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What is a Medical Coding Specialist?

By Steve Smith

The information presented here is true and accurate as of the date of publication. DeVry’s programmatic offerings and their accreditations are subject to change. Please refer to the current academic catalog for details.

 

February 21, 2024

6 min read

Medical coding and billing are important processes in modern healthcare, essential to the accurate creation and maintenance of patient medical records, patient billing and reimbursement to healthcare providers. Medical coding specialists play an important role in this healthcare information management ecosystem. What is a medical coding specialist? In this article, we’ll answer that question and describe the medical coder’s duties and responsibilities, how you can prepare to pursue a career in medical coding and what skills you need to perform effectively in this career.

What Do Medical Coding Specialists Do?

Medical coding specialists play an important role in the wider occupational area of medical billing and coding. They work in a variety of healthcare or healthcare-related settings, such as hospitals, group medical practices, nursing facilities and insurance companies. The medical coder’s main responsibilities are to assign codes that correspond to medical diagnoses and procedures performed by healthcare providers and facilities and enter them in patient records. Their duties are likely to vary, depending on the type and size of the setting in which they work. Some of their other responsibilities may include:

  • Monitoring medical records:

    Because the accuracy of medical records is so crucial in healthcare, it’s likely that a medical coding specialist may regularly study electronic medical records (EMRs) to verify their accuracy.

  • Submitting claims:

    Medical coding specialists may be responsible for submitting claims to private insurance companies or government payers, such as Medicare, to obtain reimbursement for their provider’s services. 

  • Preparing billing statements:

    Insurance often doesn’t cover the full cost of medical diagnostics or procedures. That’s when the provider’s medical coding specialist may prepare and send a billing statement to the patient itemizing anything they’re responsible for paying, and the payment terms. 

  • Protecting patient privacy:

    As both a regular job responsibility and an ethical obligation, medical coders must practice discretion and maintain and enforce the laws governing patient privacy, such as the privacy rule from the Health Insurance Portability and Accountability Act (HIPAA). 

Becoming a Medical Coding Specialist

Education, experience and certification are all important steps along the path to becoming a medical coding specialist. At DeVry, we can help you take the first step with education designed to help you learn the skills that this career requires.

Your medical coding education

According to occupational outlook data from the U.S. Bureau of Labor Statistics (BLS), medical records specialists such as medical coders typically need a high school diploma and a postsecondary certificate to enter this occupation, and some employers may require an associate degree.

At DeVry, you can prepare to pursue a career as a medical coding specialist by earning our online Undergraduate Certificate in Medical Billing and Coding. Our 100% online medical billing and coding classes begin with every 8-week session and include our Digital Health Core series of courses, designed to help students develop interdisciplinary skills required in today’s evolving health information field. This undergraduate certificate program will also help you practice your skills in a practical way by providing hands-on experience with industry-standard software systems and simulated patient records. You also can pursue an Undergraduate Certificate in Medical Billing and Coding - Health Information Coding (HIC), designed to teach you advanced coding to record the range of services provided in inpatient care.

Coursework in both certificate programs explore the natural sciences, anatomy and health information technology, and cover topics like medical terminology, ethics, compliance, patient privacy, electronic medical records and the digital aspects of the healthcare delivery system. If you elect to further your studies at DeVry, eligible courses in our Undergraduate Certificate in Medical Billing and Coding apply toward our Associate Degree in Health Information Technology when you pursue the Health Information track.1

Medical coding certifications

Certification is another important step along this career path. As noted by the BLS, employers may prefer to hire medical coders who’ve earned one or more industry-recognized certifications or expect them to earn certification shortly after being hired. A few examples of certifications relevant to the medical coding occupation are offered by the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA). 

The AAPC’s Certified Professional Coder (CPC) credential verifies coders’ skills in a physician office setting, demonstrating knowledge in physician-provider documentation review, coding proficiency, compliance with regulatory requirements and other areas.

AHIMA’s Certified Coding Specialist (CCS) certification is a credential for coders who typically work in a hospital setting, and who possess proficiency with the ICD and CPT coding systems and may be more of interest to those who are interesting in the coding side of medical billing and coding, rather than the billing side.  

Coursework in our Medical Billing and Coding certificate program aligns with the CPC certification exam, and our Medical Billing and Coding – Health Information Coding certificate program includes material addressing the CCS certification exam. Industry-relevant certifications typically require sitting for and passing exams and have their own unique and specific eligibility and renewal/recertification requirements. 

Gaining experience in medical coding

Everyone’s career journey is different. Depending on your location, personal and professional goals or other variables, you may come across different ways to gain experience for employment or career advancement in medical coding. To gain experience as a coding specialist, look for opportunities to work in health care settings like hospitals or medical practices that regularly employ coders as interns or in entry-level positions Earning certification can also be a way to gain experience. If you choose a larger healthcare setting where there may be greater potential for advancement, you may start out in an entry-level position then move into a medical coding specialist position after gaining experience. Another way to gain exposure to the industry is to attend medical coding seminars or participate in job shadowing opportunities.   

If a work-from-home position is a better fit for you, some insurance companies, healthcare IT companies and other healthcare industry employers hire coders with the proper training but little to no experience for remote jobs.

Medical Coding Specialist Skills

Medical coders need to have a variety of technical and workplace skills to perform well in this occupation. Skills acquired through technical training allow them to excel in the use of coding software and manage billing requests. Soft skills like organization, multi-tasking, collaboration and communication enable coders to work more efficiently, empower them to effectively manage relationships with other medical personnel, and help them handle potentially tricky situations like patient billing conflicts.

Some of the technical skills medical coding specialists need include:

  • Computer skills:

    Because most of the medical coder’s work is done online using medical coding software, computer proficiency is an essential skill and will enable the coder to work more efficiently.

  • Analytical skills:

    Medical coders must have the ability to analyze patient records carefully to assign the correct codes to diagnoses and procedures. 

  • Clinical documentation:

    Familiarity with clinical documentation allows coding specialists to effectively manage a variety of paper and electronic medical records, reports and other documentation of patient interactions. 

Considering a Career in Medical Billing and Coding?

At DeVry, we can help you gain the knowledge to prepare to pursue a variety of medical billing and coding careers.

Gain hands-on training with simulated patient records while you learn essential medical billing and coding skills like medical terminology, international classification of diseases (ICD) coding, health insurance and reimbursement, current procedural terminology (CPT) and health services and information systems. The material in our Medical Billing and Coding, and Medical Billing and Coding – Health Information Coding certificate programs may also prepare you to pursue industry-relevant certifications.

At DeVry, choose the schedule that fits best with your goals and busy life. You can earn your Undergraduate Certificate in Medical Billing and Coding in as little as 10 months on an accelerated schedule, or 1 year and 2 months on a normal schedule.2 Classes start soon!

1For the Undergraduate Certificate in Medical Billing and Coding, all but one course stacks into our Associate Degree in Health Information Technology. At the time of application to the next credential level, an evaluation of qualifying transfer credit will occur and the most beneficial outcome will be applied. Future programmatic changes could impact the application of credits to a future program. Refer to the academic catalog for details.

2Per 12-month period, accelerated assumes completion of 3 semesters, enrollment in 3-13 credit hours per semester and continuous, full-time year-round enrollment with no breaks. Normal assumes completion of 2 semesters and full-time enrollment in 3-13 credit hours per semester.

8-Week Class Sessions

Classes Start January 6, 2025

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