How to Determine the Medical Billing and Coding Salary

The medical billing and coding salary  will vary and depend on a number of factors, such as the type of facility the coder is employed at, their level of education, years of experience and the type of certifications, whether the certifications are basic or advanced, depending on areas of specialty.

Factors that Affect the Medical Billing and Coding Salary

Once a medical biller has completed a formal training program and obtained field experience they are given more authority over how health information is reported to outside agencies and third parties.

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These individuals are proficient in government healthcare programs, coverage determinations, and medical policies. They will also work closely with healthcare staff and advise them on proper patient documentation, help to devise billing and coding strategies and work to prevent fraud.

What Does a Medical Billing and Coding Specialist do?

Typically, medical billers and coders will work in a clinic, private practice or hospital and they will apply codes to medical procedures, working to ensure that a facility or healthcare worker has been reimbursed for care that has been provided. When working outside of a hospital setting or medical practice, the coder will have the option of setting up their own consulting business and work with clients, researching code methodology and working as independent auditors, providing advice on billing issues that can impact the business model for a healthcare provider. As a self-employed coder, the medical billing and coding salary will be significantly higher than what is experienced when working at a medical facility.

However, when working as an independent auditor, the coder will also be responsible for meeting their own overhead expenses, which will include maintaining an office, health insurance, liability insurance and required tax payments.  With professional training, experience in the field and accredited certification, a coder can also experience a high medical billing and coding salary when working in a teaching position.

According to statistics, the average medical biller will pursue a certificate or diploma program, both of which can be completed in six to twelve months. There are also associate’s degree programs which will take two years to complete and require students to complete general education courses in English, humanities and math.

It’s been reported that coders who have obtained a degree in this field experienced a salary that was $10,000 higher than coders that completed a certificate or degree program. The entry level medical billing and coding salary for professionals with a degree ranged from $38,000 to $42,000. Entry level salaries for coders who completed a certificate or degree program ranged from $24,000 to $28,000.

While having a degree is an advantage when entering the field, experience is another factor that needs to be taken into account.  Over half of coders who have more than twenty years of experience make an average of $52,000 a year. Coders that have ten years of experience can earn an average of $42,000.

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Where a professional medical biller and coder lives can also play a part in their annual salary. The highest salary for this field can be found in such states as Alaska, Hawaii, Washington, Oregon and California, where the average salary ranges from $54,000 to $56,000. In states where the cost of living is lower, such as in Mississippi, Tennessee, and Kentucky, the average salary is around $38,000. While location is important in the total yearly salary earned, the level of certification a coder has obtained will have a significant impact on their earning potential.

Medical billing and coding, as well as healthcare administration positions, is a fast growing field in which demand is only expected to increase.

Having an associate’s degree in coding is usually preferred in this profession. The BMSC and the PAHCS offer certifying credentials in this field. A coder can obtain certifications based on which type of environment they work in and what area they wish to specialize in, such as certified medical coder-hospital, certified coder –private practice or certified coder-billing.

Medical billers will usually work full-time for a doctor’s office or in a hospital, although there are part-time positions available as well. If a coder works for a smaller facility they can also double as the receptionist. A coder will work directly with patients, checking their insurance provider at the time of their visit, or beforehand, in order to ensure that medical procedures are covered.

Work Environment for Medical Coders

Working in a larger facility means the coder will not typically interact with patients, however, they will often communicate with patients over the phone, to arrange payment plans or to help a patient to dispute their bill. Often, billing specialists will need to act as a mediator between an insurance company and a patient in order to determine how much of a bill is covered by the insurance company and how much of the bill the patient is responsible for. Since many patients are not covered by health insurance, they will be required to pay out of pocket, prior to receiving any medical treatment, however, in an emergency room, patients are usually billed, but it will be the coder’s job to speak to a patient before they leave the ER and ensure that they have the correct billing address and work with a patient when it comes to how much they are able to pay at the time of treatment.

Working in a larger medial facility, such as a hospital, can often provide a higher medical billing and coding salary, in addition to the possibilities for advancement. Working in a smaller medical facility such as a private practice or clinic will offer a lower salary, with only part-time positions available.