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Owning a business is a great way to enable you to live and work anywhere. But it’s also a lot of responsibility. If you want to work as an employee but still have the freedom to travel, working as a medical coder may be a good choice for you.
What does a medical coder do?
I’m a certified coder and have been since 2014. First, I’ll give you the low-down on some of the lingo so you know what I’m talking about, then I’ll give you a brief overview.
There are two types of codes: diagnosis codes and procedure codes. Diagnosis codes are exactly what they sound like–codes that equate to a medical diagnosis.
Procedure codes are for any medical procedures or services that a patient may receive. This includes things included in doctor appointments, medication, surgery, and devices (like a pacemaker).
Each type of codes has its own book, updated and published each year. The codes are shorthand, because sending a claim to insurance with the full names and descriptions of diagnoses and procedures would be incredibly long and inefficient.
A claim is a bill created by a doctor’s office, hospital or other medical facility. It includes the patient’s name, date of birth, and insurance information. It also has information about the doctor and facility sending the bill. To tell the insurance company what the facility did for the patient, they use diagnosis codes, procedure codes, and of course prices.
A medical coder’s part
A coder looks at a patient’s medical records and applies codes to put on the bill. While most doctors and other medical personnel have some coding training, they are not experts and many of them do not feel comfortable doing their own coding. Additionally, coding gets updated constantly, and there are a lot of rules. Most clinicians don’t have time to take care of patients and keep up with coding too. So they write up the medical records using medical terms and descriptions, and a coder translates this information into codes.
A coder’s job includes learning about new codes and rules as they change. Some coders just look at medical records and input codes, while others also submit claims, and “work the claims,” meaning communicating with insurance companies and patients about the claim status. Those jobs usually fall into the category of medical biller or medical biller and coder.
How to become a medical coder
Before becoming a medical coder, I worked in medical billing for over 2 years without certification, but these days most companies probably require a certification.
There are main types of certifications and each has its own exam along with other requirements.
Certified Professional Coder
I’m a Certified Professional Coder (CPC). This type of coding is primarily for outpatient coding–the kinds of patient encounters that happen in doctor’s offices, imaging facilities, diagnostic labs, and emergency rooms, etc.
Many hospitals also have use for CPCs. For example, the hospital system I work for uses a lot of outpatient coding. There are also CPC specialty certifications, which can get you a job doing a specific type of coding. First you get a CPC, then you get your specialty. Some specialties you can certify in are Cardiology, Chiropractic, Hematology & Oncology, and Pediatrics.
The main CPC exam is 6.5 hours long, and I guarantee you will probably need every single minute of it. I highly recommend taking a training class from a very good teacher and studying your butt off and take multiple, timed practice tests before the real exam.
I was lucky enough to have an awesome teacher named Jeri Leong from Healthcare Coding Consultants of Hawaii. My former employer flew her out to California to train us. She also proctored our exam, and allowed us to have food and drink with us during the test. Jeri’s company does training and also employs coders for both coding and auditing with offices in Hawaii, but I think she also hires people from other states to work remotely.
The certifying body for CPCs is the American Association of Professional Coders (AAPC). If this type of certification sounds interesting to you, they offer a free Q&A webinar about certification. The webinar is live and requires that you pre-register. Here is the link: http://content.aapc.com/certification-training-questions?icn=2017_exam_dl_free_webinar_20170601&ici=hellobar
Certified Coding Specialist
A Certified Coding Specialist (CCS) is a medical coder who works primarily in a hospital setting with inpatient medical records. The certifying body is AHIMA (American Health Information Management Association). To qualify as a CCS, you must have a CCS-P, RHIA, or RHIT. CCS-P is for outpatient coding at physician offices, while RHIA (Bachelor’s degree) or RHIT (Associate’s degree) are certifications received from an accredited Health Information Management Program.
AHIMA also has specialty certifications, although these are more geared toward health information and data management rather than coding. If you would like more information about becoming a certified AHIMA specialist, you can visit http://www.ahima.org/
How much money does a medical coder make?
AAPC puts out a survey to its members every year and then compiles the results and publishes them. According to the most recent survey, a non-certified medical coder earns an average of nearly $40,000 and coders with at least one certification earn an average of almost $53,000 per year. Salaries vary by region. For more details about a specific region, see the full 2016 survey results here.
I’m not an AHIMA member, so I don’t know much about how often they do the salary surveys. But the most recent I could find was from 2012. It showed an average annual income of around $66,000 per year. Here are all the details.
