What is Medical Billing and Coding?

Stethoscope and medical billing and coding

In terms of job growth in 2015, look no further than the healthcare industry. Last year alone, the field added almost a half million jobs - that's a whopping 83% increase over 2014. The spike in job creation can be attributed to the health insurance overhaul and more Americans receiving coverage.

And the healthcare field shows no signs of slowing down: During the 2016 open enrollment period that ended Jan. 31, 12.7 million consumers chose plans or were automatically re-enrolled through the Health Insurance Marketplace, according to a statement from the U.S. Department of Health and Human Services. That's equivalent to about 4 million new people electing to be covered this year.

With millions more Americans seeking out coverage, the need for employees continues to grow. Hospitals, doctors' offices and outpatient centers are just some of the organizations and providers driving the demand. As the country's baby boomers continue to age and require more services, now is truly the time to land a position in the healthcare field.

One area of need within healthcare is that of medical billers and coders. If you're not familiar with the position, read on to find out exactly what is medical billing and coding, if it's a good fit for you and what earning a bachelor's degree can do for your career.

What is Medical Billing and Coding?

Medical billing and coding is essential in healthcare, according to Lynn Ward, associate dean of health information management at Southern New Hampshire University. These health information technicians must integrate themselves with both the software and their team as organizations seek to streamline efficiencies.

So what exactly do medical billers and coders do? They handle the billing and insurance details in healthcare organizations and at billing companies. They may also manage financial and electronic health records (EHRs) for their group. Their role is essential as it provides patient-facing professionals the information they need to improve quality of care, as well as providers with what they need to decrease the number of billing errors and improve care coordination in an industry that demands it.

The demand for highly educated professionals will be even more critical, as these individuals will take on management and leadership roles, creating decentralized teams that support units within large healthcare settings such as hospitals, and making recommendations that support the technology, security and compliance needs of an organization. With a bachelor's degree, you'll be well qualified to be at the helm of these departments.

According to the U.S. Bureau of Labor Statistics, coders and billers may also:

  • Look over patient information for pre-existing conditions
  • Assign diagnoses and procedure codes for patient care, health statistics and billing purposes
  • Work as a go-between with the health clinician and billing offices

What is medical billing and coding in a healthcare setting? It's a skill that's necessary in almost every health setting. In addition to the hospitals, doctors' offices and outpatient centers previously mentioned, these jobs can be found at long-term care facilities, ambulatory care facilities, insurance companies, pharmaceutical companies, medical manufacturers, behavioral health organizations, governmental healthcare agencies and healthcare-related organizations.

In other words, coders and billers can be found everywhere. And with a bachelor's degree in this field, so can plenty of opportunities for HIM managers.

What Education is Necessary for Medical Billing and Coding?

What is medical billing and coding in terms of the education needed for this type of career? In many instances, a certificate in billing and coding may get your foot in the door for an entry-level position. However, when it comes to the growth in healthcare, the educational edge - like a bachelor's degree - may help you get ahead and prepare you to take on additional responsibilities.

"The BS in Health Information Management program is a good fit for a student interested in this career path, especially for someone who would like to work in management of an HIM department," Ward said.

SNHU's health information management degree program teaches the technology, terminology and professional skills required for an HIM career, especially in advanced roles. As a graduate of SNHU's bachelor's degree program, you'll learn to:

  • Apply health data structure, standards and regulations to manage clinical classification systems and reimbursement
  • Analyze the uses, risks and management of health statistics and biomedical research data and support performance improvement programs
  • Interpret and apply current laws regulations, policies and healthcare ethics as they relate to decision-making in healthcare delivery and systems
  • Implement and manage hardware and software technologies to ensure effective data collection, storage, analysis and reporting of information
  • Evaluate information system applications for their capacity to meet the needs of healthcare organizations
  • Use current management principles to propose solutions and develop project management plans that solve organizational challenges

Included in the Health Information Management (HIM) curricula are two coding and classification systems courses: HIM-215 (Coding & Classification Systems) and HIM-360 (Coding & Classification Systems II). Required for the program, Ward said, they provide a strong foundation for medical reimbursement specialists in the International Classification of Diseases' rules and guidelines, as well as ICD-10-CM codes, which are used to identify diseases, symptoms, findings and more. As an HIM student, you'll go more in depth in the second course, learning about file structures, data sharing, the Health Information Exchange and the Nationwide Health Information Infrastructure.

The courses that make up the HIM program create a well-rounded degree - and a skilled, capable graduate. Aside from the coding courses, you - as a student - can expect to learn more about healthcare management, project management, human resources, data analytics, computer platform technologies, pathophysiology and pharmacology, and the ethics and legal aspects of HIM. In a medical billing or coding career, this knowledge will complement your training well, giving you an edge in your current position, providing a holistic view of your role in the healthcare industry and setting you up for success for other possible HIM careers down the road.

Those who seek to take their training even further may find some of SNHU's master's programs of interest: MS in Information Technology with a concentration in Healthcare Informatics or the MBA in Healthcare Management could offer you the level of advancement or salary bump you're looking for.

What is Medical Billing and Coding's Job Outlook?

Similar to the rest of the healthcare industry, job growth for medical billing and coding specialists looks good. According to the U.S. Bureau of Labor Statistics, positions for health information technicians will grow by 15% through 2024 - faster than the average for all occupations.

"As baby boomers age and require more medical services, we'll need more health information technicians to manage all of their data," Ward said. "This increase in demand - combined with the number of insured citizens on the rise - will mean more reimbursement claims from insurance companies. The industry will need more trained HIM staff to stay organized."

Learn more about how SNHU's BS in Health Information Management degree could be the right fit for you and the advancement of your career.

Deidre Ashe ‘18G is a copywriter in higher education. Connect with her on LinkedIn.


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