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What Are the Functions of a Medical Coder?

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Medical coders play an essential role in the creation of medical claims, ensuring that physicians and other health care providers get paid for the services they perform. Medical coders are in demand, and with a two-year associate's degree, you can find opportunities to work part-time, full-time and even from home. Is a career as a medical coder right for you?

Medical Coding Job Description

Medical coders assign universally-accepted numbers to every interaction a patient has with a health care provider. These include doctors' visits, laboratory tests and usage of equipment such as x-ray machines. By putting a patient's information in numerical format, the medical coder provides the data needed by a medical biller to generate a claim for reimbursement by an insurance company. Since medical billing and coding are closely related, some workers perform both functions. Others specialize in one or the other, working as part of team to generate claims to send to the insurance companies.

Education Requirements

On-the-job training is seldom provided. Entry-level positions usually require an associate's degree or completion of a certificate program in medical billing and coding. Many community colleges and vocational training schools offer programs, and there are plenty of options for online study, too. You'll take courses in medical terminology, pathology, health laws and ethics and medical coding classification systems. You'll learn about Medicaid and Medicare, two government-funded payers of medical claims.

Although certification as a medical coder is not a legal requirement, most employers prefer hiring individuals who have earned certification in the field. Certification demonstrates attainment of a certain level of professional knowledge as well as commitment to the field. Options for certification include:

  • Certified Coding Assistant (CCA), awarded by the American Health Information Management Association (AHIMA) 
  • Certified Coding Specialist (CCS), earned by examination, with specialization in physician-based or hospital-based practice

Work Environment

The medical coding process requires workers in a variety of settings. Medical coders work in hospitals, doctors' offices, specialty clinics and government agencies. Some coders are employed by the insurance industry to see claims from the other side of the table. Law firms hire medical coders when investigating billing fraud. Colleges and technical schools offering programs in medical billing and coding look to experienced professionals to train the next generation. Although most medical coders work Monday through Friday during normal business hours, some employers may have shifts working around the clock.

Some medical coders are self-employed and work from home. Though there can be rewards to having your own business, the risks are substantial. You'll have to bring in your own clients, which is difficult to do without years of experience as a coder. You may have to charge less than competitive rates to get clients to come to you. If you work alone, you have sole responsibility for any mistakes made in a claim. If you can afford to take the risks associated with starting your own business, you'll have more control over your schedule and the companies you work with.

Salary and Job Outlook

On average, a certified medical coder earns $56,000 a year with full-time employment. Hourly rates average $18.83. Pay varies, according to geographic location, years of experience, certifications, specializations and employer. Opportunities are expected to grow by 13 percent through 2026, a rate faster than average, compared with all other jobs. As the population ages, there will be more demand for workers in almost every aspect of the health care field.

References
Writer

Denise Dayton is a a freelance writer who specializes in business, education and technology. She has written for eHow.com, Library Journal, The Searcher, Bureau of Education and Research, and corporate clients.

Photo Credits

Luis Alvarez/DigitalVision/GettyImages