A Billing and Coding Specialist at her desk

How to Become a Medical Insurance Billing & Coding Specialist

Duties, Responsibilities, Schooling, Requirements, Certifications, Job Outlook, and Salary

A Billing and Coding Specialist at her desk

Not everyone is keen on the idea of being on the front lines of patient care, and that’s OK! The healthcare industry is full of rewarding career opportunities, even for people who’d rather avoid some of the things you might see in the trauma ward or the operating room. Suppose you’re a natural organizer who prefers administrative work to administering first aid. In that case, a career as a medical insurance billing & coding (MIBC) specialist could be a great career choice for you.

This career guide will teach you everything you need to know about becoming a medical insurance billing & coding specialist, including the educational requirements, certifications, day-to-day responsibilities, and how long it generally takes to launch a career as a MIBC specialist.

Not sure if becoming a billing & coding specialist is right for you? Click here to see our full list of the best entry-level medical jobs.

Medical Insurance Billing & Coding Specialist Definition

What is a Medical Insurance Billing & Coding Specialist?

Accurate record-keeping is an often-overlooked part of providing quality health care. From helping patients navigate their insurance coverage to tracking public-health data that informs policymaking, Medical insurance billing & coding specialists are administrative professionals with a broader impact than you might expect at first glance.

Medical Insurance Billing & Coding Specialist: Job Description

What Does a Medical Insurance Billing & Coding Specialist Do?

Medical insurance billing & coding specialists use a variety of software and databases to organize, manage, and classify health information data. While they don’t treat patients themselves, MIBC specialists work closely with registered nurses and other healthcare professionals to verify patients’ diagnoses or any other necessary information. They then translate that information into codes that can be shared among healthcare and insurance providers.

Medical Insurance Billing & Coding Specialist Duties

Some of the day-to-day responsibilities of medical insurance billing & coding specialists include:

  • Keeping patients’ health records accurate, complete, and up to date
  • Organizing and updating information in healthcare software and registries
  • Making sure important data is easy to find and analyze
  • Assigning the necessary codes for insurance reimbursement
  • Maintaining confidentiality of patients’ private medical information
  • Serving as a liaison between healthcare providers and billing offices

Medical Insurance Billing & Coding Specialist Skills

To excel as a MIBC specialist, you’ll need solid analytical skills and attention to detail, as you’ll be interpreting medical documentation and transcribing it into important patient records. Equally critical are the communication and interpersonal skills you’ll need to verify information with doctors, nurses, finance personnel, and others. Finally, you’ll need a strong sense of integrity, as you’ll be dealing with confidential patient information that’s strictly governed by privacy laws.

Where Do Medical Insurance Billing & Coding Specialists Work?

While many healthcare-related businesses and organizations employ billing & coding specialists, the most common workplaces are hospitals, outpatient clinics, and private physicians’ offices. Most MIBC specialists work full-time, 40-hour weeks, though hours may vary depending on the facility’s operating hours. For example, hospitals or emergency clinics that provide round-the-clock care may require evening or overnight shifts. In contrast, outpatient clinics are likely to be more in line with standard business hours.

Medical professional assisting a patient

Medical Insurance Billing & Coding Specialist Schooling & Certification

How Long Does It Take to Become a Medical Insurance Billing & Coding Specialist?

What Degree Do You Need to Be a Medical Insurance Billing & Coding Specialist?

While many healthcare jobs require years in school before you can even apply for openings, billing & coding specialists have one of the quickest routes to a great-paying career. You’ll need to earn your Medical Insurance Billing & Coding (MIBC) diploma, which can be completed in as little as 34 weeks. That means in less than nine months, you could be wrapping up your diploma and getting ready to start in an entirely new career with excellent long-term prospects.

Like any long-term goal, working toward a new career as a medical insurance billing & coding specialist seems much more attainable when you break it down into individual steps.

Here’s a step-by-step guide to the education, experience, and certifications you’ll need to become a medical insurance billing & coding specialist:

1. Enroll in a Medical Insurance Billing & Coding (MIBC) Program

Launching your career as a billing & coding specialist starts with enrolling in a MIBC program at an accredited college or university. You’ll need to stay focused and work hard, but just about anybody can earn their diploma if they’re willing to invest the necessary time and effort. For example, to gain admission to the Medical Insurance Billing & Coding Program at Brookline College, all you’ll need is a high school diploma or GED, plus a passing score on a Scholastic Level Exam.

2. Earn Your Medical Insurance Billing & Coding Diploma

Your MIBC diploma program will help you build the knowledge and skills you’ll need to succeed in any healthcare environment. You’ll start learning an overview of healthcare industry basics and gaining a baseline understanding of how different professions work together to facilitate patient care.

