What Is a Medical Coder and How to Become One

By ZipRecruiter Marketplace Research Team

A medical coder works in the billing department of doctor's offices, hospitals, or other medical facilities. Medical coders transfer healthcare claims into universal medical codes for insurance reimbursement. To work as a medical coder, you must have great attention to detail and a solid base knowledge of medical terminology, procedure and visit authorizations, and insurance billing procedures. Having a degree is not required, but many employers prefer candidates who have an associate degree in medical coding or the Certified Professional Coder (CPC) credential. When you first start in this job, your employer may have you shadow other billing staff members and be supervised when you submit your first few claims.

Employers have varying preferences for the qualifications that you should have to apply for a medical coding job, though most medical coders have at least a high school diploma or equivalent. Some aspiring medical coders complete a medical coding certificate program or earn an associate degree in medical billing. These programs provide you with hands-on experience in medical billing software and teach you how to understand the different billing codes required to file claims. Many employers provide on-the-job training and start medical coders as billing department assistants; as an assistant, you learn how to navigate through insurance claims procedures and the proper ways to translate medical services into billing codes. Certification is not required, but those who wish to become certified may take the certification course and exam administered by the Registered Health Information Technicians (RHIT) Organization.

Traditionally, medical coders work in doctors’ offices and hospitals, but those options are only two of many. Some healthcare facilities outsource their billing to a medical coding agency. Government healthcare agencies need medical coders to handle insurance claims of clients. Insurance companies hire medical coders to process requests and verify the accuracy of the application. Law firms that handle cases involving medical services may have a medical coder on staff to decipher medical records. Experienced medical coders may teach in post-secondary medical coding and billing programs. There may also be opportunities for medical coders to work from home or another remote location outside of the office.

The process to become a medical coder varies, depending on the employer and which route you choose to take. To start, you must earn a high school diploma or equivalent. Some continue their education by completing a medical coding certificate program at a vocational school or an associate degree in medical billing from a community college. Certification is not required, but it is available for those who wish to stand out in the job market. You may also choose to seek entry-level positions right out of high school. Many employers provide on-the-job training for aspiring medical coders; they hire you as a billing department assistant, then move you into medical coding once you are proficient with insurance billing procedures.

Job Summary

We are seeking a detail-oriented and organized medical coder to join our growing team. In this position, you will play a key role in reviewing and analyzing medical billing and coding for processing. You will review and accurately code office and hospital procedures for reimbursement.

Duties and Responsibilities

• Receive and review patient charts and documents for accuracy
• Ensure that all codes are current and active
• Report missing or incomplete documentation
• Meet daily coding production
• Update and maintain document lists
• Performs accurate charge entries
• Ensure proper coding on provider documentation
• Serves as a resource regarding insurance resolutions and coding questions
• Handles co-pays, balances, and charge posting
• follows coding guidelines and legal requirements to ensure compliance with federal and state regulations
• Performs additional duties assigned by the coding manager as needed

Requirements and Qualifications

• High school degree or equivalent; Bachelor's degree in related field preferred
• Medical Coding Certificate; RHIT or CPC by AAPC or AHIMA license; meet state licensure requirements
• Maintain coding certification and attends in-service training as required
• Two (2) years of medical coding experience
• Understanding of medical terminology, anatomy, and physiology
• Ability to work independently or as an active member of a team
• Strong computer skills in data entry, coding, and knowledge of Electronic Medical Record software; Microsoft Office Suite
• Accurate and precise attention to detail
• Ability to multitask, prioritize, and manage time efficiently
• Excellent verbal and written communication skills
• Goal-oriented, organized team player