Why Should a Coder Get Certified?

By Torrey Kim, CPC

Remember the days when a physician could point to his or her receptionist and say, "From now on, you're my coder"? Those days are well behind us. In today's medical environment, it takes an intricate knowledge of government and private payer regulations, frequent code and coverage changes and myriad other technical facts to be a medical coder. Medical practices can't risk hiring an untrained medical professional, so they look for coders who have met the challenge of acquiring medical coding credentials.

But coding certification isn't just a plus for the physicians and other health care practitioners who hire coders. Certification can help the coder immeasurably as well, in several ways.

Hiring Plus

It wasn't that long ago that doctors thought "anyone" could be a coder, but today's physician practices are increasingly requiring certification. In a recent American Academy of Professional Coders (AAPC) poll, more than 40 percent of respondents said that certification was required for employment. Medical practices don't want to waste time interviewing candidates who are simply looking for a temporary job - they want coders who are committed enough to medical coding that they've made it their career, and certification is one sign of how serious and well-trained a coder is.

Likewise, the Office of Inspector General requires independent review organizations to use certified coders for claims review and some states, such as Hawaii, require certified coders to perform medical claims review.

Salary Boost

Once the coder gets the job, the next step is establishing a salary -and studies have shown that certified coders walk away with more annual pay than non-certified coders.

According to a 2006 survey conducted by the AAPC, the average annual salary is 21 percent higher for a certified coder than for a non-certified coder. A 2005 survey by The Coding Institute backed that data up, reporting that certified coders earned, on average, more than $5,000 more per year than coders without certification.

The most likely reason that physicians are willing to pay more for certified coders is that the medical practice's income is in the hands of the coder. You won't find many other careers where the employee has to protect the employer against fraud while still trying to capture millions of dollars in revenue each year. A well-trained coder knows how to seek the deserved amount of income for his or her practice while staying well within legal and ethical boundaries.

If the certified coder gets a denial from an insurer, he or she knows the process of appealing the claim to fight for accurate reimbursement. And on the other side of the coin, if the certified coder reads a chart and feels that the physician has recorded a code that appears too high for the service provided, that coder will speak up and let the physician know that a lower-valued code is more applicable.

In its occupational handbook, the Department of Labor considers medical coding a "high growth" career, meaning that demand for coders is on the rise. Coding and billing professionals who want their careers to grow along with the rest of the field should consider certification as the first step toward a successful professional future.

Torrey Kim, CPC, is senior editor at the AAPC. Visit the AAPC Web site at

Certifications and Credentials Archives

I am a student at UMA going for medical billing a coding. I took this course because I always wanted my own business or a job where I could work from home. I'm a mother of one and being that i have a full time job and in school I have no spare time to spend with my baby. When I am home i either sleeping and resting instead of spending time with my baby. I want other than cashiering, or management under my belt I want to make my baby proud of her mommy and main thing is that I be proud of myself.

Keila Martin,  CSR,  Corner StoreJune 17, 2016
Lafayette, LA

I am currently in my fifth month at UMA for medical billing and coding. I am looking forward to having my own career apart from being a full-time stay-at-home mom of six. My ultimate goal is to work from home and have the flexibility to still enjoy being with my kids when I want. I am really excited about earning my own way and having friends that are not connected to my family.

Crystal Snuffer,  stay-at-home mom of sixJune 15, 2016
Vass, NC

Hello, I am also a student at Ultimate Medical Academy. I have spent 29 years in nursing in various setting it was for a change and stay ing the medical field so I am taking a billing and coding course . With the focus on coding . I hav a few leads on employment opportunity before I even graduate in October 2016. Taking certification exam shortly after graduation for CPC and also and 8 week boot camp for CCS then that exam as well. Excited to start something new.

De Anna  SmallMay 26, 2016
New Orleans, LA

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