New York State Medical Billing and Coding Careers

As more people have access to health insurance through the Affordable Care Act, healthcare providers require support staff to maintain records and to bill the correct payer. Patients may never see the medical coders and billers in the doctor’s office, but these invisible individuals are vital to the medical industry. The Bureau of Labor Statistics predicts the job outlook for health information technicians to grow at 15 percent through 2024. The New York – White Plains – Wayne, NY-NJ Metropolitan Division is one of the metropolitan areas in the United States with the highest levels of employment for this occupation.

New York State does not require medical coders and billers to be professionally certified. However, according to the American Academy of Professional Coders (AAPC), the more credentials or certifications a coder has, the more they earn. Certification for medical coding and billing can be earned through the AAPC or the American Health Information Management Association (AHIMA). Although medical coders and billers can take the test to earn certification with only a high school diploma, training from an accredited institution is highly recommended.

Becoming a Medical Coder and Biller in New York

When a patient goes to the doctor or hospital for treatment, the provider makes notes in the chart about what was performed. This information must be transcribed into codes for documentation and billing. Medical coders and billers should have a basic understanding of physiology and anatomy, as well as the medical coding lists, Current Procedural Terminology (CPT) codes, International Classification of Diseases (ICD), and the Healthcare Common Procedure Coding System (HCPCS). In addition, there are healthcare guidelines which must be followed.

Although medical coders and billers work hand-in-hand, coders specialize in the conversion of procedures into codes. Billers work with the financial aspect of the business and must have knowledge of insurance companies, Medicare, and Medicaid. Claims made to payers must have the right information or they will be denied, which means that the provider is not paid for providing treatment. Medical coders and billers are an important member of the healthcare team, even though they aren’t directly providing treatment to patients.

According to the BLS, medical record technicians should be detail-oriented and have good analytical skills. Because technology is such a big part of their job, individuals should be comfortable using today’s computer programs and apps to input or find information. Healthcare records are considered private data. Medical billers and coders need to have integrity and ethics to handle this secure information. Good interpersonal skills are also recommended to deal with insurance companies, patients, and other healthcare providers.

What Education should I get for a Medical Billing Job in New York?

When searching for a program to learn medical coding and billing, students will find three types:

  • Certificate – six to twelve months of training
  • Associate’s degree – typically a two-year program
  • Bachelor’s degree – a four-year college program 

Classes in each program include courses in anatomy, medical terminology, and healthcare ethics. The exact classes depend on each college’s requirements. For example, at Trocaire College, students in the associate’s degree program take a courses in pharmacology, health statistics, and pathophysiology, in addition to general courses such as philosophy. These additional classes help students learn important critical thinking and deductive reasoning skills.

When earning a bachelor’s degree, students receive a well-rounded education because general education courses are required for graduation along with courses that meet the requirements of the course of study. According to a 2014 AAPC study, education pays off. AAPC members with only some college or an associate’s degree made around $46,815 annually, while those with a bachelor’s degree made an average of $54,552. Post-graduate education increased earning power significantly. Professionals with a master’s degree or higher earned almost $90,000 on average.

New York Institutions With Medical Coding and Billing Programs

When deciding on an institution to matriculate, it’s important to make sure that the classes lead toward certification in either the AAPC or AHIMA. Because the industry is booming, there are many scams. If something sounds too good to be true, it probably is. It is practically impossible to learn the coding and billing industry in just a few weeks. Expect the program to take a minimum of six months. In addition, the program should include an externship, where students actually work in the field in conjunction with the school.

  • Associate Degree or Certificate
  • Elmira Business Institute – Elmira
  • Trocaire College – Buffalo
  • Touro College – New York
  • Mildred Elley School – Albany
  • Bryant & Stratton College –  Getzville, Orchard Park  (no certificate)
  • The College of Westchester – White Plains
  • DeVry University – Queens, Manhattan
  • Certificate Only
  • Hunter Business School – Levittown
  • Sanford Brown Institute – New York, White Plains, Garden City
  • Ridley-Lowell Business & Technical Institute – Poughkeepsie
  • Branford Hall Career Institute – Bohemia, Albany
  • EDP School of Computer Programming – Brooklyn
  • CITI, Center for Instruction, Technology & Innovation – Mexico, NY
  • New Life Business Institute – Jamaica
  • Alfred State College -SUNY – Alfred
  • Nassau Community College – Garden City
  • ASA College – Brooklyn, Manhattan
  • Community colleges
  • Bachelor Degree
  • Trocaire College – Buffalo
  • Touro College – New York (includes post-graduate degrees)
  • Bryant & Stratton College – Getzville, Orchard Park 
  • The College of Westchester – White Plains
  • DeVry University – Queens, Manhattan

Online Programs for Medical Coding

There are many online programs. Students should carefully check out each program to ensure it meets their needs. Kaplan University is a top-ranked college with U.S. News, coming in tied at #79 for Best Online Bachelor’s Programs.  Kaplan offers a master’s and bachelor’s degree in health information management, and they have a shorter certificate program. Grantham University offers an associate’s degree in medical coding and billing through their online program, preparing students to take the AHIMA certification exam.

How to Apply to a Medical Billing Program in New York

When applying to colleges, students should check out the application requirements for the school. Generally, high school transcripts or the GED are required, along with any transcripts from other colleges which have been attended. Four-year colleges usually require the SAT or ACT. For example, Trocaire College requires students to have earned a 2.0 GPA or better in their laboratory science classes to enter the A.A.S. in Healthcare Information program, and algebra and biology are required high school classes for the B.S. in Healthcare Information. Students who do not have these credentials may need to take a prerequisite class at the college or in a community college before beginning some of their classes required to graduate.

