Medical Billing Guide

What You Need to Know About Medical Billing and Coding as a Business or Career

Medical bills with stethoscope
••• Burazin/Photographer's Choice RF/Getty Images

The need for medical records and health technicians, such as medical billing and coding jobs, is expected to grow 15% from 2014 to 2024, according to the Bureau of Labor Statistics, making it a viable home business option. Medical records specialist earn a median pay of $35,900 per year, which isn't bad for a profession that requires little education or training.

Medical billing and coding lends itself well to working at home, and many in the medical billing profession have been able to do just that, either by setting up a home business and working for themselves with independent physicians as their clients, or by working from home in medical billing jobs with larger healthcare firms that make and track medical billing work assignments electronically. Medical billing and coding professionals may also be hired by insurance companies, pharmacies, and related companies and even the government for their expertise.

Pros of Medical Billing and Coding

  • Can be done from home as a business or a telecommuting job.
  • Healthcare is a trillion-dollar industry that is always in need.
  • Help with billing and coding continues to grow as health facilities and workers move toward electronic billing and filing.
  • Doctors are happy to outsource medical billing to free them up to do what they do best, provide services.

Cons of Medical Billing and Coding

  • It can be difficult to break into the industry as most medical and health facilities have a source for their medical billing and record keeping.
  • Most sources of work will want you to be certified as a medical biller and/or coder.
  • There are medical billing job and certification scams you need to watch out for.

Required Skills for Medical Billing and Coding

Currently, there are no set educational standards for the medical billing profession. Many employers who offer work at home medical billing jobs look for some level of formal medical billing and coding training through an accredited vocational or career training school, along with actual experience in a medical billing office. Formal accredited programs may take from as little as nine months to as long as two years or more and may also offer assistance with career placement.

Educational Requirements for Medical Billing and Coding Professionals

Medical billing requires a fairly strong knowledge of medical terminology, anatomy, knowledge of how to properly complete various forms, and industry coding for medical procedures. If you don't have that type of experience, you can take a course and get certified as a medical biller and coder. You just need to be sure you choose a reputable program.

Medical billing expert, Paul G. Hackett says that "Almost 80% of people end up choosing the wrong types of online medical billing courses." He also advises that there are only seven medical billing training subjects you should look for before enrolling in any medical billing training program. He calls these his medical billing "essentials" that every medical billing training program should have.

In addition to knowing what to look for when you're researching medical billing and coding training programs, you also need to know what to avoid. Medical billing training expert, Paul G. Hackett believes that by learning what you need to avoid before signing up for a medical billing program is easier to remember that knowing what to look for when you are shopping for an online medical billing study program.

Unfortunately, because of the growing popularity of medical billing home businesses and because it logically makes sense that a medical billing career might be one with strong opportunities to work from home, the industry is loaded with scams like "You Can Earn $50,000+ Processing Medical Claims From Home. No experience necessary!"

Scams also abound to try to get you to purchase training, software, marketing materials, and lists of doctors. Additionally, some medical billing software scams try to sweeten their offers with discounted clearinghouse services if you buy medical billing software from them. Any of these scams can cause you to part with your hard earned money and waste your time getting established in the medical billing and coding profession.

Other needed skills include a strong level of computer skills and a typing speed of at least 35 words-per-minute, as well as good customer service skills to deal with patients who may be under stress, physician and hospital billing staff, and other medical personnel.

Medical Billing as a Work at Home Job

Medical billing professionals are usually able to work independently from home since medical billing software can easily facilitate electronic billing of patients, health insurers and government health agencies like Medicaid and Medicare from through their home computers. However, most of these opportunities are for experienced medical billing professionals only. 

Medical Billing as a Home Business

A medical billing or medical coding home business could have good potential for success and have been growing in popularity. One of the reasons for this growth is the wide availability of online training in medical billing and medical billing software, as well as the increased need to transfer medical records into digital form.

Like any home business, starting a medical billing and coding home business is much easier if you already have some medical billing experience to your credit and you've received full training before you decide to go it alone. Additionally, you'll have gained some contacts during your medical billing employment that will help in establishing your customer base. Other things you need for a medical billing or home business include:

  • A business license. Check with your local Chamber of Commerce and with your state officials about licensing requirements.
  • A computer, printer, and fax, as well as accounting and billing software and fast Internet connection
  • Medical billing and coding software, which ranges between $500 and several thousand dollars. Much of it should be geared toward processing HCFA 1500s, the standard claim form used by health plans.
  • Medical billing and coding reference books. The recommended ones are the ICD-10, CPT and HCPCS Expert 2000, plus the CDT-3 for dentists.

    Marketing Your Medical Billing Home Business

    Like any service-based home business, getting your first clients may be your biggest challenge. If you're coming from a medical billing background, you can ask your former employer to be a client or network with the people you know in the industry to find work. Visiting or calling local doctor's offices, clinics, and hospitals can be another way to find work. Don't forget that many mental health professionals also need billing and coding services.

    Medical Billing Clearinghouses

    An electronic medical billing clearinghouse acts as a middleman that takes electronic medical claims information and then submits it electronically to insurance companies the medical billing clearinghouse contracts with. Many who run medical billing businesses, however, fail to take advantage of this time saver in their medical billing and coding practices.

    Updated by Leslie Truex