Medical Billing and Coding in Georgia

Improvement in healthcare are at the heart of improvements in medical coding systems. These systems have grown complex. A Georgia billing and coding specialist will not be state-licensed but will likely hold certification through a third party organization. While credentialing is not mandatory, it is becoming the expectation, at least for coding specialists. Medical coders often pursue education at the certificate level.

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Medical Billing and Coding Salary and Careers in Georgia

There are many professionals who do some medical billing or coding as part of their job duties. A medical administrative assistant may handle some billing/ coding functions. A coding or reimbursement specialist will have a deeper skill base. Duties can include coding same-day surgeries and other complex cases, abstracting information from inpatient medical records, determining co-morbid conditions that require coding, educating practitioners about policy changes and documentation requirements, and carrying out auditing. Hospital coding can be more difficult than doctor's office coding. Some reimbursement systems are more complex than others. Some payers pay for service while others use statistical information to pay for care received; such systems are sometimes called risk adjustment.

Professionals with expertise often make good money. The AAPC, one of two industry-leading national certifying agencies, surveyed its experienced and well-credentialed membership and reported an average salary of $49,116 for those in the South Atlantic Region (https://www.aapc.com/blog/33226-2015-salary-survey-credentials-tip-the-scale/).

The following are examples of positions advertised in Georgia in February of 2017:

  • Coding Specialist I
  • Hospital Inpatient Coder III
  • Coder Assistant
  • Medical Coding Analyst
  • Coding/ Abstracting Specialist
  • Outpatient Coder

Medical Billing and Coding Education Options in Georgia

Medical billing and coding programs offer preparation at different levels. Preparation will to some degree determine what level a person can enter the field, but experience is also a significant factor, as is the credential obtained.

A medical coding program will include some biomedical science coursework (or require it as a prerequisite). Medical terminology and anatomy are the most basic requirements. The program may include pharmacology and pathophysiology. It will likely include several coding courses, covering procedural and diagnosis coding. It may or may not include coursework at what is considered the advanced level. Practicum and externship experiences are included in many programs; they can be useful for making connections as well as developing skills.

Entrance requirements are typically modest. A person will provide evidence of high school graduation or GED. There may be tests in basic skills areas like reading and math.

Some medical coding programs are offered by schools that also have CAAHIM-accredited health information management programs. In order to qualify its graduates to take AHIMA examination beyond the associate level, a program must meet curricular requirements set by AHIMA. This requirement does not apply to experienced professionals (http://www.ahima.org/certification/CCS). Individuals who complete CAHIIM-accredited degree programs at the associate's level or higher constitute another exception – they may test for expert-level AHIMA coding certifications after achieving their health information management certification.

Some hospitals or health systems do look for professionals who have completed health information management degrees to fill coding specialist positions. Others value associate’s degrees even if they are not in a field that is as closely related.

The program may cite one or more certifications that the graduate will be able to test for upon course completion. The student may receive a discount for testing through a particular organization; the program may even include a voucher for a particular certification examination.

Students may consider professional associations at the student stage. Among the perks: Members can participate in forums, asking coding questions and discussing certifications and job opportunities.

There are many opportunities to educate oneself beyond the initial program; some are for academic credit while others are noncredit. Certification agencies require some continuing education. However, some billing and coding specialists go a good deal beyond the minimum. Many opportunities are available online.

Medical Billing and Coding Certification Examinations

A person at the beginning career stage will likely test for the Certified Coding Associate, Certified Professional Coder (or other closely related AAPC credential), and/ or a certification offered through another organization. While AHIMA and the AAPC are the industry leaders for healthcare coding, there are other credentials that enjoy some level of recognition; one is the National Healthcareers Association (NHA) Certified Billing and Coding Specialist (CBCS) exam. The NHA offers several related certifications, including medical administrative assistant.

A person who passes the AHIMA CCA will have a generalist credential that tests basic proficiency across medical coding settings. The CCA is referenced in some Georgia job ads. Sometimes an employer will hire before certification; the credential may be expected within a specified period of time.

A person who takes the CPC (or AAPC credential for outpatient or payer settings) and is successful will have passed an examination at the professional level but will have an "apprenticeship" designation if he or she has not accrued sufficient experience in the field. Provided the person has completed a medical coding program, the requirement will be relatively low: just one year.

The AAPC also offers specialty and expert-level examinations.

The same tests are available around the nation.

Approved AHIMA candidates schedule through Pearson VUE. There are Pearson VUE Assessment Centers in Savannah, Atlanta, Macon, and Augusta. Candidates can search for sites by proximity to their zip code.

Information about AAPC examination dates is available on the AAPC website. Local chapters are also a good source of information. Albany, Athens, Atlanta, Covington, Gainesville, and Rome are among the many AAPC chapters that host examinations at least periodically. Some chapters hold CPC review classes.

Employers sometimes administer coding examinations as part of the selection process. These are separate from the certification examination.

Additional Resources

The Georgia Health Information Association is the state chapter of AHIMA (http://www.ghima.org).

Fully 18 of the AAPC’s local chapters are located in Georgia.