A Career in Medical Billing and Coding in California

The Affordable Care Act (ACA) has made healthcare available to millions of Americans who were previously uninsured. It’s estimated that about 750,000 people in California remain uninsured, but efforts are being made to get them to take advantage of subsidies to get healthcare. The healthcare industry is only going to keep booming as population increases. One career that is growing within the profession that doesn’t directly relate to patient care is medical coding and billing.

The State of California does not require that medical coders and billers have certification to obtain employment. However, employers may demand that their employees be nationally certified by either the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC). As with certification, education is not necessarily required to earn certification, but it is highly recommended and preferred by employers.

Although coding and billing are separate entities, they are related to each other. In medical coding, the coder translates the doctor’s notes into codes which will be sent to the insurance provider or other payer. The biller handles the financial end of the transaction, ensuring that payment is properly processed through each responsible individual. Coders and billers must have knowledge about the different coding systems, the CPT codes, for procedures, ICD codes, for diagnosis, and HCPCS codes, for additional products and procedures not included in the CPT codes.

How to Become a Medical Coder and Biller in California

Based on statistics from 2014 from the Bureau of Labor Statistics (BLS), California has the highest level of employment for medical record technicians. The average annual salary is $45,380 in California, while the average salary across the United States is $38,860. Santa Cruz-Watsonville is third on the list of highest paying metropolitan areas at $57,160, with Oakland and San Jose coming in fourth and fifth on the list. The city of Los Angeles is the metropolitan area in the United States with the highest levels of employment for medical coders and billers, but opportunities are abundant in both rural and urban areas. Any organization which provides healthcare services will require medical coders and billers to ensure payment.

To enter most medical billing and coding programs, a student will need their high school diploma or GED. Students may earn a certificate, an associate’s degree, or a bachelor’s degree. A certificate program takes six to twelve months, while the associate’s degree is generally completed in two years. A student will receive more practice time in a program where a degree is earned. Always look for a program which leads to earning certification either from the AAPC or AHIMA. Programs which take less than six months are most likely a scam. A good program will include an externship, where the student gets real-life practice in a healthcare office setting.

Students interested in medical coding and billing should also have the skill set to be productive in the healthcare environment. Integrity and ethics are a must; as healthcare privacy laws are very stringent. Medical coders and billers should be detail-oriented and have good technical skills to keep up with the software components of the job. Government HealthIT recommends that individuals figure out which healthcare industry interests them, because medical coding in a long term care facility is different than that of an orthopedic center.

Students should expect to take classes about coding, but there are generally classes about anatomy and physiology, healthcare ethics, and healthcare technology. Before entering a program, students should have good keyboarding skills, or they should plan to take courses to improve their abilities.

California Medical Coding and Billing Schools

According to a survey from AAPC, the more credentials and experience a coder or biller has, the more money they earn. The key to getting a good education is to do the research about the school before enrolling. California has more than 70 institutions which offer education towards certification. Students need to check out tuition and fees before entering the program, as this can vary by location and school. For example, estimated tuition at Westwood College in Anaheim is around $15,000 for the associate’s degree, while at Cypress College in Cypress may only cost about $1,100 for an in-state resident. 

  • Bachelor’s Degree, Associate, and Certificate
  • Allied American University, Laguna Hills
  • Loma Lind University, Loma Linda includes post-master’s education
  • National University, La Jolla, includes post-master’s programs
  • University of Antelope Valley, Lancaster
  • Westwood College, multiple locations
  • Associate Degree and Certificate
  • Advanced College, South Gate
  • American Career College, multiple locations
  • Asher College, Sacramento
  • Canada College, Redwood City
  • Career Networks Institute, Orange
  • Carrington College California, multiple locations
  • Casa Loma College – Van Nuys
  • City College of San Francisco
  • Charter College – Canyon Country
  • Concorde Career College, multiple locations
  • Cosumnes River College, Sacramento
  • Cypress College, Cypress
  • East Los Angeles College, Monterey Park
  • Four-D College, Colton
  • Institute of Technology, Inc. Clovis
  • Kaplan College, multiple locations
  • Mayfield College, Cathedral City
  • Mendocino College, Ukiah
  • MTI College, Sacramento
  • Santa Barbara City College, Santa Barbara
  • Southwestern College, Chula Vista
  • United Education Institute, Huntington Beach
  • Wyotech, Long Beach 

Where Can You Find Online Medical Billing Schools?

Technology is making education even easier to obtain with online programs. Carrington College California offers an associate’s degree in medical coding and billing online. Grantham University in Kansas also offers a program which can be completed online. Students take 64 credits to complete the associate’s degree. 

How to Apply to a California Medical Billing Program

California offers an official college and career planning website at Californiacolleges.edu, with information about applying to each individual school. A high school diploma or equivalent will most likely be required, and some colleges may require certain classes before admission to the medical coding and billing program. Lab science or algebra is a common class that is required, but most colleges have methods to make up any deficiencies in a student’s education. 

