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Medical Coding Specialist: Job Description and Requirements

Medical coding specialists require little formal education. Learn about education requirements, job duties and certification options to find out if this is the career for you.

Medical coding specialists work on the financial and technical side of the medical industry, coding claims for reimbursements and dealing with insurance billing. They need a certificate or associate's degree for entry-level positions. They also have a number of options for certification if they choose.

Essential Information

Medical coding specialists are responsible for correctly coding healthcare claims in order to obtain reimbursement from insurance companies and government healthcare programs, such as Medicare. Completion of a certificate or associate's degree program in medical coding or a related field is typically required. Qualified medical coders can earn the Certified Professional Coder (CPC) credential through the American Academy of Professional Coders (AAPC).

Required Education Certificate or associate's degree in medical coding or a related field
Optional Certifications Certified Professional Coder (CPC), CPC-Hospital, CPC-Payer, Certified Interventional Radiology Cardiovascular Coder (CIRCC) and Certified Professional Medical Auditor (CPMA)
Projected Job Growth (2014-2024) 15% for all medical records and health information technicians*
Median Annual Salary (2015) $37,110 all for medical records and health information technicians*

Source: *U.S. Bureau of Labor Statistics

Medical Coding Specialist Job Description

Medical coding specialists work in hospitals, clinics and physicians' offices to obtain accurate reimbursement for healthcare claims. They utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Coders also review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission. If a claim is denied due to incorrect coding, the coding specialist conducts medical records research and corresponds with insurance companies and healthcare professionals to resolve the issue.

Recommended Education for Medical Coding Specialists

Medical coding specialists generally complete a program leading to a certificate or associate's degree in medical coding, health information technology or another closely related field. Typical coursework includes classes in medical terminology; basic and advanced ICD-9-CM coding; anatomy and physiology; computer data entry; and medical law, privacy and ethics. CPC candidates might benefit from advanced courses in Healthcare Common Procedure Coding Systems (HCPCS), Current Procedural Terminology (CPT) coding and healthcare reimbursement methods.

Certification Requirements for Medical Coding Specialists

Medical coding specialists can advance their career opportunities by obtaining certification through the AAPC. Requirements for the CPC credential include current AAPC membership, two years of experience as a medical coder and the successful passage of an exam. An associate's degree in medical coding or a related field is recommended but is not required for certification. CPCs must maintain annual membership in the AAPC and submit 36 continuing education units every two years for recertification.

In addition to the CPC designation, which is intended for medical coders who work in physicians' offices, the AAPC offers CPC-Hospital, CPC-Payer, Certified Interventional Radiology Cardiovascular Coder and Certified Professional Medical Auditor certifications. The association also offers 19 stand-alone credentials in areas such as anesthesia and pain management, dermatology and urology.

Medical Coding Career Outlook

Medical records and health information technicians were predicted to see 15% job growth from 2014-2024, according to the U.S. Bureau of Labor Statistics (BLS). This was an above-average increase due in part to an increasing aging population and the computerization of medical records. Medical records and health information technicians earned a median salary of $37,110 in May 2015.

Medical coding specialists work in hospitals, doctors' offices and clinics and code healthcare insurance claims for reimbursement. Becoming a medical coding specialist requires a certificate or associate's degree in medical coding, health information technology or a related field. Those wishing to advance their career opportunities might consider obtaining one of the many optional certifications offered through the AAPC.

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