Insurance Coder: Job Description and Education Requirements
Insurance coders enter medical records information into a database to ensure reimbursement for healthcare services. They typically complete a certificate or degree program and are employed in hospitals or physicians' offices. Opportunities exist for insurance coders to become certified specialists through the American Health Information Management Association.
Job Description for Insurance Coders
Insurance coders work with patient medical records to ensure payment or reimbursement for medical services. Hospitals, insurance companies or physicians' offices employ insurance coders. Insurance coders are trained to read medical diagnoses, conditions and treatments on patient records and use industry-standard coding systems, such as CPT (Current Procedural Terminology), that are entered into healthcare databases. They have a working knowledge of common insurance reimbursement options and sources, such as Medicare, Medicaid and private insurance, as well as the Health Insurance Portability and Accountability Act (HIPAA).
The U.S. Bureau of Labor Statistics, (BLS), projected a 20% increase in employment opportunities for insurance coders for the 10-year period of 2008-2018 (www.bls.gov). This growth is expected to stem from the increase in medical procedures and the responsibilities associated with electronic data. In May 2009, the BLS reported a national median wage of $31,290, with 80% of salaries ranging from $20,850 to $51,510, for insurance coders.
Education Requirements for Insurance Coders
Aspiring insurance coders may consider completing a certificate or associate's degree program in medical billing and coding. Students take coursework in anatomy and physiology, and are introduced to medical terminology, pathophysiology and healthcare delivery systems. These programs expose students to common software applications used within the industry, as well as common coding guidelines, such as ICD-9, CPT, DSM-IV and HCPCS.
American Health Information Management Association (AHIMA) offers certification designations for insurance coders, including Certified Coding Assistant (CCA), Certified Coding Specialist (CCS) and Certified Coding Specialist-Physician-based (CCS-P). While AHIMA indicates a minimum of a high school diploma to be eligible for taking certification exams, it does recommend completing advanced coding training and acquiring work experience. Beginning and experienced insurance coders obtain a certification designation as a way to boost career opportunities.
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