Medical coders work in the back office of various health care and medical companies. They are responsible for assessing patient records and assigning medical codes to treatments to facilitate payment processes. Many coders have a certified professional coder, or CPC, certification from the American Academy of Professional Coders. Certification is not essential to a coding job, but many employers require a CPC or alternative qualification. This may also improve your salary and job prospects. According to the AAPC, certified coders earn 17 percent more than coders without credentials.
Payment for medical treatment works on a coding system. As a medical coder, you assess a patient's chart or record, establish the type of treatment, condition and supplies used, and assign codes as appropriate from the three primary resource books, the CPT, HCPCS Level II and ICD-9-CM. This is part of the health care claims and payment process. The job may also involve liaising with medical staff to discuss patients, auditing and dealing with disputed claims.
Job Types and Prospects
Most CPCs start work as a coder. You may work alone or as part of a team, depending on the work environment. Larger organizations may offer opportunities to move into supervisory or management roles over time. According to the AAPC, potential career development options also include moving into medical audit, billing, analysis, compliance and practice management roles, although you may need further study or certification to do this. Some coders also use specialty certification to move into expert medical areas.
CPCs work in a variety of health care environments. It is possible to work from home in some cases -- these jobs are usually in coding consulting companies that take on outsourced work from health care facilities. Most jobs, however, are located in physician and dentist offices, hospitals, nursing homes and health care facilities and agencies. Some coders work for insurance companies, government agencies and public health organizations.
The AAPC offers three core CPC certifications and various specialty programs. If you take the CPC credential, you are qualified to work as a coder in an outpatient physician office. A CPC-H targets outpatient hospitals, and a CPC-P targets payer environments, such as health plan providers. If you wish to specialize, you can get specialty certification in various medical fields, with or without a general CPC credential. It is possible to take these exams without previous coding experience, although this gives you apprentice status and a CPC-A, CPC-H-A or CPC-P-A designation. You can only switch to full credentials once you have gained relevant work experience.
You can learn medical coding on the job -- this is an apprentice occupation, according to the U.S. Department of Labor. You are likely to need previous knowledge of medical terminology, anatomy, biology and physiology. The minimum educational requirement is a high school diploma or equivalent, and a college degree may be useful, especially in a related medical field. The job requires analytical skills, an eye for detail and the ability to make judgments based on a variety of data.
The American Health Information Management Association also offers certification options for medical coders. These include the certified coding associate, a general credential for both physician and hospital environments, and certified coding specialist programs for physician or hospital jobs. These credentials are also widely accepted by employers as an alternative to CPC certification.
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