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What's the Job Description of an Insurance Billing & Coding Specialist?

Insurance billing and coding specialists help ensure that doctors and hospitals are sufficiently reimbursed by insurance companies. Read on to find out about the duties and responsibilities, education requirements, certification options, and salary statistics for insurance billing and coding specialists.

Duties and Responsibilities

As an insurance billing and coding specialist, also known as a medical billing and coding specialist, you will act as an intermediary between a healthcare facility and the insurance companies. You'll be responsible for submitting paperwork to insurance companies for the purpose of seeking reimbursement for medical procedures performed. You will have to be familiar with a variety of industry-standard coding systems, such as CPT and ICD-9 diagnostic codes, that are often used in insurance claims submissions. You may also have to contact the insurance companies before a patient receives medical treatments to ensure that the procedures are covered.

You have to work with patients to correctly fill out paperwork, doctors to verify that the proper procedures are submitted, and insurance representatives to ensure proper reimbursement. You may also be expected to perform some basic clerical duties in the medical office, such as answering telephones, managing patient correspondence, and entering data into computers.

Important Facts About Insurance Billing & Coding Specialists

On-the-Job Training Not typically required, but available through work experience
Key Skills Reading comprehension, critical thinking, clear communication, attentive listening, interpersonal
Work Environment Hospitals, physicians' offices, nursing and residential care facilities
Similar Occupations Medical transcriptionists, medical and health services managers

Education and Certification Options

A high school diploma is the minimum education required to become an insurance billing and coding specialist. However, many employers prefer to hire candidates with some postsecondary training, such as the kind received from a diploma, certificate, or associate's degree program. These educational programs teach you about insurance billing and coding techniques, basic medical terminology, human anatomy, medical coding systems, and other essential areas of the occupation.

Professional certification may also be highly valued by some employers. Many agencies offer such designations, such as the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). The AHIMA offers the Certified Coding Associate (CCA) and Certified Coding Specialist (CCS) designations, and the AAPC offers the Certified Professional Coder (CPC) designation with several specialty options. Each professional designation has specific eligibility requirements, so you are advised to consult the certifying agency for details.

Salary Statistics and Job Outlook

According to PayScale.com, most medical billing and coding specialists earned annual incomes between $28,000 and $54,000 a year. PayScale.com also reported that the majority of medical billing and coding specialists earned between $11.72 and $20.75 an hour. Those with 20 or more years of experience typically earned between $14.70 and $23.61 per hour. The U.S. Bureau of Labor Statistics (BLS, www.bls.gov) reported that the median annual salary earned by medical records and health information technicians was $40,350 as of May 2018. The Bureau also published its prediction that employment of such technicians could grow by as much as 13% between 2016 and 2026.