How to Earn Medical Coding Certification in California

When earning certification, the choice is either the AAPC or AHIMA. AHIMA directs their certifications for coders in a hospital setting, while AAPC covers other health-related fields, but it does have certifications for an inpatient hospital setting. Inpatient billing and coding does tend to be more detailed and difficult than outpatient. Expect to be required to have more extensive experience when applying for jobs in an inpatient setting.

AHIMA Medical Coding Tests in California

AHIMA is a highly recognized organization of medical records technicians across the United States. Earning certification with AHIMA generally leads to positions in a hospital. The entry-level exam is the Certified Coding Assistant. Applicants sitting for the two-hour examination will need to have their high school diploma or equivalent. No experience is required to take the test; however, it is highly recommended. AHIMA suggests at least six months of working in the field before taking the exam, in addition to completing an educational program designed to prepare the student to take the Certified Coding Assistant test.

Pearson VUE Center is the official site to take the examination. There are centers in most major cities in California, Fresno, Santa Maria, San Francisco, San Diego, and Los Angeles. Applicants apply with AHIMA to take the exam, then schedule a time to take the exam. Applicants do not need to be a member of AHIMA to sit for the exam, but membership does offer a substantial discount on the exam fee.

The exam for the Certified Coding Assistant is 100-questions, all multiple choice. Ninety of these questions are scored and 10 are considered pre-test exams, although the test taker will not know which questions are scored and which aren’t. Students should expect to cover six areas of competency, including coding, compliance, healthcare IT protocols, reimbursement, and health records. Study guides and practice exams are available through AHIMA.

Where You Can Find AAPC Exams in California

The AAPC is also a highly recognized organization within the healthcare industry. The entry-level exam, the Certified Professional Coder (CPC) is designed for outpatient settings, such as a physician’s office. AAPC recommends having an associate’s degree or higher before taking the CPC exam, but it is not required. To get the full certification, an individual will need two years of more experience in an office setting. If an applicant does not have this experience, they receive an apprentice designation, CPC-A, which will be removed when the experience is earned.

Applicants taking the CPC exam should have a good understanding of anatomy, ICD-10 codes, the HCPCS Level II codes, and medical terminology. Practice exams and test-taking tips are available through the AAPC. AAPC does offer student memberships for those earning their degree, does provide a discount on the tests. 

When taking the test, applicants are given five hours, 40 minutes to complete the 150 multiple choice questions. The AAPC schedules tests in different cities as examiners offer it. For example, in March 2016, the test is scheduled to be given in Chula Vista and San Francisco, then in April, it’s scheduled for West Los Angeles, Chula Vista, Pasadena, and San Diego.

Keeping up with Your Medical Billing and Coding Certification in CA

After you are certified, employers will require medical coders and billers to maintain their certification, typically every 2 years. AAPC requires 36 units of continuing education units (CEUs) every two years to keep your certification current. CEUs can be earned through webinars online, events with local chapters, and national events. In California, some chapters may be more active than others. The Chula Vista AAPC Chapter is very active. Not only does it offer the exam at regular times throughout the year, it also holds regular meetings with professional speakers where members and non-members can earn CEUs. In September, a regional conference will be held in Anaheim.

AHIMA also requires CEUs for recertification. The CCA requires 20 CEUs every two-year cycle, but webinars are readily available through their website. AHIMA has a national convention. In 2016, the event will be held in Baltimore, Maryland, but in 2017, the national convention is scheduled for Los Angeles. The California Health Information Association (CHIA) is another avenue for CEUs and information about medical coding and billing. Their annual convention is in June, 2016 in Long Beach. CHIA also offers local chapters with regional and local events.

How to Find a Medical Billing and Coding Job in California

According to John D. Halamka, MD, MS, is CIO of Beth Israel Deaconess Medical Center, Chairman of the New England Healthcare Exchange Network and Co-Chair of the HIT Standards Committee, physicians and healthcare providers must invest in IT to move forward in their practice. Medical coders and billers will be required to keep each practice moving forward financially.

California medical coders and billers have many job boards to access to find employment. CHIA offers a job board, which is new to their site. Current openings include an outpatient surgery coder with the Certified Coding Specialist certification from AHIMA at Altegra Health in Los Angeles. Most employers want experience, but according to AAPC, more apprentices are finding employment.

Jobs.net currently lists almost 600 jobs for medical coding and billing specialists. In Pasadena, Saint Cabrini Healthcare has an opening for a billing specialist but doesn’t list which certification they prefer. Offisol has an opening for a biller in West Hills, and they do not specify a particular certification, but require a GED and knowledge of medical billing.

Although medical coding and billing jobs from home can be found, this type of employment is not the norm, especially for beginners. Healthcare providers are bound by strict laws when sharing private health information. Any provider will want to ensure their patient’s data is secure before allowing just anyone to provide medical coding and billing. If a school promises that a student will be able to work from home, it is most likely a scam. Expect to work in the industry in an office for many years before being allowed to access records in your home.

Medical coding and billing can be a rewarding career that is set to grow at the rate of about 15 percent over the next ten years. This is more than twice as fast as most careers. Medical health technicians have excellent job prospects locally and nationally. Make a move into the healthcare field.