Coder or CRC. The credential qualifies a professional to work in all healthcare settings and insurance companies.

Aspiring healthcare billing professionals should consider which certificate program best fits their needs or career prospects. Generally, a CPC certification is the most well-rounded and appropriate certificate to pursue. It is also the certification most available at online schools and universities.

Certificate programs take one to two years from start to finish. Many only take a matter of months. In addition, certificate programs are available in conjunction with associate or bachelor’s level programs. Some of the above college programs may even simultaneously include classes to complete certificate programs. Then, near graduation, students can take final exams and get certified to become medical coders while also receiving their degrees.

What to Factor in When Selecting a Program

While there are many different types of programs to choose from, students should carefully consider their core factors before selecting.

Accreditation

Firstly, the American Academy of Professional Coders will certify any quality medical billing certificate or college degree program. The AAPC regularly accredits certificate programs and college degrees. It also created professional certifications for the medical billing industry.

This accreditation organization is crucial because it specializes in healthcare business education. However, students can also seek out program-specific accreditation. For example:

• The American Health Informatics Management Association, or
• The Commission on Accreditation for Health Informatics and Information Management Education.

Any certificate program or college degree accredited by one of these organizations should be enough to ensure program quality. Students should avoid a certificate or college program not accredited by one of these organizations.

Type

Students should then consider whether the program in question is a certificate or a degree. Certificates are faster and are often easier to complete. However, they only qualify graduates to work in specific industries or positions.

For example, it is not possible to get a position as a nurse with a professional coding certificate. But getting a nursing position with a BSN or a related subject is possible.

However, degrees take longer to complete and have stricter admission requirements. They are more competitive by nature and are also more expensive. Overall, students may wish to take a professional certificate program if they just want to become medical coders. But a college program may be the way to go if they want to progress their careers in the long-term or have more career flexibility.

Length

Students should also consider the length of a given program. Again, professional certificate programs take between one to two years to complete on average. Associate degree programs take two years, while bachelor’s degrees usually take four years. Master’s degrees typically take another two years after completing a bachelor’s degree.

Don’t forget to consider whether a program is part-time or full-time. Part-time online programs are more flexible and allow students to hold down a job or juggle other responsibilities. But they necessarily take longer to complete. Full-time programs are faster but require more dedication to the program at hand.

Cost

Cost is a huge factor. Professional certificate programs usually cost less than $10,000, and many only cost a few thousand dollars overall. Associate degrees can cost anywhere from $5000-$20,000. Bachelor’s degrees may cost upwards of $20,000, while master’s degrees can cost $40,000 or more.

Students should look at the estimated cost of tuition before signing on the dotted line for any program.

Courses

Consider course offerings in a certificate or college program before registering. Again, certificate programs are usually more focused. They should include classes on subjects such as:

• Medical billing and coding practices
• Healthcare moral principles
• Coding terminology
• Computer science for medical billing
• And more

College programs are more well-rounded and also include general education programs. Depending on the program’s focus, they may consist of classes on healthcare management, administration practices, business principles, finances, and more.

Specializations

Lastly, students should consider whether a program comes with specialization options. For instance, students can take one of four medical coding certification programs. A certified inpatient coder program specifically prepares medical billing professionals to work at inpatient hospitals and facilities.

Students must determine where they are likely to work to determine the best program or certificate to pursue.

Licensing/Certification for Medical Coding

As noted above, aspiring medical coders must receive the necessary licenses or certifications to acquire positions in this field. These certifications are more important than college degrees.

What Types of Licensing/Certifications Are There?

The core medical coding license is Certified Coding Associate or CCA. It’s a fundamental certification and qualifies new medical coders for entry-level positions.

The next step is the CPC or Certified Professional Coder certification. CP is the most common certificate medical coders and billing professionals hold. Most complete it within 1 to 2 years of entering the field. It showcases that the graduate has a strong working knowledge of medical billing, coding principles, and terminology.

The other three core medical coding certifications specialize graduates to work in specific industries. They contain information so that graduates know what terminology or coding principles to use. To recap, these are:

• COC, or Certified Outpatient Coder, to work at outpatient hospital locations
• Certified Inpatient Coder to work at inpatient hospital facilities
• And Certified Risk Adjustment Coder to work at insurance companies

Note: Beyond those certificates, students may further pursue two additional specialized certifications.

Certified Coding Specialist (CSS)

The AHIMA awards the Certified Coding Specialist certificate. This certificate combines skills so coders can record and categorize inpatient and outpatient records. It also allows certificate holders to work with insurance companies or bill patients accurately according to government programs like Medicare and Medicaid.

Overall, it’s an excellent certificate to pursue to increase one’s career prospects and potential salary.

