Explore Online Medical Billing and Coding Programs with Externships

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HealthcareMedical CodingNursing

HealthcareOnline Learning

Updated: 05/12/2026

Feeling prepared for your first job in medical billing and coding can be intimidating without any experience. I’ve been there and know firsthand that feeling confident with the material and passing the certification test is a world away from managing the workflow in a busy billing office. With the majority of the work being administrative, gaining confidence for the role comes with practice – and externships allow you to apply what you learned in the classroom.

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Externship Basics
Top Schools
Success Tips
FAQs

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Externship Basics
Top Schools
Success Tips
FAQs

Medical Billing and Coding Externships: Basic Details

Medical billing and coding externships often take place in settings like:

Physician offices
Outpatient clinics
Hospitals
Billing companies

In some cases, they’re offered remotely, especially since so much of the work is done through electronic health record (EHR) systems. That said, many entry-level roles still require an in-office start, so having an on-site externship can give you a better sense of:

The role
The workflow
How teams communicate
How things connect behind the scenes

During an externship, you can expect to spend time on tasks like:

Reviewing patient charts
Applying the appropriate codes
Processing claims
Working through explanation of benefits (EOB) documents
Reviewing and correcting automated code suggestions as AI is increasingly used in the field
Supporting compliance and audit-related work

An externship can also turn into a job offer, as many healthcare practices with open positions use it as an opportunity to see how you work, learn, and fit with the team.

Externship placement works differently depending on the program. Some schools will:

Have established partnerships with local medical offices and coordinate your site directly
Provide a list of approved sites and expect you to reach out and secure your own placement

That difference can impact how quickly you complete your externship, and it’s worth asking about it before you enroll.

Inside Look at 5 Programs that Include an Externship

When choosing a medical billing and coding program, you might consider length, cost, or whether it’s online. I did the same. But one detail that can really shape your experience is whether the program includes an externship.

Here’s a look at a few programs that do:

American Career College

American Career College offers a Medical Billing and Coding Specialist program designed for flexibility, with coursework completed fully online through its Ontario, California campus.

The 220-hour externship is a mandatory requirement for graduation and breaks down into two phases:

20 hours of pre-externship professional development, covering resume writing, interview techniques, and workplace communication skills
200 hours of on-site externship, completed under the direct supervision of qualified personnel

Supervisors evaluate students throughout the externship, and those evaluations become part of the student’s permanent record.

Preppy

For those looking for a fully self-paced option, Preppy offers an online medical billing and coding program that can be completed in as few as four months, with a certificate of completion from an accredited university.

A few things to know about Preppy’s externship before enrolling:

It’s a post-completion opportunity, not a built-in graduation requirement.
Eligibility requires finishing your tuition payments, so if you’re on a payment plan, factor that into your timeline.
Placement is arranged for you by a dedicated externship coordinator, who works to match you with a local clinic, hospital, or medical group.

Since the externship is arranged after graduation, availability may depend on your location and the organizations in your area

Northwest Career College

Based in Las Vegas, Northwest Career College’s Medical Billing and Coding program is accredited and designed for students who want a mix of online convenience and face-to-face support.

A major part of the training is a 220-hour externship completed at healthcare facilities in Las Vegas. The school handles the placement for you, which can be in:

Medical offices
Hospital billing departments
Billing companies

The externship is a part of the program and is completed under the supervision of working billing professionals. Tasks performed include coding encounters, submitting claims, posting payments, and following up on denials using industry-standard systems.

CCI Training Center

If you’re based in Florida and looking for a structured, live-learning environment, CCI Training Center is an accredited school worth considering. The Medical Billing and Coding Specialist program offers multiple completion paths, ranging from four to 26 weeks, along with Certified Professional Coder (CPC) exam prep.

What to know about the externship:

Placement is arranged by CCI directly, with students placed in an approved medical facility near their location in Florida.
The work is office-based, applying classroom knowledge to real-world billing and coding workflows.
Externship hours are not prominently listed on the program page, so it’s worth asking the admissions team for that detail before enrolling, especially if you’re comparing programs side by side

San Francisco State University

If a university-backed program is on your list, San Francisco State University offers an online medical billing and coding certificate course that can be completed at your own pace while preparing for national certification exams.

What to know about the externship:

The externship is optional and volunteer-based, structured as a post-completion opportunity rather than a graduation requirement.
An externship coordinator assists with placement and helps connect you with a local organization in your area.
Site availability and timelines can vary, so consider asking about placement logistics in your area before enrolling with the expectation of that externship.
It requires some initiative on your end, but it still offers a structured way to gain hands-on experience before your first job.

How to Succeed in Your Billing and Coding Externship

Think of your externship as more than practice. In many cases, it’s also your first audition for a job, so you want to show your site supervisor that you are an asset and a potential future employee.

Here are a few ways to make the most of your externship:

Dress professionally and arrive prepared. Unless the site allows scrubs, business casual is the safe default. Show up on time, bring a notepad and pen, and come ready to observe and engage.
Get familiar with common billing software before you arrive. Schools often include training on platforms like Medisoft or practice management systems. Brush up on whatever system your coursework covered so you can walk in with a basic comfort level of EHR systems.
Pay attention and ask questions. You’ll learn a lot from watching how the staff troubleshoots missing documentation or payer-specific rules. Don’t hesitate to ask questions; that’s part of learning. When I was training new billing and coding staff, the ones who asked thoughtful questions showed they were paying attention and wanted to improve.
Focus on accuracy. Supervisors would rather you take your time and get it right than move fast and make mistakes that can cost the practice money. This is especially true when reviewing AI-generated codes, which is becoming a part of how we work. That attention to detail can help set you apart..

Frequently Asked Questions

Are medical billing and coding externships paid?

Most medical billing and coding externships are unpaid. They’re considered part of your training and meant to give you hands-on experience, though some may lead to paid opportunities later.

Can I do a billing and coding externship remotely?

Some programs offer remote externship options. That said, remote placements are less common than in-person ones, and availability depends on your program and location.

In-person externships can help you better understand workflows and team communication.

What software will I use during a billing and coding externship?

It depends on the site. Common software includes Medisoft, athenahealth, Intergy, and AdvancedMD.

Your school will likely introduce you to at least one practice management system, but the specific software used during externship varies by office.

What is AAPC Project Xtern, and how is it different from a program-arranged externship?

AAPC Project Xtern connects newly certified coders with approved employer sites for hands-on experience. This program is pursued after obtaining your billing and coding certification, independently of your school, and is free to qualifying AAPC members.

It can be helpful if your school doesn’t include externship placement.

Will completing a billing and coding externship count toward the CPC work experience requirement?

Completing an externship can count toward the CPC work experience requirement.

AAPC allows externship hours to count toward the two years of on-the-job experience needed to remove the “apprentice” designation from a CPC-A credential. You’ll need a signed letter from your site verifying your work and dates.

Check the current AAPC guidelines, so you have the right documentation before you finish.

Explore Online Medical Billing and Coding Programs with Externships

Medical Billing and Coding Externships: Basic Details

Inside Look at 5 Programs that Include an Externship

American Career College

Preppy

Northwest Career College

CCI Training Center

San Francisco State University

How to Succeed in Your Billing and Coding Externship

Frequently Asked Questions

Are medical billing and coding externships paid?

Can I do a billing and coding externship remotely?

What software will I use during a billing and coding externship?

What is AAPC Project Xtern, and how is it different from a program-arranged externship?

Will completing a billing and coding externship count toward the CPC work experience requirement?

Maggie Aime, RN, MSN, CPC AUTHOR

Jordan Cosselman EDITOR