From there, you’ll dive into the bread and butter of your MIBC program, which is mainly learning about the intricacies of medical insurance billing, coding, and health insurance. However, to be effective as a MIBC specialist, you’ll need enough medical knowledge to understand the terminology, diagnoses, and other medical documentation. You’ll also complete courses dedicated to anatomy and the human body’s various systems. Even though you’ll never be expected to treat patients, you’ll still need the contextual knowledge to organize and analyze information from doctors, nurses, and other healthcare workers.

For the final stage of your MIBC diploma program, you’ll complete something known as an externship. In the externship, you’ll gain practical knowledge by completing the same kind of daily tasks you’ll be expected to perform on the job. It’s an excellent opportunity to develop the skills and experience that will let you hit the ground running once you land your first job as a MIBC specialist.

When deciding where to enroll in a medical insurance billing & coding program, consider looking into colleges or universities that offer students job-placement assistance after finishing their diplomas. Having somebody who can help you get your foot in the door with employers can be a significant advantage when starting your job search.

3. Get Certified by One of the Major Credentialing Organizations

After completing your MIBC diploma, you’ll be eligible to sit for an exam to earn certification with one of the major professional organizations. The two major certifications that will make you most appealing to potential employers are the Certified Professional Coder (CPC) and Certified Coding Associate (CCA) certifications. The exams for each are similar, consisting of around 100 to 150 multiple-choice questions. Your diploma program will do a great job of preparing you for either certification exam, as most people pass on their first attempt.

Close up of hands writing on paper

How Much Does it Cost to Earn a Medical Insurance Billing & Coding Diploma?

Plenty of colleges and universities charge $20,000 and up per semester in tuition alone. That number often doesn’t even account for the cost of lab fees, books, or other course materials. Fortunately, the rise in online education means a college education is becoming much more attainable.

Medical Insurance Billing & Coding Specialist Salary

How Much Do Medical Insurance Billing & Coding Specialists Make?

Although the U.S. Bureau of Labor Statistics does not report on specific salary data for MIBC specialists, they do report that the average annual salary for medical records specialists is over $48,000, which works out to more than $23 per hour. Salaries can go up significantly from there—the top 25% of earners among medical records specialists bring home nearly $58,000 per year, and those among the top 10% of earners average over $73,000 annually.

Highest Paying Industries for Medical Insurance Billing & Coding Specialists

According to the BLS, you’ll find the top-paying jobs for medical records specialists in these industries:

Industry Average Hourly Pay Average Salary
Federal Executive Branch $27.74 $57,690
Colleges, Universities, & Professional Schools $26.90 $55,950
Health Insurance Companies $26.43 $54,970
Management & Consulting Companies $25.34 $52,700
Medical & Surgical Hospitals $24.49 $50,940

Highest Paying States for Medical Insurance Billing & Coding Specialists

According to BLS data, medical records specialists earn the highest average wages in these states:

Location Average Hourly Pay Average Salary
Washington, D.C. $29.10 $60,530
Alaska $28.18 $58,620
Washington $27.35 $56,890
Massachusetts $27.23 $56,650
Minnesota $26.66 $55,450

Highest Paying Cities for Medical Insurance Billing & Coding Specialists

The latest data from the BLS shows Medical Insurance Billing & coding specialists earn the highest average annual wages in these cities:

Location Average Hourly Pay Average Salary
Kokomo, IN $34.36 $71,470
Trenton, NJ $33.86 $70,430
Richland, WA $32.48 $67,650
Vallejo, CA $31.29 $65,080
Corvallis, OR $31.14 $67,770
Stockton, CA $30.89 $64,250
Sacramento, CA $30.71 $63,880
San Francisco, CA $30.51 $63,460
Danbury, CT $30.21 $62,840
San Jose, CA $30.09 $62,590

Medical Insurance Billing & Coding Specialist Job Outlook

What is the Job Outlook for Medical Insurance Billing & Coding Specialists?

As the overall demand for healthcare increases and more medical facilities switch to electronic health records, the demand for medical records specialists should remain strong. The BLS estimates that the overall employment of medical records specialists will grow 8% by 2029, double the projected growth rate among all careers during the same time frame(4%).

Female student in front of a blackboard

Ready to Start Your Career as a Medical Insurance Billing & Coding Specialist?

While they probably won’t be the stars of the next hit medical drama, MIBC specialists play an essential role in keeping the healthcare industry running smoothly. And for many people, not having to deal with the stress of saving lives suits them just fine! You’ll still get all the benefits of a full-time job in the healthcare industry and a versatile skill set that can easily transfer between different types of employers.

Click here to learn more about the Medical Insurance Billing & Coding Program at Brookline College, and start working toward your new career as a medical insurance billing & coding specialist today.