Medical coders work for doctors, hospitals, and insurance companies, assigning codes to hundreds of different medical ailments and procedures listed on a patient's medical record for billing and insurance purposes. By assigning universal codes to various procedures, medical and insurance personnel are able to streamline the billing process. This task requires extensive knowledge of medical terminology and processes, so medical coders often get certification to confirm their abilities and ease the hiring process for future employers. As with most certifications, medical coder certification requires either education or experience to sit for a certification exam.
Though certification is not required to work as a medical coder, it will improve your chances of getting hired if you don't have much experience. Several agencies offer certification, but the most recognized in the US is the American Health Information Management Association (AHIMA). This agency grants the entry level designation of Certified Coding Associate (CCA). To obtain this beginner's certificate, you must have a high school diploma or the equivalent and pass an exam. Though not required before taking the exam, it is strongly recommended that you complete an AHIMA-approved coding program or have at least six months of work experience in the field.
The next step in medical coder certification is the Certified Coding Specialist (CCS) credential. This certification acknowledges a higher level of skill and knowledge than CCA certification. Again, the only requirement to sit for the exam is a high school diploma or its equivalent, but for this exam, it is strongly recommended that candidates have at least three years of job experience in medical coding in multiple areas, such as hospital-based inpatient coding and hospital-based ambulatory and outpatient care. You should also complete coursework in anatomy, physiology, and pharmacology.
Additionally, a special certification for those seeking employment in a physician's office is offered. This is the Certified Coding Specialist-Physician based (CCS-P) certification. The exam requirements for this medical coder certification are the same as for the CCS, but instead of three years experience in multiple areas in a hospital-based setting, candidates should have three years of experience coding for physician services. Whichever certification is desired, all may be achieved with a combination of education and experience, depending on the individual's background. Many have learned coding on the job, but newcomers in the health field will find there are a range of educational programs available of varying lengths to suit each candidate's goals.