What is Medical Billing and Coding?

The healthcare industry continues to help drive job growth in the United States.* A recent U.S. Bureau of Labor Statistics (BLS) report predicts an additional 1.9 million jobs in the field annually through 2033.*

While many of those positions are for doctors, nurses and dental hygienists, they also include medical billing and coding professionals. Jobs for medical records specialists, which includes medical coders, are projected to grow 9% through 2033, according to BLS — much faster than the average for all occupations.*

If you’re unfamiliar with this work, read on to find out exactly what medical billing and coding is, if it’s a good fit for you and what earning a bachelor's degree can do for your career.

What Does a Medical Biller and Coder Do All Day?

Medical billing and coding are essential in healthcare, according to Dr. Lynn Ward, health information management (HIM) program director at Southern New Hampshire University (SNHU).

These health information technicians must integrate themselves with both the software and their team as organizations seek to streamline their operations.

So, what exactly do medical billers and coders do? They handle the billing and insurance details in healthcare organizations and billing companies, according to BLS, and they may also manage their group's financial and electronic health records (EHRs). Their role is essential because it provides patient-facing professionals with the information they need to improve the quality of care and providers with what they need to decrease the number of billing errors and improve care coordination in an industry that demands it.

According to BLS, medical records specialists such as medical coders may also:

• Look over patient information for pre-existing conditions
• Assign diagnoses and procedure codes for patient care, health statistics and billing purposes
• Work as a go-between with the health clinician and billing offices

Medical billing and coding are necessary for almost every health setting. In addition to hospitals and doctors’ offices, these jobs can be found at outpatient care centers, skilled nursing facilities, administrative services, specialty hospitals, insurance companies, and other healthcare-related organizations, BLS said.

And with a bachelor's degree in this field, you may be able to access additional opportunities as an HIM manager.*

The demand for highly educated professionals will be even more critical. BLS projects a 29% job growth for medical and health services manager roles between 2023 and 2033, which is more than four times faster than the growth for all other management jobs.*

These individuals take on leadership roles, managing teams that support units within large healthcare settings such as hospitals and making recommendations relating to an organization's technology and compliance needs, BLS said. With a bachelor's degree, the typical qualification for medical and health services managers according to BLS, you can be well-qualified to be at the helm of these departments.

Is Medical Billing and Coding Hard?

Whether you enjoy medical billing and coding or find it difficult depends on your personal aptitude and skill sets. According to Catina L. Flagg, MBA, MS-HIM, RHIA, CPC, CPB, CPMA, CPMA-I, LSSGB, a clinical faculty member at SNHU with nearly four decades of industry experience, a successful medical biller and coder will have the following traits:

• Attention to detail. Accuracy in coding and billing ensures proper reimbursement.
• People savvy. Medical billing and coding professionals often work with healthcare providers, insurance companies and patients, so effective communication and problem-solving abilities are key.
• Technical skills. This includes a solid understanding of medical terminology, coding systems and healthcare reimbursement processes.

Professionals in this field often work with numbers, such as calculating patient co-pays and deductibles and ensuring that reimbursement amounts align with the services provided. But that doesn't mean you have to be a math whiz to be a medical biller and coder.

"The ability to perform simple addition, subtraction and basic calculations is important for accuracy," Flagg said. "However, the focus is primarily on coding, attention to detail and understanding healthcare processes rather than complex mathematical equations."

Flagg added that familiarity with billing software, adherence to confidentiality standards and good time management skills also contribute to thriving in this essential healthcare role.

What Education is Necessary for Medical Billing and Coding?

In many instances, a certificate in billing and coding may get your foot in the door for an entry-level position. (SNHU does not currently offer certificates in billing and coding.) However, when it comes to the growth in healthcare, the educational edge — like a bachelor's degree — may help you get ahead and prepare you to take on additional responsibilities.

“The (Bachelor of Science) in Health Information Management program is a good fit for a student interested in this career path, especially for someone who would like to work in management of an HIM department,” Ward said.

Ward, who has more than 15 years of experience in higher education, is also a registered health information administrator and certified professional in healthcare information and management systems.

What Can You Learn in an HIM Program?

A health information management degree program teaches the technology, terminology and professional skills required for an HIM career, especially in advanced roles.

You can learn to:

• Analyze the uses, risks and management of health statistics and biomedical research data and support performance improvement programs.
  
  
• Evaluate information system applications for their capacity to meet the needs of healthcare organizations.
  
  
• Interpret and apply current laws, regulations, policies and healthcare ethics as they relate to decision-making in healthcare delivery and systems.
  
  
• Apply health data structure, standards and regulations to manage clinical classification systems and reimbursement.
  
  
• Implement and manage hardware and software technologies to ensure effective data collection, storage, analysis and reporting of information.
  
  
• Use current management principles to propose solutions and develop project management plans that solve organizational challenges.

The courses that make up an HIM program create a well-rounded degree — and a skilled, capable graduate.

SNHU's program includes a medical billing and coding course, where you'll learn about the technologies used in the industry. If you're not quite ready to take on a full degree program, you're able to take this course on its own to determine if medical billing and coding courses are worth it for you.

Aside from the coding courses, you can learn more about healthcare management, project management, human resources, data analytics, computer platform technologies, pathophysiology and pharmacology, and the ethics and legal aspects of HIM.

In a medical billing or coding career, this knowledge can complement your training and may give you an edge in your current position, providing a holistic view of your role in the healthcare industry and setting you up for success in other possible HIM careers down the road.

"Beyond billing and coding, the degree could open doors for advancement into roles such as health information analyst, compliance officer or healthcare administrator," Flagg said.

If you wish to take your training and education further, you can explore master’s programs, such as a Master of Science (MS) in Health Information Management or an MBA in Healthcare Management, that may lead to advanced opportunities in the field.

Not all programs are created equally, so if you're looking for a degree that can help you grow in an HIM career, consider its accreditation. For example, SNHU's bachelor's and master's degrees in HIM are accredited by the Commission on Accreditation for Health Informatics and Information Management Accreditation (CAHIIM). That means its curriculum and learning outcomes are aligned with industry expectations.

Learn more about what CAHIIM accreditation means.

Is Billing and Coding a Good Career?

According to Flagg, working in medical billing and coding offers several rewarding aspects, including the ability to contribute to the smooth operation of healthcare systems.

"The flexibility of the job is another benefit," Flagg said. "Many medical billers and coders can work remotely or in various settings, from hospitals to private practices."

Flagg also suggested that you could find stability in medical billing and coding. Similar to the rest of the healthcare industry, job growth for medical billing and coding specialists looks good.*

“As Baby Boomers age and require more medical services, we’ll need more health information technicians to manage all of their data,” Ward said. “This increase in demand — combined with the number of insured citizens on the rise — will mean more reimbursement claims from insurance companies.* The industry will need more trained HIM staff to stay organized.”

*Cited job growth projections may not reflect local and/or short-term economic or job conditions and do not guarantee actual job growth. Actual salaries and/or earning potential may be the result of a combination of factors including, but not limited to: years of experience, industry of employment, geographic location, and worker skill.

Deidre Ashe was 9 years old when she launched her professional writing career. While spending a day at work with her dad, she penned her first book, illustrated it and sent it off to a publishing company — after finding the address on the copyright page of one of her paperbacks. While the story never made it to the shelves of libraries, the editors wrote back, encouraging her to continue pursuing her writing passion. (Yes, she still has that letter.)

After earning a bachelor’s in journalism, Ashe spent a decade working in the media industry. She then transitioned into marketing, later getting her MA in Communication from Southern New Hampshire University in 2018. Connect with her on LinkedIn.