medical coding specialties :: Article CreatorMedical Billing And Coding Certification: How To Find Training
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Key Takeaways
Medical coding and billing certifications usually involve passing a multiple-choice exam. Certified medical coding and billing professionals generally earn higher annual salaries than their peers who don't hold certifications. You don't need any prior medical experience to learn medical billing and coding, though being familiar with relevant topics such as medical terminology and human anatomy can be helpful before you enroll in a medical billing or coding course. If you're interested in the healthcare field but don't think medical school is the route for you, consider pursuing a medical billing or coding certification.
Medical records specialists such as medical coders and billers ensure that healthcare organizations run smoothly by applying standardized codes to clinical information as well as helping collect patient data and process health insurance claims.
You can become a medical biller or coder with a high school diploma or GED and the right professional certification. Read on to learn more.
What Do Medical Billing and Coding Professionals Do?
Medical coders and billers often perform separate job functions in many healthcare settings, though in other settings—especially smaller medical offices—one person may perform both roles.
Medical coders use physicians' notes, lab results and other clinical documentation to apply standardized medical codes used throughout the healthcare industry. These codes chronicle a quick summary of medical services provided and help streamline insurance claims.
Medical billing involves using these codes to submit and follow up on claims with insurance companies. These professionals carry out front-end and back-end responsibilities, including collecting patient information, verifying insurance coverage, deducting copays and payments and monitoring claims.
Salary and Job Growth
The U.S. Bureau of Labor Statistics (BLS) groups medical billing and coding professionals under the overarching category of medical records specialists. According to the BLS, as of May 2024, medical records specialists earned a median annual wage of $50,250, which was roughly the same as the median annual salary for all occupations ($49,500) that month.
Between 2023 and 2033, the BLS projects 9% job growth for medical records specialists, which is more than twice the projected growth rate for all occupations (4%) during that same period.
To expand your earning potential in the field, you may consider pursuing medical billing and coding certification. According to a 2025 survey from AAPC—one of the field's major credentialing organizations—professionals with the Certified Professional Biller credential earn an average annual salary of $60,316, while those with the Certified Professional Coder credential make an average of $64,495 annually.
Medical Billing and Coding Certification Options
Along with those offered by AAPC, you might also pursue relevant certifications through the American Health Information Management Association (AHIMA) or the National Healthcareer Association (NHA).
Below are several certifications you can pursue. Make sure to choose the option that best aligns with your desired career and skills.
Certified Professional Coder (CPC)®
The AAPC advertises the CPC credential as the "gold standard" for medical coders. Candidates have four hours to pass a 100-question, multiple-choice exam either online or at a testing center. The AAPC offers a prerequisite course to prepare candidates for the exam, which costs $399 for one attempt or $499 for two. The course, Fundamentals of Medicine, is a 12-week program with synchronous classes, and it costs $1,695 for AAPC members and $2,459.95 for nonmembers.
To maintain certification, CPCs must be AAPC members and complete 36 continuing education units every two years.
Certified Professional Biller (CPB)®
The CPB credential from the AAPC demonstrates competency in all core aspects of medical billing. Candidates must correctly answer 70% of questions during a four-hour, 135-question, multiple-choice exam, which costs $399 for one attempt or $499 for two. The AAPC also offers an accompanying exam prep course, the self-paced version of which costs $1,495 and includes one year of AAPC membership.
Certified Risk Adjustment Coder (CRC)®
Risk adjustment coding helps ensure proper treatment and funding for high-risk patients. The CRC credential from the AAPC requires a mastery of ICD-10-CM codes, and candidates must pass a four-hour, 100-question, multiple-choice exam. One exam attempt costs $399, while two attempts cost $499. The AAPC offers a CRC online training course, which costs $1,495 for the self-paced version.