For the average RVer, these annual salaries are probably more than enough for a comfortable lifestyle for 1-2 people.
Working from home as a medical coder
Not all companies will allow remote work, but many do. Many of the companies will allow contract work during their busy seasons, but there are definitely opportunities for permanent positions that even have benefits!
If you work from home, you will probably need to have your own computer and a reliable internet connection. Also, a telephone line (either land line or cell phone) are required. You will also need your own set of coding books for the current year.
Software exists that assists with coding and requires a membership fee. If an employers wants you to use it, they will usually pay for that membership. Many employers require a coder to code without software. Also, this software is no substitute for skill or knowledge. You still have to evaluate the answers the software gives you and know whether it’s correct or not.
Here is an example of a coding position you can get. A few years ago I worked a seasonal contract position re-coding older records. They required a minimum number of hours per week (I had a full-time job at the same time). I believe the company would have an incentive if they completed the contract early, so you could work extra hours if you wanted (even overtime). They wanted to know in advance what hours you planned working every week. You got a username and password to their system, and could log in 24 hours per day. Scanned medical records were viewable online through a secure network.
Coding positions usually have quotas to fulfill. You must pass audits for both speed and accuracy. An employer tells you requirements up front. I don’t remember this employer’s requirements, but they did have auditors who sent quality control reports to me and my supervisor.
One thing I know is that a legitimate coding job should never, ever ask you to give them money as a condition of the job, or to buy materials.
How to get a medical coder job
For the job mentioned above I found it through a public job board (I think it was indeed.com). I submitted a resume and cover letter online. My interview consisted of a few basic questions followed by a coding test emailed to me that I had to turn in within 24 hours. I passed the test and was offered a position for $18 an hour. I believe they also had bonuses for meeting quotas.
Both AAPC and AHIMA have job boards. You do not need to be a member to view the jobs or apply.
Some job agencies can also get you coding jobs. This is how I got my foot in the door–my first coding job was through a recruiter called OfficeTeam. I was not certified at the time, but had previous healthcare experience. I passed a coding test at their office, and got placement for a coding project at a nearby hospital. This was over 10 years ago and paid $12 per hour.
Other useful skills and education for a medical coder
Medical terminology, anatomy and physiology knowledge are very important, as is previous healthcare experience. You need to understand the terms you read in the medical records. Luckily, this knowledge is often included in the training you take for your certification exam.
Being detail-oriented is also necessary. You can’t just gloss over what you are reading, or have a lot of typos. Changing one character in the code can change its meaning entirely, so you should be good at typing. A wrong code can cause a claim rejection, which is bad news. Because the codes are alphanumeric and some are numbers-only, speed and accuracy with a 10-key numeric pad is a bonus.
You should also be able to focus and have a quiet environment. Trying to work with a lot of background noise and distractions is not ideal and can lead to errors.
This job also means working under pressure. Medical coding and billing is how healthcare professionals get paid by insurance, so there will always be a desire for you to get records coded and claims submitted as quickly as possible. If you work directly with doctors, they may also argue with you about why you can’t code things they way they want you to. Have a calm, confident demeanor. Answer professionally with responses backed up by rules and regulations. Also, as mentioned, many of these jobs have quotas they want you to meet, and it’s possible to lose your job if you consistently cannot meet expectations (just like any other job). However, I find expectations by most companies are reasonable and attainable for a well-trained coder.
Is being a medical coder fun?
I like it. For me, it’s very black and white in a world of grey, and is comforting when other parts of my job cause confusion or uncertainty. I also like working with doctors when that’s an option. Most of the doctors I’ve worked with are awesome people who are more than willing to share their knowledge with me, and appreciate my dedication to my job.
I also enjoy reading medical records. I learn something new all the time about illness and disease and how doctors treat it. This information is invaluable to me both as a healthcare professional and a patient. Sometimes, things don’t work out and it’s sad to read about that. But it’s great when you see in records that a patient responds well to treatment and recovers.
I also see this job as a type of advocate for both doctors and patients. By coding records as accurately as possible, you justify the highest insurance reimbursement possible with the least amount of delays from adjudication or denials. This means doctors receive payment for their hard work, and patients get coverage and hopefully pay less out of pocket due to a rejected claim.
There are other jobs involving coding or where coding is a useful skill. My current job is one of them. I will talk about it in a future post.