How to Become a Medical Coder: Educational Requirements & Qualifications
Medical coders handle patient records and code information for insurance purposes, helping to maintain the integrity and privacy of sensitive medical data. Find out how to become a medical coder, the specialized education they need, and other common medical coding qualifications by reading below.
What do I Need to Become a Medical Coder?
Medical coders, also called coding specialists, are a type of health information technician who performs administrative duties at medical facilities, largely related to insurance and billing. They fill in patients' medical records with new information regarding preexisting conditions, diagnosis and treatment, and they can act as the bridge between providers of healthcare services and those who pay for these services, such as insurance companies.
To work as a medical coder, it's important to hold some form of post-secondary education related to the field. Since many medical records today are electronically stored, medical coders need to be adept with computers. A number of certifications are also available, which can help to demonstrate specialties within the field and may be a benefit when applying for medical coder jobs.
Medical Coder Skills and Qualifications
Medical coders work extensively with computers and use specialized programs to edit and store patient data, so typing ability is critical in addition to a general understanding of how to use computers. Because they act as the point of contact between hospitals or other providers and insurance companies, medical coders must have good phone etiquette and be able to clearly and effectively communicate. Since much of their work deals with confidential records, medical coders need to have a respect for privacy as well. Mistakes can cause patients to be treated wrongly or left with a bill that insurance should cover, so an eye for detail and attentiveness at work is also very important.
As is common for careers in the healthcare industry and allied health professions, a criminal background check may be required before being hired. The private nature of health records and proximity to controlled substances are key reasons why applicants must have clean records. Similarly, drug and health screenings are often administered, since medical coders may be around immunocompromised individuals and risk spreading disease. Vaccinations may be required and kept up to date to work in certain medical facilities as well.
Medical Coder Education Requirements
Medical coding programs exist as certificate programs, diploma programs, and associate's degrees. Certificate programs in medical billing and coding are often sufficient to secure a position and can be completed in under a year. Courses that are common among medical billing and coding programs include:
- Coding foundations
- Anatomy and physiology
- Medical terminology
- Medical insurance and billing
- Administrative Office Procedures
Medical coding degrees at the associate's degree level take about two years and include a general education component. Holding a higher credential, such as an associate's degree, may offer more opportunity for advancement. Some medical coding programs will also prepare you to obtain certain certifications after completion, which may help with finding employment. Practicums, internships, and other hands-on job experience may also be included in some programs, but are not always available or required. Many medical coding degree programs are available online, and can be done almost entirely over the internet.
Medical Coding Certification Requirements
Certification for medical coding is done through several groups, such as the American Academy of Professional Coders (AAPC), or the American Health Information Management Association (AHIMA). AHIMA offers two main certifications, the Certified Coding Associate (CCA) and Certified Coding Specialist (CCS). The CCA is the first level, requiring completion of a medical coding program or 6 months experience, while the CCS requires 2 years of experience, or that an individual hold the CCA credential with an additional year of experience. Both certifications require that applicants pass a certification exam.
AAPC offers a large number of certifications, with the most common being Certified Professional Coder (CPC). An associate's degree is recommended, although not required; 2 years of job experience is necessary for the full certification; however, if an individual can pass the exam with under 2 years experience, they will receive the CPC-A (apprentice) certification, until such time as the experience qualification is met. Certifications for inpatient, outpatient, and risk adjustment also exist, as well as over 20 specialty certifications, in areas like cardiology, pediatrics, and general surgery. These specialty certifications are designed to work in tandem with the other major certifications offered.
Certification can help to demonstrate confirmed ability to employers and may be preferred or even required by some. Certification often requires continuing education be completed in order to remain certified, and these continuing education requirements will vary with each certification.