According to the 2011 annual salary survey conducted by the American Academy of Professional Coders (AAPC), salaries earned by professional medical billers and certified medical coders vary widely by job duties and geographic area. That said, the earnings potential of medical coders and medical billers is above minimum wage for their locality. This is understandable since medical billing and medical coding professionals have specialized training, and they practice a skills that touch on all aspects of healthcare delivery. Their training does not only involve them in reimbursement issues, but also issues of appropriate documentation of provided medically necessary services. They are a resource of somewhat esoteric knowledge that ensures compliance with applicable government programs and private commercial contracts.
Professional medical billers and certified medical coders are paid well not only for what they do, which is assemble bills, post payments, and reconcile accounts, they earn their salaries by being cognizant of the various requirements needed to manage information regarding healthcare delivery. They are masters of the specialized language of medical code, assigning appropriate codes to accurately describe medical services and conditions. The integrity of a medical practice’s interactions with outside entities relies on the successful performance of professional medical billers and certified medical coders.
Medical Billing and Coding Jobs
Naturally, medical billers and medical coders in entry level positions earn less than those more experienced in the field. Entry level positions include data entry, charge entry, payment posting, collecting, and claim reconciliation. All of these jobs require a basic understanding of medical coding and the healthcare reimbursement system, but they require little professional judgement. For instance, charge entry is the role of entering codes and associated charges in a database for submission to third-party payers. Account reconciliation is the posting of payments and patient financial obligations from explanations of benefits (EOBs) as directed by insurers when a check is received. Collections is the act of contacting patients to encourage payment for their obligations under the terms of their insurance contracts. Professionals who perform these jobs are vital to a medical practice’s financial health, and they are compensated accordingly.
With experience and more advanced training, professional medical billers and certified medical coders are given more authority over how health information is reported to third-party payers and outside agencies. They are conversant with the coverage determinations of government healthcare programs, the medical policies of commercial healthcare insurance, and with the various medically unlikely edits and code combinations that insurers use to process claims. They advise healthcare providers of documentation requirements, and they help devise coding and billing strategies to accurately describe services provided in order to legally maximize reimbursement. They prevent fraud and abuse of the healthcare reimbursement system, and they protect a medical practice, and individual providers, from legal exposure to charges of the same. Medical billers in management positions monitor trends in the overall accounts receivable in order to identify deficits in the practice’s billing processes, rather than reconciling individual accounts.
Auditors compare available documentation to assigned codes, both before and after submission to third-party payers. When claims are found to be improperly denied, they manage appeals to payers on a case-by-case basis. When coding methodologies are found to be out of alignment with available documentation, auditors conduct training with healthcare providers to improve coding and documentation skills. Compliance personnel apply the published statutes, contractual obligations, and industry standards to coding and billing practice in order to ensure that bills and codes are submitted in such as way that meets legal definitions of described services, that modifiers are applied appropriately, and that contractual obligations are met or exceeded to provide quality care and accurate reporting of that care.
Outside the medical practice or hospital setting, some professional medical billers and certified medical coders open their own consulting businesses, working with clients to research code methodology, working as independent auditors, and providing professional advice on coding and billing issues that may impact a healthcare provider’s business model. As self-employed individuals, medical coding and medical billing consultants command the highest salaries, but they also incur the most expenses. As self-employed professionals, they are required to meet their own overhead expenses, including maintaining an office, liability insurance, their own health insurance, retirement plan, and required tax payments without the aid of an employer. An alternative career path that is also well-paid is that of educator. With professional training, accredited certification, and experience in the field, many medical billers and medical coders train the next generation of billers and coders to prepare them for the well-paid challenges and duties that await them.
Of the medical coders and billers surveyed in 2011, the latest year for which statistics are available, professionals with a bachelors’ degree earned, on average, $10,000.00 more per year than coders and billers without a degree. The national average was $51,825.00 for degree-holding professional coders and billers versus $41,802.00 per year for non-degreed coders and billers. This is the national average across the gamut of professional opportunities available.
While holding a degree is an advantage when entering the field, experience is another kind of training that needs to be taken into account. More than half of professional medical billers and certified medical coders who have more than twenty years experience earned in excess of $50,000.00 per year according to the latest survey. More than a quarter of those who have at least ten years experience earned the same amount. Having the ability to stay with this profession and learn on the job has its rewards. It is a demanding field, but for those who choose to stick with it, and master the fundamentals, the rewards are accessible. Professional medical billers and certified medical coders who continue their education through seminars, professional associations, and educational programs offered by Medicare, Medicaid, and commercial insurance companies stay on top of the issues that affect the industry, and, through experience, they provide positive results to their employer’s business operations.
Location is Important
Where professional medical billers and certified medical coders practice their trade affects their salary. In the Pacific states of California, Oregon, Washington, Hawaii and Alaska, the average salary for all medical billers and medical coders is $57,334.00 per year. In New England, the average annual salary is $47,852.00. In regions where the cost of living is lower, such as in Kentucky, Tennessee, Mississippi, and Alabama, the average annual salary is $39,830.00. Though location is important in the total salary earned, the relative parity of income earned by professional medical billers and certified medical coders is consistently above the average for each geographical region.
With appropriate preparation for entering the field, entry level medical coding and medical billing jobs consistently pay better than unskilled administrative positions. With experience, the earning potential of medical billers and medical coders only increases.
Healthcare administration, medical coding and medical billing in particular, is a growing field in which demand is only expected to increase according the U.S. Bureau of Labor Statistics. As the regulatory environment changes due to the Patient Protection and Affordable Care Act of 2010, the implementation of the International Classification of Diseases-10th Edition (ICD-10) for diagnostic and inpatient procedural coding, and the increased focus on preventing fraud and abuse in the healthcare reimbursement system, the potential for more billing and coding positions, and their importance in conducting the business of healthcare, means that good salaries will continue to be paid for professionals who can meet the expectations and requirements of potential employers. People considering entering the field are encouraged to get a solid formal education in the basics, and to continue that education in order to command top salaries over the course of their individual career path.