Certified Coding Specialist Physician-Based (CSS-P)

The AHIMA also awards CSS-P certificates. These specialized certificates help medical billing professionals code records accurately in group practices, specialty centers, and physician offices. Again, it’s a solid advanced certificate to acquire to improve your potential career options or to increase the positions for which you qualify.

State Licensure

In addition to core licenses, medical billers and coders must have state licenses to operate in their states of residence legally. State licenses are usually awarded in tandem with core professional licenses, but not always.

Students must check for the specific state requirements to earn licensure for their states. Each state has different requirements, but they are usually:

• A CPC or equivalent license
• High school diploma
• Certain classes or prerequisites

Licensing/Certification Requirements

Because medical billing and coding are so important, licenses and certificates have strict requirements to which all candidates must adhere.

Alternative Paths

Current nurses or similar specialists may be able to apply on-the-job experience for school credits. Generally, there are few shortcuts or alternative paths to licensure or certification.

Main Requirements

The primary requirements to earn medical coder licensing or certification include:

• Complete a medical coding training program or college degree program
• Have one to two years of medical coding experience
• Have a medical coding certification

Again, requirements can vary from state to state. But medical coders must have these qualifications before being hired for most common billing positions.

In addition, all licensed medical billers and coders must complete continuing education credits every two years. These require billers and coders to attend classes online or in-person to ensure they remain up-to-date with relevant medical terminology and other topics.

Exam

Most medical billers and coders must take the CPC or certified professional coder exam. Since it is a rigorous exam, students should employ various practice tools to ensure they pass it on the first try. The exam assesses students’ abilities to assess ICD-10-CM codes, CPT codes, and HCPCS Level II codes. Students must have an in-depth understanding of anatomy, pathophysiology, medical terminology, and more.

The certificate exam takes up to four hours to complete, comprising 100 multiple-choice questions. Once a student passes the exam, they do not need to retake it unless their licensure lapses.

Medical Coder Career Information

Many pursue medical coding because of its excellent career prospects and relative accessibility.

Medical Coder Salary Information

According to the BLS, medical coders and other health information technologists earn around $51,840. However, more experienced medical billers and coders can earn over $100,000 annually. Entry-level positions may pay as little as $29,000 per year on average.

Types of Jobs for Medical Coders

Medical billers and coders may qualify for many different positions and titles. These include:

• Coding specialist
• Records coordinator
• Medical records analyst
• Health information technician
• Health information clerk
• Medical records director for advanced medical coders with supervisory experience
• Billing managers for advanced medical coders with supervisory experience

Careers for Different Degree Levels

Qualified professionals can attain different medical coder jobs based on degree levels and personal experience.

For example, most entry-level medical billers and coders qualify for medical coding specialist or medical records analyst positions. These positions are available to only those with a certificate or an associate-level degree.

Medical billers and coders with a bachelor’s degree in health analytics or health information management may qualify for additional positions. These include health information technicians or medical billing managers. Essentially, those with bachelor’s degrees have the extra information management and business skills so that they may qualify for higher-paid positions.

Graduate-level medical billers and coders could become medical records directors or similar professionals. They’ll earn more money, have more responsibilities, and direct the medical billing and coding efforts of entire hospitals or healthcare organizations.

Related Careers

Medical billers and coders don’t have to stay in this position forever. They can branch out into related careers if they so choose, for example:

• Pharmacy technicians
• Medical assistants
• Health services managers
• Information clerks for other businesses
• Medical transcriptionists

Many medical billers and coders also choose to become registered nurses or RNs. Note that this takes additional education and certification.

Where Do Medical Coders Work?

Medical coders work in locations such as:

• Hospitals
• Small medical clinics
• Private healthcare practices
• Inpatient and outpatient recovery practices
• Health information management buildings

Career Outlook

According to the BLS, medical records and health information specialists should become more numerous by about 9% until 2030. Thus, graduates should have no trouble finding employment once they have the relevant certificates and licenses.

Essential Skills

Medical coders and billers must have several essential skills to succeed in this industry. Specifically, they need skills such as:

• Attention to detail. Medical coders and billers handle the financing information for healthcare organizations and patients, so they can’t afford to make mistakes.
• Good memory, especially for numbers and strings of letters
• Empathy to speak regularly with patients and healthcare professionals
• Task-oriented mindset
• Computer familiarity or expertise
• Team-oriented personality. Most medical coders and billers work as part of teams.

Medical Coding FAQs

What is the fastest way to become a medical coder?

The fastest way to become a medical coder is to take a 1 to a 2-year professional certificate program, then apply for medical billing positions.

Is medical coding hard to learn?

Medical coding can be challenging to learn and master. However, it is not harder to learn than the information in most bachelor’s degree programs.

Do medical coders make good money?

Yes, especially for the educational requirements. Most medical coders make over $50,000 yearly, which is above the national average salary.