Certified Inpatient Coder (CIC)®
CIC certification prepares coding professionals to work in inpatient hospital settings. The proctored exam consists of 40 multiple-choice questions and seven case studies accompanied by fill-in-the-blank sections. Like many other AAPC tests, the exam costs $399 for one attempt and $499 for two. The self-paced version of AAPC's CIC preparation course costs $2,195.
Certified Outpatient Coder (COC)®
The COC credential prepares medical coders to work in outpatient hospital settings, including clinics, emergency departments and cancer centers. The exam costs $399 and consists of 100 multiple-choice questions. Candidates have four hours to finish the test. The AAPC offers a self-paced COC prep course for $2,195.
Certified Coding Specialist (CCS)®
The CCS credential is an AHIMA certification. The exam tests candidates on five domains—coding knowledge and skills, coding documentation, provider queries, regulatory compliance and information technologies—plus various medical scenarios. The exam consists of 107 questions, 97 of which are scored. Candidates must complete the exam within four hours. The test costs $299 for AHIMA members and $399 for nonmembers.
AHIMA recommends that anyone sitting for the CCS exam has completed at least two years of relevant coding experience, as well as coursework in anatomy and physiology, pathophysiology, medical terminology and other related subjects.
Certified Billing and Coding Specialist (CBCS)
The NHA administers the CBCS certification, which requires a high school diploma or GED and either completion of a medical coding and billing training program or relevant professional experience. The exam consists of 100 questions and costs $129, and the NHA provides an interactive study guide ($64) and a practice test ($49).
What to Know About Medical Billing and Coding Certifications
Requirements for each certification exam, and the available resources to help you prepare for the test, differ by credential. Consider your options for exam prep materials, as well as the costs involved and what each test entails.
Prerequisites and Preparation
Many of the study materials for medical billing and coding certification are designed for students to learn on their own time. The AAPC also offers some instructor-led preparation courses to help candidates prepare for and pass the organization's certification exam of their choice.
Courses and exam prep materials aren't always free, but they generally increase your chances at passing the exam and may provide resources to help you find a job.
Requirements
Each medical billing and coding certification listed here requires candidates to pass an exam. In most cases, that exam is multiple-choice, although some tests include case studies with fill-in-the-blank components. Students typically must complete certification exams within a set number of hours, either online or at an in-person testing center.
Once credentialed, many certifications require that you maintain membership in their organization and complete a certain number of continuing education units during a specified period to remain certified.
Cost
There are two main costs to consider when evaluating medical billing and coding certifications: the exams themselves and preparation courses/materials.
The price tag for a medical billing or coding certification exam varies by certification type and credentialing organization. For many of its certification exams, the AAPC generally charges $399 to take an exam once and $499 to take it twice.
AHIMA members can take the Certified Coding Specialist exam for $100 less than people who are not members of the organization, and the National Healthcareer Association charges $129 for its Certified Billing and Coding Specialist exam.
Exam prep courses and materials also vary in cost. Explore the materials available for the certification you want to find the best option for you; for example, you may prefer to take an instructor-led preparation course if you have that option, or you might want to take a practice exam to help you prepare for the real thing.
Frequently Asked Questions (FAQs) About Medical Billing and Coding Certifications What does a medical biller and coder do?
Medical coders translate clinical information into industry standard codes that provide a summary of medical services performed. Medical billers use these codes to submit insurance claims. Billers also collect patient information, handle copays and verify insurance coverage.
What is the salary for medical billing and coding jobs?
According to the BLS, medical records specialists earned a median annual wage of $50,250 as of May 2024. Salaries can vary based on employer and location.
How much experience in the medical field do you need before you can learn medical billing and coding?
You don't need any prior medical experience to learn medical billing or coding. According to the BLS, postsecondary certification is often enough to pursue these jobs.
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What Is Medical Billing And Coding?
Understanding the numbersWhen reviewing job growth and salary information, it's important to remember that actual numbers can vary due to many different factors—like years of experience in the role, industry of employment, geographic location, worker skill and economic conditions. Cited projections are based on Bureau of Labor Statistics data, not on SNHU graduate outcomes, and do not guarantee actual salary or job growth.
