Where the Jobs Are in Medical Billing & Coding
Jobs in billing and coding are primarily available with:
- Healthcare Providers such as Physicians
- Healthcare Facilities such as Hospitals and Outpatient Clinics
- Insurance Companies
- Billing Services
- Government Agencies
While certification in medical billing is not a requirement to work in the field, many employers prefer certification. It establishes you as a professional that has met certain criteria and is dedicated to the profession.
Larger employers such as hospitals place more emphasis on certification. The advantage is it makes you more appealing to potential employers, justifies higher pay, and can lead to better opportunities for advancement.
There are two professional organizations which offer certification in medical billing and coding:
AMBA – American Medical Billing Association.
AAPC – American Association of Professional Coders.
AMBA Medical Billing Certification
The Certified Medical Reimbursement Specialist (CMRS) is an exam based certification awarded by AMBA. The CMRS exam is a comprehensive 800 question exam that covers all aspects of the medical billing process. Taking the exam requires membership in AMBA which costs $99 a year. The exam is given online and requires an 85% grade to pass. The CMRS exam has covers several areas:
- Medical Terminology
- Anatomy and Physiology
- Information Technology
- ICD-10-CM Coding
- CPT Coding
- EDI Transactions & Clearinghouses
- CMS-1500 Form
- Insurance Types and Carriers
- Acronyms and Healthcare Terms
- HIPAA & Compliance
- Managed Care
- Fraud & Abuse
The exam is open book and the examinee is allowed 45 days to complete the exam. If a passing grade of 85% is not obtained, two free retakes are allowed within 60 days after a 30 day waiting period.
Maintaining certification requires completion of 15 credits of continuing education every year. Qualified continuing education can be taken through several professional organizations.
AAPC offers coding in a variety of coding specialties as well as medical billing. For billing the Certified Professional Biller (CPB) is obtained upon successfully passing the CPB exam, maintain continuing education units (CEU), maintaining membership in AAPC.
The CPB exam is 200 questions that must be completed in one sitting which takes about 6 hours. A passing grade is 70%.
The AAPC Certified Professional Coder certification is one of the more popular coding certifications. It requires maintaining continuing education credits, two years of experience, and and membership in AAPC. A CPC-A designation is given to those who lack 2 years of experience.
AAPC is an excellent organization which offers extensive coding resources and specialty certifications. It also has an extensive community and recognition in the healthcare community.
AAPC recommends having an associates degree before attempting certification.
If you desire to get a degree or become certified, we recommend completing a program from a school with a good medical billing and coding curriculum. You can find a good local or online school using the search below.
Working From Home
Situations where billers and coders are allowed to work from home:
- If the employer allows it.
- Contracted as a Business Associate.
- Business that provides services to a provider such as a billing service.
Anyone working for a health care provider may remotely access health information systems and use mobile devices to access electronic protected health information (ePHI) in a cloud.
HOWEVER the systems and devices must have appropriate physical, administrative, and technical safeguards are in place to protect the confidentiality, integrity, and availability of ePHI.
Starting a Billing Service Business
Those who start a Billing Services business typically have some experience.
Any program that promises you can immediately work from home by taking an online course is delusional.
The value of any training – whether it’s online or not – is what it teaches you. Consider what the instructor or organization delivering the course has accomplished. If they are trying to sell you a course or program starting a business from home, have they done so successfully?
We don’t emphasize the Starting a Medical Billing Business from Home route because it’s not for everyone and we don’t want to mislead people without knowing all that’s involved. Although we started a vibrant billing business from home, most of what we learned was through experience and self learned from a variety of sources.
Remember that medical billing and coding are extremely important to the financial health of a providers office. Its a very complex process. They’re not going to hand these responsibilities off to someone who has never gotten a claim paid before.
Stay away from any program that provides you a software, a few generic instructional books, and a listing of physicians that supposedly need a billing and coding services.
There’s much more info on starting a medical billing business at our sister site All-Things-Medical-Billing.com.