Top Menu

Getting to Know Which Medical Billing Certification Is the Best

Person taking a blood pressure incorrectly on patient as part of Medical Billing Certification training

Image: CC 0 by Public Domain, rawpixel, via Pixabay

Medical billing certification is becoming more popular as more employers are requiring prospective employees have at least some postsecondary education.

Medical billing and medical coding are often lumped together into the same position. While the same person often works in both roles, the jobs that they do day to day differ in quite a few different ways.

Knowing Your Responsibility

In short, the daily task for medical coders includes reviewing clinical statements and assigning standard codes to practices, procedures, and diagnoses. These people use the CPT, ICD-10-CM, and HCPCS Level II classification systems. Medical coders will refer to a patient’s medical record and will not only assign each procedure, lab and diagnoses a code.

They will also abstract the information, verify that the work was actually done, and then work alongside the medical biller. This happens if they do not work as the biller themselves, which is common. The people ensures that invoices are paid properly and on time. Coders will also occasionally audit, and re-file appeals when an insurance claim is denied for whatever reason.

Medical Billing

Medical Billing Certification Passers Endorsing a New Software Specialized for Medical Bills

Image: CC by A-SA 2.0, jlblue, via Flickr

Medical billing is the process of not only submitting medical claims on behalf of a practice but also following up on claims. It includes health insurance companies to assure the receipt of payment for services rendered by the healthcare provider. In other words, medical billing translates a healthcare service into a billing claim that is submitted to the patient’s insurance company.

Your Job Description

The job of the medical biller is to initiate and follow through on a claim. This works to ensure that the medical facility receives proper payment for the work that the providers performed. Day-to-day duties of a medical biller can vary with the size of the work facility. The biller remains generally in charge of not only following through on claims but to initiate them. Hence, assembling all the data concerning the bill requires skill. This data can include any of the following bits of information:

  • Charge Entry
  • Claims Transmission
  • Payment Posting
  • Insurance Follow-Up
  • Patient Follow-Up

Your Medical Billing Certification Working Environment

Operating room with latest technology as part of Medical Billing Certification training

Image: CC 0 by Public Domain, ZahidJavali, via Pixabay

Medical Billers don’t only work with the insurance companies; they also work alongside physicians and other healthcare professionals in order to obtain additional information on the patient, the treatments provided and even clarifying a patient’s diagnoses. While some medical billers also work as medical coders, many times a separate individual is doing the coding work, and in that case, the medical biller will work side-by-side with the medical coder.

They must also know and fully understand how to read medical records. Familiarity with CPT, HCPSC Level II, and ICD-10-CM codes makes them more fit.

The Medical Billing Certification Pre-requisites

While there is no set industry standard when it comes to educational requirements to become a medical biller, many employers expect prospective hires to have some level of educational education besides the minimum of a high school diploma or GED. Most employers are looking for someone with a background in the following areas:

  • Medical Terminology
  • Health Information Technology
  • Computer Systems
  • Coding Systems
  • Statistics
  • Communication Skills

Yes, there is a small possibility of obtaining a job in this field without postsecondary education, but more and more employers are looking for individuals with a minimum of an associate degree in medical billing and coding.

Available Classes

Medical Billing Certification students on school fair held during the training period

Image: CC by A-SA 3.0, Danieladelrio, via Wikipedia Commons

Those looking to go into this occupation can do so by taking a few paths, either traditional classes in a classroom or online. While it is not unusual to go the conventional classroom route, many chose to take classes online.

The online coursework for a Medical Billing Certification and coding degree covers a few different subjects. Students will be introduced to terminology used in medical billing to describe diagnoses, procedures, and policies. Other coursework focuses on the legal and ethical issues associated with handling medical information.

Your Annual Salary

The annual salary for a medical biller averages out to around $36,733 per year. Overall experience in the occupation plays a big factor in this number as an entry level biller with less than five years of experience can expect to ear around $30,000 annually. Alternatively, a medical biller with 20 or more years in the industry can expect somewhere closer to $38,000 annually.

Medical Billing Certification Professional Association

Medical supplies and instruments as part of Medical Billing Certification training

Image: CC 0 by Public Domain, rawpixel, via Pixabay

Few professional certificates become available.  Some require specific courses while certain certificates come unnecessarily. However, it helps a medical biller obtain certain jobs or advancements.

Below, we have listed the professional associations that help guide and supply professional medical billing certifications

The Healthcare Business Management Association (HBMA)

The Healthcare Business Management Association (HBMA) is a professional trade association that reportedly represents more than 47,000 employees currently working in healthcare billing and information management.

HBMA offers member with a certification program, educational resources and even supplies job listings for those who are looking for work. They also work in collaboration with business partners and the government to help eliminate any unethical business practices within the medical records and health information industry.

The American Academy of Professional Coders (AAPC)

AAPC, formerly known as the American Academy of Professional Coders. The league boasts to be the world’s largest training and credential organization for the business of healthcare. They come with 175,000 members worldwide.

Members of AAPC currently work in medical coding, medical billing, clinical documentation improvement. Moreover, medical auditing, healthcare compliance, revenue cycle management and practice management comes as the necessity.

This offers educational resources and administers more than a dozen certification exams. Areas related to both medical coding and billing extends as part of it.

The American Health Information Management Association (AHIMA)

The American Health Information Management Association is an organization of reportedly more than 100,000 health information technology professionals. AHIMA offers a variety of professional certification exams, along with accompanying pieces of training and educational and preparatory resources.

Leading Certification Associations

So, does having a medical billing certificate really matter? In 2016, the AAPC surveyed their members and found that those without a certification earned around $39,956 a year. Those with at least one certification made, on average, $52,588 per year. Those who held more than one certification reported that they earned even higher yearly salaries.

So out of the variety of medical billing certifications out there, which ones are the best? Well, one of the leading certifications in the industry is AHIMA’s Registered Health Information Technician program (RHIT).

Eligibility for Medical Billing Certification Requirements

Qualified for Eligibility requirements for Medical Billing Certification

Image: CC 0 by Public Domain, HarinathR, via Pixabay

Qualified applicants must meet at least one of the following eligibility requirements to be considered for the program:

  • Complete the academic requirements, at an associate degree level
    • Health Information Management (HIM) program accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM); OR
  • Graduate from a HIM program approved by a foreign association with which AHIMA has a reciprocity agreement

According to the RHIT webpage, those professionals who hole the RHIT credential are health information technicians. These people professionally work with computer applications to assemble and analyze patient data. This improves the patient care or controlling costs. They also ensure the quality of medical records by verifying their completeness, accuracy, and proper entry into computer systems. Finally, those with the RHIT certification often specialize in coding diagnoses and procedures in patient records for reimbursement and research.

Medical Billing Certification and Your Job Outlook 

Laptop. Stethoscope, Pen, and Phone as part of the Job Outlook for Medical Billing Certification Passers

Image: CC 0 by Public Domain, rawpixel, via Pixabay

Both medical billing and medical coding fall under the occupation of medical records and health information technicians. Currently, employment of health information technicians is projected to grow by 13% from 2016 to 2026. That reportedly means adding nearly 30,000 new jobs in that ten-year timespan.

The current job trends in this occupation look promising. With the proper education, certifications, and training, this could be a viable option for many in the years to come.


Featured Image: CC 0 by Public Domain, rawpixel, via Pixabay

, , , , , , , , , , ,