Medical Billing and Coding Certification in New York

When earning certification, the choice is either the AAPC or AHIMA. Neither organization is better than the other, and both are highly regarded in the industry. 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 Entry Level Exams for Medical Coders in NY

With AHIMA, applicants need to have a high school diploma or the GED to sit for their entry-level exam, the Certified Coding Assistant. AHIMA highly recommends that test-takers have six months of experience and have completed a formal education program that includes CPT and ICD-10 coding, medical terminology, and anatomy and physiology. Once the initial certification is earned with AHIMA, there are specialty and advanced certifications to demonstrate more experience and competency.

Applicants need approval from AHIMA to sit for the two-hour exam, but they do not need to be a member of AHIMA. (It should be noted that members do receive a discount on the test fees.) Tests are taken at any Pearson VUE Center. New York City has 10 locations within the heart of the city. Albany lists five centers. Most cities with a college will have a Pearson VUE Center. Applicants schedule a time to take the test. Some coding manual are allowed during the exam.

AHIMA’s certification exam consists of 100 multiple-choice questions, 90 which are scored and 10 are considered pre-test questions. However, test-takers do not know which questions are which when taking the exam. Six areas of competencies are covered in the test:

  • Clinical Classification Systems
  • Reimbursement Methodologies
  • Health Records and Data Content
  • Compliance
  • Information Technologies
  • Confidentiality and Privacy 

Where Can I find Certified Professional Coder Certifications in New York?

The Certified Professional Coder (CPC) is the entry-level certification with the AAPC. It is recommended that test-takers have an associate’s degree or higher when taking this test, but experience is not required. The CPC is granted to those who pass the exam and have two years of experience in the industry. Without that experience, applicants receive an Apprentice designation (CPC-A). Once an applicant has experience, the apprentice designation is removed.

The AAPC CPC exam is just as extensive as the AHIMA certification process. Students should understand:

  • Medical terminology
  • Anatomy
  • CPT codes 10,000 through 60,000 series
  • ICD-10 codes
  • HCPCS Level II
  • Billing compliance 

The AAPC offers practice exams and tips for taking the exam.

As with AHIMA, members get a discount on exam fees, but applicants are not required to join AAPC to earn certification. AAPC test takers take the exam at a designated site. The upcoming exam dates in New York have not been updated on the AAPC website, but most major cities will have dates throughout the year. Test takers are given five hours and 40 minutes to take the 150-question multiple-choice exam.

Maintaining Your New York Coding Certification

Although New York does not require health records technicians to be certified, the industry is certainly moving in that direction. Once a coder and biller is certified through AAPC or AHIMA, continuing education is required to maintain that license. Both organizations offer classes and workshops through their website.

AAPC also has local chapters in many communities in New York, such as Albany, Middleton, Utica, and the Bronx. Most chapters have regular meetings in which members can earn continuing education units (CEUs). AAPC’s 2016 national conference is in Orlando, FL, and they are holding regional conferences in Anaheim, CA and Atlantic City, NJ in 2016.

AHIMA holds an annual convention where its members can earn CEUs and network. In 2016, the convention is in Baltimore, MD in October. The location changes annually. The New York Chapter Health Information Management Association (NYHIMA) also holds an annual conference in New York State. In June 2016, the location is in Huntington. NYHIMA has local chapters which provide additional opportunities for CEUs.

How to get a Medical Billing Job in New York

As more people have access to healthcare, the demand for medical billers and coders will only increase. According to Careeronestop the top five fastest growing industries are all related to healthcare. It’s not just doctor’s offices or hospitals which require health information technicians. Long-term care facilities, pharmacies, and insurance companies are also in need of healthcare support services. Any business which bills insurance or provides healthcare treatment will require medical billers and coders.

The average salary for medical coders and billers in New York is $42,250, but this will vary by location and experience. Urban areas tend to have higher salaries, but because rural areas also need record-keepers, jobs can be found in every community. The AAPC estimates that the unemployment rate for certified coders and billers is less than two percent, while the national average for all jobs is a little over seven percent.

There are many job boards which list jobs for medical coders and billers. NYHIMA has a listing for jobs in New York and international locations. The jobs listed on their job bank require the AHIMA credentialing. For example, Maimonides Medical Center in Brooklyn needs coders and billers with the CRC as the preferred credentials. Bassett Healthcare Network Cobleskill Regional Hospital requires an associate’s degree and certification from AHIMA.

New York Department of Labor Career Services also lists job openings. Transcare, in Brooklyn, has an opening for a Medical Billing Claim Follow-Up Representative, which requires insurance experience and a high school diploma, but does not specify if credentialing is required. NYU Medical Center lists a number of openings for Billers in different departments. A high school diploma is required, as is experience and coursework, but no credentials are specified.

Another job board, NYCityWorks has an extensive list of jobs. Type in medical coding and billing in their search engine, and it pulls up a long list of jobs in the area. This network is available for many New York counties, also. Planned Parenthood of Nassau County currently has an opening for a Medical Biller, asking for experience and a high school diploma, but not specifying certification. Weill Cornell Medicine’s opening for an Account Coding Specialist requires the CPC.

Take a step toward a rewarding career by earning certification in medical coding and billing. Be part of an industry which is only growing and will continue to be needed as Baby Boomers and GenXers get older.