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How Do I Become a Medical Billing and Coding Specialist?

By Gabriele Sturmer
Updated May 17, 2024
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A medical billing and coding specialist puts the appropriate diagnostic codes on medical billing claims forms to ensure that the hospital, care facility or doctor's office is reimbursed by insurance companies. He or she learns the classification system used for medical coding and analyzes medical documentation to review the medical procedures, diseases and injuries dealt with at the facility. Medical billing and coding specialists are also responsible for following special protocols for each claim. If you want to work in this position, then you'll need a high school diploma or college degree and training in the field, which could include earning industry certification.

A high school diploma or its equivalent is the basic educational requirement to become a medical billing and coding specialist. Those who want to advance in the field usually consider at least an associate's degree related to coding, and many employers require that their employees have a degree. Common classes focus on productivity software, law, anatomy, biology, insurance, coding, and medical records. Many programs include an internship at a medical facility as a final requirement. There also are certificate programs available that can be completed in less time, and some employers even train coders on the job. In any case, coding classes can help prepare you for the job and help you perform better during your employer's training program.

You can also consider taking one of the many certification exams available. The exams typically expect you to have some experience in the field, but not all of the testing vendors require this. A test will usually show you example medical records and ask you to code them according to the appropriate standards. The tests typically allow you to use code books, but they have a time limit for each part. Many recommend that you have completed some college coursework in medical coding and require a high school diploma at a minimum.

Some employers prefer that you have experience in a healthcare setting before you become a medical billing and coding specialist with their company. Participating in a college degree program or certification program that required you to work in an office setting will be helpful when you apply for a permanent job. Employers also like to see that you understand insurance plans, have strong analytical skills, and understand medical terminology and anatomy. Communication skills are also vital, because you'll be working with others in the office.

WiseGEEK is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.

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