Online Medical Billing & Coding Certification
Learn certification basics, why it matters to employers, and where and how to earn your certification today
Medical billers and coders serve an important function in health care. Hospitals, doctor offices and other health care facilities rely on these professionals to navigate the complex world of health insurance rules and regulations. There are more than 30 different medical billing and coding certification options, ranging from general credentials to specialty designations for various type of medical care. Specializing in one or more of these credentials can increase both salary and job prospects. Ready to take your career to the next level?
What Medical Billing and Coding Certification Means?
If you’ve already graduated from a medical billing and coding program, you may wonder why you need to be certified, too.
Education programs can vary in quality, and certification provides employers with a standard by which to judge a person’s expertise. Plus, they can help distinguish between billers and coders with general knowledge and those with specialized skills. Certification can prepare you for more advanced medical billing and coding jobs and may lead to increased salary, as well. Let’s see how it all works, and which online certifications may be available to you.
The Certification Process
The certification process begins with getting the right education. Start by earning your high school diploma or GED and then applying for an accredited billing and coding program.
Some certifications – such as the AAPC’s Certified Professional Coder designation – recommend an associate degree, but that’s not required. A few credentials, such as the Certified Coding Associate from the AHIMA, suggest postsecondary education but don’t have any minimum education requirements beyond a high school diploma. Some certifications may allow applicants to substitute work experience for education while advanced designations may require both a postsecondary education and work experience.
Once you have the right level of education or experience, the next step to certification is to take an examination. To be eligible for the exam, you’ll need to pay a fee, and you may be required to join the credentialing organization. In other words, AAPC and AHIMA will only certify people who are members of their respective association.
After passing the exam, you may have to renew your certification on a regular basis. To do so, you may be required to complete a certain number of continuing education credits.
Medical Coding Certification Online
Now that we’ve established why certification is important, let’s explore the various options available. There are two main certifying organizations, and both offer several coding designations. Let’s take a closer look at each one.
AAPC Core Certifications
Founded in 1988, the AAPC was originally known as the American Academy of Professional Coders. It has grown to encompass more than 180,000 members worldwide and offers 28 different certifications for professionals working on the business side of health care. The group offers four designations specifically for coders.
Certified Professional Coder (CPC) – AAPC describes this as the gold standard for coders working in doctor office settings. A CPC is expected to have mastery of all code sets – CPT, ICD-10-CM and HCPCS Level II – as well understand how to handle claims denials, charge captures and other issues.
Certified Outpatient Coder (COC) – This credential is for those with the expertise needed to work in outpatient facilities such as emergency departments, therapy offices and diagnostic centers. AAPC anticipates career opportunities in outpatient facilities may rise as physicians move away from private practice and increasingly join hospital groups.
Certified Inpatient Coder (CIC) – This new certification is the only credential specific to inpatient medical coding. It’s intended for coders who work in hospitals or other inpatient facilities.
Certified Risk Adjustment Coder (CRC) – As another new certification option, the CRC indicates a coder’s ability to read a medical chart and assign correct diagnosis codes. In addition to understanding medical coding guidelines, CRC applicants must know the audit process and documentation requirements for risk adjustment coding.
AHIMA Coding Certifications
The American Health Information Management Association has been serving health information management professionals since 1928. The group has more than 103,000 members which it serves through a variety of professional development opportunities. For medical coders, it offers the following certification programs.
Certified Coding Associate (CCA) – The CCA is a general certification offered by AHIMA and appropriate to coders working in both hospital and physician office settings. Those with the credential are said to exhibit the competency, commitment and professional capability sought by employers.
Certified Coding Specialist (CCS) – This certification is designed for those who will be classifying medical data, such as those working in a hospital setting. AHIMA notes the skills of a CCS may also be needed by researchers and public health officials as they monitor health patterns and interventions.
Certified Coding Specialist-Physician Based (CCS-P) – The CCS-P designation is for those who specialize in physician-based settings such as doctor offices, group practices or specialty clinics. Applicants for this credential must have an in-depth knowledge of the CPT coding system as well as an understanding of the ICD-10-CM and HCPCS Level II systems.
Specializing as a Medical Coder
In addition to the core medical coding certifications, coders also have a handful of specializations from which to choose. These are from the AAPC and also require certification exam and, in many cases, a certain level of experience. Here are the 22 medical coding specializations that professionals in the field have as options:
- Ambulatory Surgical Center (CASCC)
- Anesthesia and Pain Management (CANPC)
- Cardiology (CCC)
- Cardiovascular and Thoracic Surgery (CCVTC)
- Chiropractic (CCPC)
- Dermatology (CPCD)
- Emergency Department (CEDC)
- Evaluation and Management (CEMC)
- Family Practice (CFPC)
- Gastroenterology (CGIC)
- General Surgery (CGSC)
- Hematology and Oncology (CHONC)
- Internal Medicine (CIMC)
- Interventional Radiology and Cardiovascular (CIRCC)
- Obstetrics Gynecology (COBGC)
- Orthopaedic Surgery (COSC)
- Otolaryngology (CENTC)
- Pediatrics (CPEDC)
- Plastics and Reconstructive Surgery (CPRC)
- Rheumatology (CRHC)
- Surgical Foot and Ankle (CSFAC)
- Urology (CUC)
Visit the AAPC’s page on specialty medical coding certifications for details on each, including how to prep for the exams and, when you’re ready, how to schedule one.
Medical Billing Certification Online
There are also certifications for medical billing although the options here aren’t as extensive as what is offered for coding. There are two main options for billers to demonstrate their ability to manage claims to private insurers and government health plans.
