What Education is Needed for Medical Billing and Coding?

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To become a Medical Biller or Coder, you need your high school diploma or GED and then a certificate or associate degree in the field. This foundational education ensures that you have the understanding, knowledge, and skills to work in medical billing and coding. It also demonstrates your qualifications to employers. Check out what you need to know for medical billing and coding and how you can get the right education.

Get your High School Diploma to Work in Billing and Coding

A high school education provides you with some basic skills you need to work in medical billing and coding like:

Math
English
Cognitive abilities
Attention to detail
Problem solving
Computer and data entry
Written and verbal communication

Most importantly, your high school diploma proves that you can process and learn new information.

What If You Don’t Have a High School Diploma?

If you do not have a high school diploma or GED, you may be able to earn it while you earn a certificate. Programs like C4L Academy allow you to earn your diploma and your certificate at the same time.

Earn a Healthcare Certificate in Medical Billing and Coding

You can learn billing and coding as a part of another certificate program—like Medical Assistant or Administration—or choose one that concentrates specifically on medical billing and coding. Your program should teach you the basics of medical billing and coding, including how to use the ICD-10, which contains a comprehensive listing of all medical codes used to describe every symptom, illness, injury, and treatment. You also learn the fundamentals of the billing process, such as how to file an insurance claim or how to generate an invoice.

Earn an Associate Degree in a Medical Billing and Coding

In a medical billing and coding associate degree program, you gain more in-depth knowledge about billing, coding, and the healthcare delivery system. Your medical billing and coding education should cover:

U.S. Healthcare System

To work as a Medical Biller or Coder, you need an education in healthcare delivery and issues within the U.S. health care system. You need to know the roles of individuals and institutions from patients and providers to insurance companies and the government. And you need to understand healthcare administration, processes, and procedures.

Medical Terminology

Understanding some basic medical terminology, such as the technical names for common ailments, helps you communicate with healthcare professionals, patients, and insurance companies. It also allows you to quickly translate medical terms into something a layperson can understand.

Medical Codes

At the very foundation of what you do will be applying medical codes to injuries, illnesses, and diseases to their diagnoses and treatments. And while there are thousands of codes, there are ways to learn many of them and resources to find out about others. The International Classification of Diseases (ICD) provides you with alphanumeric codes you can use to note conditions, diagnoses, treatments, and coverage. When you’re first introduced to medical codes, it may seem like a foreign language, but you’ll be surprised how quickly you’ll be able to make sense of it all.

Computerized Billing and Coding

Courses that focus on the use of technology in health record maintenance and computerized billing and coding procedures are important to help you prepare for your job as a Medical Biller or Coder. You need to know the basics of electronic health record and practice management including front office activities in a medical facility, information management, and billing and coding principles. You also need to understand how to code diagnostic and professional services rendered by providers and the procedural and diagnostic coding utilized in insurance claim processing.

Medical Insurance Processing and Reimbursement Methods

For every service your healthcare facility performs, it needs to be paid. Most often, it’s paid for by an insurance company. There are different types of insurance plans with unique coverage, so you need to be familiar with common plans. You must understand how to properly report procedural and diagnostic codes to the insurance provider and how to secure the benefits and payments your facility and patients deserve. Lastly, it’s essential that you know how to complete, interpret, and process manual and automated insurance claim forms for government and third-party payers.

Legal and Ethical Issues in Health Care

If you want to work in any healthcare career, you need an understanding of the laws, regulations, guidelines, ethics, and bioethics in the medical industry. Legal topics may include licensure and certification requirements, laws specific to health care, and the legal responsibilities of medical personnel. You also need to know any regulations relating to electronic medical records, record-keeping, charting, and the rules of the workplace.

HIPAA Rules and Regulations

One of the most important rules to follow comes from the Health Insurance Portability and Accountability Act. HIPAA is a federal law that governs how insurance can move with an employee and helps protect the privacy of patient information. It guides what information can be shared, and when it is and isn’t appropriate to send data electronically.

Do you want to work in medical billing and coding? Charter College offers an Associate of Applied Science in Medical Billing and Coding that can prepare you for entry-level employment in as few as 14 months. Call 888-200-9942 or fill out the form to learn more.

888.200.9942