The healthcare industry continues to help drive job growth in the United States.* A recent U.S. Bureau of Labor Statistics (BLS) report predicts an additional 1.9 million jobs in the field annually through 2033.*
While many of those positions are for doctors, nurses and dental hygienists, they also include medical billing and coding professionals. Jobs for medical records specialists, which includes medical coders, are projected to grow 9% through 2033, according to BLS — much faster than the average for all occupations.*
If you're unfamiliar with this work, read on to find out exactly what medical billing and coding is, if it's a good fit for you and what earning a bachelor's degree can do for your career.
What Does a Medical Biller and Coder Do All Day? Dr. Lynn Ward
Medical billing and coding are essential in healthcare, according to Dr. Lynn Ward, health information management (HIM) program director at Southern New Hampshire University (SNHU).
These health information technicians must integrate themselves with both the software and their team as organizations seek to streamline their operations.
So, what exactly do medical billers and coders do? They handle the billing and insurance details in healthcare organizations and billing companies, according to BLS, and they may also manage their group's financial and electronic health records (EHRs). Their role is essential because it provides patient-facing professionals with the information they need to improve the quality of care and providers with what they need to decrease the number of billing errors and improve care coordination in an industry that demands it.
According to BLS, medical records specialists such as medical coders may also:
Look over patient information for pre-existing conditions Assign diagnoses and procedure codes for patient care, health statistics and billing purposes Work as a go-between with the health clinician and billing offices Medical billing and coding are necessary for almost every health setting. In addition to hospitals and doctors' offices, these jobs can be found at outpatient care centers, skilled nursing facilities, administrative services, specialty hospitals, insurance companies, and other healthcare-related organizations, BLS said.
And with a bachelor's degree in this field, you may be able to access additional opportunities as an HIM manager.*
The demand for highly educated professionals will be even more critical. BLS projects a 29% job growth for medical and health services manager roles between 2023 and 2033, which is more than four times faster than the growth for all other management jobs.*
These individuals take on leadership roles, managing teams that support units within large healthcare settings such as hospitals and making recommendations relating to an organization's technology and compliance needs, BLS said. With a bachelor's degree, the typical qualification for medical and health services managers according to BLS, you can be well-qualified to be at the helm of these departments.
Is Medical Billing and Coding Hard?
Whether you enjoy medical billing and coding or find it difficult depends on your personal aptitude and skill sets. According to Catina L. Flagg, MBA, MS-HIM, RHIA, CPC, CPB, CPMA, CPMA-I, LSSGB, a clinical faculty member at SNHU with nearly four decades of industry experience, a successful medical biller and coder will have the following traits:
Attention to detail. Accuracy in coding and billing ensures proper reimbursement. People savvy. Medical billing and coding professionals often work with healthcare providers, insurance companies and patients, so effective communication and problem-solving abilities are key. Technical skills. This includes a solid understanding of medical terminology, coding systems and healthcare reimbursement processes. Catina L. Flagg
Professionals in this field often work with numbers, such as calculating patient co-pays and deductibles and ensuring that reimbursement amounts align with the services provided. But that doesn't mean you have to be a math whiz to be a medical biller and coder.
"The ability to perform simple addition, subtraction and basic calculations is important for accuracy," Flagg said. "However, the focus is primarily on coding, attention to detail and understanding healthcare processes rather than complex mathematical equations."
Flagg added that familiarity with billing software, adherence to confidentiality standards and good time management skills also contribute to thriving in this essential healthcare role.
What Education is Necessary for Medical Billing and Coding?
In many instances, a certificate in billing and coding may get your foot in the door for an entry-level position. (SNHU does not currently offer certificates in billing and coding.) However, when it comes to the growth in healthcare, the educational edge — like a bachelor's degree — may help you get ahead and prepare you to take on additional responsibilities.