Certified Professional Biller (CPB)
Offered by AAPC, the CPB credential is awarded to billers who have demonstrated expertise in all aspects of the revenue cycle. To earn this certification, you must have knowledge of various type of insurance plans, coding guidelines and laws pertaining to health care billing such as HIPAA, False Claims Act and Fair Debt Collections Act.
AAPC recommends those applying to be a CPB have an associate degree. Applicants must be members of AAPC and score at least 70 percent on a 200-question multiple-choice certification exam. The exam costs $425, or $325 for AAPC students, and is an open code book test, allowing the use of certain approved manuals.
Certified Medical Reimbursement Specialist (CMRS)
The other certification for medical billers comes from the American Medical Billing Association. Founded in 1998, the organization provides a number of professional development opportunities for medical billers. Among these is the CMRS designation.
Unlike other coding and billing certifications, there are no education requirements for those wishing to take the CMRS exam. Any member of the association who has current year code books is eligible to apply although the AMBA recommends applicants use a study guide to prepare for the exam.
The CMRS certification exam is extensive and includes 710 questions spread across 16 sections. A score of 85 percent is needed to pass. The exam costs $325, and applicants have a 45 day enrollment period in which to complete it.
Preparing for the Exam
A quality medical coding and billing program should cover all the major content areas tested by certification exams. However, it’s still wise to do some additional preparation to maximize your chances of earning a passing score. Here are a couple options to help you prepare.
AAPC study guides: The AAPC offers study guides for each of its certifications. These guides won’t teach you coding but do offer a review of the coding concepts you learned in your medical billing and coding program.
Each task force that creates an AAPC certification exam also develops the corresponding study guide. Within the guide, there are testing tips and techniques to help applicants maximize their opportunity for success. Each study guide also includes a review of medical terminology and anatomy, practical examples and sample questions that are designed to mimic those on the exam.
The AAPC study guides cost $99.95 for members of the association. Non-members pay $129.95.
AAPC practice exams: The AAPC also offers practice exams for its certifications. These 50-question exams are designed to replicate the content and difficulty of the official certification exams. They prove immediate feedback, and once purchased, you can take each practice exam as many times as you’d like. Your results can provide a gauge of your readiness for the actual exam.
Each AAPC practice exam costs $39.95 for members and $69.95 for non-members. There are several practice exams available for each certification, and they may be purchased individually or in bundles of three. The bundle price is $79.95 for AAPC members and $109.95 for non-members.
No Cost Prep: In addition to official study guides and practice exams, you can find free test prep resources online. These include apps and websites with sample questions, webinars and practice quizzes. The quality of free resources can vary, and be sure you are using study materials for the latest version of each coding system.
Here are a couple places to start looking for no cost prep.
The Career & Salary Impact of Certification
Earning a medical billing and coding certification can have a significant impact on both your job opportunities and income. Many employers seek our certified coders and billers and are willing to pay more to hire them. According to a 2017 salary survey by the AAPC, professionals with at least one certification earn nearly 15 percent more than those without any certification.
- Medical Biller Salary
Salaries can vary depending on several factors, but the average AAPC medical biller earns more than $61,000 annually. That was the conclusion of the 2017 AAPC salary survey. However, actual incomes can vary depending on a person’s geographic location, certifications and years of experience. Across the board, biller salaries increased 4.8 percent from 2016 to 2017.
The AAPC salary survey notes that billers with a CPB certification have an average of 12 years of experience. They also average three certifications, including the CPB. Those with experience may go on to work as billing managers, a position that comes with an average salary of $64,623, making managers among the highest-paid professionals in the field.
- Medical Coder Salary
The average AAPC coder doesn’t make as much as the average biller, but they still earn $52,411 per year according to the 2017 AAPC salary survey. Earning a medical coding certification can significantly increase a person’s salary potential too.
Coders who are not certified earn an average annual salary of $45,032. Obtaining one certification bumps average incomes up $6,442 to $51,477 per year. Those with two certifications earn $57,656, and coders with three or more credentials have an average salary of $66,659.
The type of certification can also impact a coder’s salary. Here are the average salaries for those with AAPC coder credentials in 2017:
- CIC: $49,713
- CPC: $52,037
- COC: $60,806
- CRC: $62,310
Beyond certification, incomes can vary by region and state. The highest paying region in the country is in the states along the Pacific Ocean where coder incomes average $60,011. The lowest paying region is the East South Central states of Alabama, Kentucky, Mississippi and Tennessee. Although incomes are lower here than elsewhere in the country, coders still earn an average of $49,209 annually in this region.
Education is another component of coder salaries. Not surprisingly, those with higher levels of education tend to make more than those with no postsecondary training. Here’s a closer look at average coder salaries, broken down by years of college:
- No college: $49,004
- Some college/associate degree: $50,987
- Bachelor’s degree: $53,748
- Master’s degree or higher: $69,378
While these numbers can provide a guide as to what to expect in terms of income, actual salaries can fluctuate based on a coder’s certifications, years of experience and work setting. For instance, inpatient hospital coders typically earn more than those who work for a solo or small group practice.
What’s Next for Medical Billers & Coders?
Medical billing and coding can be a launching point for a variety of careers. Moving to a billing and coding manager position is a common career path for professionals in the field, but it’s not the only option.
Some billers and coders shift to new responsibilities as office managers or auditors. While office managers may oversee all administrative operations in a practice, auditors are responsible for checking the work of coders and billers to ensure it is accurate and meets regulatory requirements. The AAPC offers a Certified Professional Medical Auditor credential for those working in this capacity.
As an occupation within the category of medical records and health information technicians, billers and coders should have positive job prospects in the coming years regardless of how they plan to advance their career. Overall, health information technicians should see 13 percent job growth from 2016-2026, according to the Bureau of Labor Statistics. The federal agency notes employment opportunities may be best for those who have obtained certification.
