Billing and Coding Consultant: Job Description and Requirements

Sep 17, 2019

When most people visit a clinic or hospital, they use their medical insurance to cover all or part of the cost. In order to receive payments from an insurance company, however, healthcare facilities must have all medical paperwork filed and submitted appropriately - this is the responsibility of billing and coding consultants. No formal education is required for this position, but employers may require certification, which requires a minimum of an associate's degree.

Essential Information

A billing and coding consultant codes patient medical records and submits claims to insurance companies for reimbursement. They also perform billing services, sending invoices to patients from a variety of healthcare facilities. No formal education requirements apply to becoming a billing and coding consultant. However, because of the nature of the job, knowledge of accounting techniques, medical insurance practices and/or business may be helpful.

Required Education Certificate or associate's degree in health information technology (required for medical records and health information technicians); no formal education required for billing and coding consultants
Other Requirements Certification available through the American Health Information Management Association may be required by many employers
Projected Job Growth (2018-2028) 11% increase for medical records and health information technicians*
Median Salary (2018) $40,350 for medical records and health information technicians*

Sources: *U.S. Bureau of Labor Statistics

Job Description for Billing and Coding Consultant

A billing and coding consultant provides coding and invoicing services to various businesses in the medical industry. These consultants work as independent contractors, rather than as direct employees, and can be hired by a medical facility or an insurance company. Their services include using medical coding and classification systems to calculate and invoice patients. They also submit procedure and diagnosis claims to insurance companies for reimbursement.

Because billing and coding consultants work independently, they might work at the office or hospital holding their contract, at their own office or even from home. The U.S. Bureau of Labor Statistics forecasted that employment of medical records and health information technicians, which includes billing and coding professionals, would grow much faster than the average through 2028. Employers for billing and coding consultants include hospitals, doctors' offices, outpatient care centers, nursing homes, rehabilitation centers, pharmacies and insurance companies.

Education and Certification Requirements

Employment as a billing and coding consultant requires no formal postsecondary education. Continuing education to keep up to date with current training and practices in coding and billing software is recommended.

Many employers require some form of certification. Options for further credentialing in billing, coding or other forms of health information management include certification as a Registered Health Information Technician (RHIT) or a Registered Health Information Administrator (RHIA). These certifications are offered by the American Health Information Management Association. A candidate must hold an accredited associate's degree to become an RHIT and a bachelor's degree to become an RHIA. Candidates must also pass a certification exam.

Billing and coding consultants keep track of patients' insurance information and medical histories so that both the patient and the healthcare facility get the full benefit of the patient's medical insurance. Like many occupations in healthcare and medicine, job growth is expected to be much faster than that of occupations in other fields. Applicants holding certification as health information technicians or health information administrators may have the best job prospects as many employers prefer professional certification; a minimum of an associate's degree is required for certification, though there are no formal education requirements for billing and coding consultants in general.

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