"The (Bachelor of Science) in Health Information Management program is a good fit for a student interested in this career path, especially for someone who would like to work in management of an HIM department," Ward said.
Ward, who has more than 15 years of experience in higher education, is also a registered health information administrator and certified professional in healthcare information and management systems.
What Can You Learn in an HIM Program?
A health information management degree program teaches the technology, terminology and professional skills required for an HIM career, especially in advanced roles.
You can learn to:
Analyze the uses, risks and management of health statistics and biomedical research data and support performance improvement programs. Evaluate information system applications for their capacity to meet the needs of healthcare organizations. Interpret and apply current laws, regulations, policies and healthcare ethics as they relate to decision-making in healthcare delivery and systems. Apply health data structure, standards and regulations to manage clinical classification systems and reimbursement. Implement and manage hardware and software technologies to ensure effective data collection, storage, analysis and reporting of information. Use current management principles to propose solutions and develop project management plans that solve organizational challenges. The courses that make up an HIM program create a well-rounded degree — and a skilled, capable graduate.
SNHU's program includes a medical billing and coding course, where you'll learn about the technologies used in the industry. If you're not quite ready to take on a full degree program, you're able to take this course on its own to determine if medical billing and coding courses are worth it for you.
Aside from the coding courses, you can learn more about healthcare management, project management, human resources, data analytics, computer platform technologies, pathophysiology and pharmacology, and the ethics and legal aspects of HIM.
In a medical billing or coding career, this knowledge can complement your training and may give you an edge in your current position, providing a holistic view of your role in the healthcare industry and setting you up for success in other possible HIM careers down the road.
"Beyond billing and coding, the degree could open doors for advancement into roles such as health information analyst, compliance officer or healthcare administrator," Flagg said.
If you wish to take your training and education further, you can explore master's programs, such as a Master of Science (MS) in Health Information Management or an MBA in Healthcare Management, that may lead to advanced opportunities in the field.
Not all programs are created equally, so if you're looking for a degree that can help you grow in an HIM career, consider its accreditation. For example, SNHU's bachelor's and master's degrees in HIM are accredited by the Commission on Accreditation for Health Informatics and Information Management Accreditation (CAHIIM). That means its curriculum and learning outcomes are aligned with industry expectations.
Learn more about what CAHIIM accreditation means.
Is Billing and Coding a Good Career?
According to Flagg, working in medical billing and coding offers several rewarding aspects, including the ability to contribute to the smooth operation of healthcare systems.
"The flexibility of the job is another benefit," Flagg said. "Many medical billers and coders can work remotely or in various settings, from hospitals to private practices."
Flagg also suggested that you could find stability in medical billing and coding. Similar to the rest of the healthcare industry, job growth for medical billing and coding specialists looks good.*
"As Baby Boomers age and require more medical services, we'll need more health information technicians to manage all of their data," Ward said. "This increase in demand — combined with the number of insured citizens on the rise — will mean more reimbursement claims from insurance companies.* The industry will need more trained HIM staff to stay organized."
*Cited job growth projections may not reflect local and/or short-term economic or job conditions and do not guarantee actual job growth. Actual salaries and/or earning potential may be the result of a combination of factors including, but not limited to: years of experience, industry of employment, geographic location, and worker skill.
Deidre Ashe was 9 years old when she launched her professional writing career. While spending a day at work with her dad, she penned her first book, illustrated it and sent it off to a publishing company — after finding the address on the copyright page of one of her paperbacks. While the story never made it to the shelves of libraries, the editors wrote back, encouraging her to continue pursuing her writing passion. (Yes, she still has that letter.)
After earning a bachelor's in journalism, Ashe spent a decade working in the media industry. She then transitioned into marketing, later getting her MA in Communication from Southern New Hampshire University in 2018. Connect with her on LinkedIn.
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