Insurance Coder: Career Summary, Job Outlook, and Training Requirements

Explore the career requirements for insurance coders. Get the facts about duties, education requirements, professional certification and the employment outlook to determine if this is the right field for you. Schools offering Insurance Billing & Coding Specialist degrees can also be found in these popular choices.

What Is an Insurance Coder?

An insurance coder is a clerical-level worker who assigns a numerical code to diagnostic and medical procedures on medical insurance forms. Often classified as medical records and health information technicians, insurance coders may find work at hospitals, doctor's offices and nursing care facilities. Daily tasks often include maintaining clinical databases, handling paperwork and using classification software when coding. In this career, maintaining patient confidentiality is very important when handling data.

Take a look at the following chart for an overview of how to enter the field:

Degree Required High school diploma, Associate's degree
Education Field of Study Health information technology
Key Responsibilities Analyze data, review records, organize records, use coding software, ensure integrity of patient data
Licensure or Certification Certification preferred
Job Growth (2014-2024) 15% (for all medical records and health information technicians)*
Median Salary (2015) $37,110 (for all medical records and health information technicians)*

Source: *U.S. Bureau of Labor Statistics

What Is an Insurance Coder?

An insurance coder is a clerical-level worker who assigns a numerical code to diagnostic and medical procedures on medical insurance forms. You perform your duties using computer software and one of several classification systems. Assigning patients to diagnosis-related groups, reviewing the accuracy and completeness of coded forms, protecting the confidentiality of medical records and forwarding forms to their proper recipient are among your supporting obligations. You might also perform general office administration tasks and data entry.

Step 1: Earn a High School Diploma

A high school diploma may be sufficient for you to become a coder. Figures from O*Net OnLine show about 48% of coders have no more than a high school diploma or General Educational Development (GED) certificate (www.onetonline.org). In addition, high school courses in biology, English, computers and business can help develop general skills you can adapt to coding duties.

Step 2: Consider Formal Training

Community and technical colleges offer coding programs at the certificate level and in rare instances at the associate's degree level. Associate's degree programs are more widely available at private-for-profit schools. Certificate programs train you to use the ICD-9-CM, CPT or HCPCS coding systems and cover topics such as medical terminology, medical ethics, billing procedures and software applications. A certificate may be earned in 1-2 years.

Step 3: Consider Certification

Certification is voluntary, but most employers will give you preference if you have one. At least two organizations offer credentials you can obtain as a beginning coder, including the Certified Professional Coder (CPC) from the American Academy of Professional Coders and the Medical Coding Specialist (MCS) from the Professional Association of Health Care Coding Specialists.

Full CPC status requires one year of coding experience, but passing the certification exam earns you the CPC - Apprentice designation. The CPC exam consists of 150 multiple-choice questions that test your knowledge in 24 areas, including coding guidelines, practice management, anesthesia and radiology. MCS certification requires either two years of experience or completion of a coding education program. The certification exam consists of a 60-question section covering a medical specialty of your choice and a 140-question section covering general coding practices. The American Health Information Management Association also offers a number of coding certifications, including Certified Coding Associate, Certified Coding Specialist and Certified Coding Specialist - Physician-Based.

Step 4: Pursue a Job

The U.S. Bureau of Labor Statistics (BLS) classifies insurance coders as a subcategory of medical records and health information technicians (www.bls.gov). Dedicated figures for coders are not available, but as of 2015 an estimated 189,930 people were employed as medical records technicians. By 2024, employment of medical records and health information technicians is projected to reach 217,600. You could work for private physicians, hospitals, insurance companies, outpatient clinics and nursing homes. BLS figures show hospitals and physicians' offices are the largest two employers. Salary.com reports that as of 2017 medical records coding technicians earned a median salary of $49,585.

Step 5: Advance Your Career

With enough experience you could rise to a position supervising other coders. Becoming the assistant director or director of medical records is a possibility if you work at a smaller facility. Earning a bachelor's degree in health information systems or health information management can lead to a position as a health information manager. You could also consider an advanced certification from the Board of Medical Specialty Coding, including the Specialty Coding Professional, Advanced Coding Specialist, Certified Compliance Professional, Home Care Coding Specialist and Home Care Clinical Specialist.

What Are Some Related Alternative Careers?

There are a few other careers that involve work related to the duties of insurance coders. Information clerks are also responsible for maintaining records, but don't necessarily have medical coding knowledge. Often they are tasked with collecting data and giving information to clients. Medical and health service managers, while being responsible for directing and coordinating medical and health services, also share some clerical responsibilities with insurance coders. Medical transcriptionists listen to voice recordings of doctors and other health care workers to create written reports.

To continue researching, browse degree options below for course curriculum, prerequisites and financial aid information. Or, learn more about the subject by reading the related articles below:

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