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Preparing for Medical Billing and Coding Jobs in Nevada Starts with a Solid Education

Medical billing and coding represents a career, not just a job. There has been a lot of hiring as of late.

The Nevada Office of Statewide Initiatives and Nevada Area Health Education Centers provided the following information in their 2016 to 2017 publication Health Care Careers in Nevada. The average salary was placed at $36,470 (or $18 an hour). The typical education time was listed as one to years. The number of jobs posted in 2017 was 258. There were 1,043 professionals employed in the field (701 of them in Las Vegas).

Experienced medical coding specialists aren’t limited to jobs in their own geographical location. Some code from home. There are many potential career treks. Some careers combine medical billing and coding while others focus on one or the other. Medical coders apply and sequence codes to describe patient diagnoses, procedures, equipment, and other relevant information; billers, meanwhile, follow claims through their cycle. There are opportunities for advancement in either profession. Professionals in advanced roles may have titles such as coding reimbursement auditor, medical billing advisor, or coding supervisor.

Medical billing and coding specialists work in many kinds of setting. Traditionally, a major distinction has been drawn between hospital and physician coding; there is a significant difference in how procedures are coded between these two settings. But many settings, from long-term care and rehabilitation to insurance, require coding services.

The two main certifying agencies for medical coders are the American Health Information Management Association (AHIMA) and the AAPC. They have very different traditions. Employers may state a preference for one or the other. However, both are well represented in Nevada.

A person can be certified as a medical biller through AHIMA. However, coding certification can also be highly valued in positions that use "biller" or "billing" in the job title.

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Nevada Medical Billing and Coding Education

While there is no formal requirement for post-secondary education, at least not at the state level, education can provide significant benefits. It can, for example, shorten the amount of time needed to achieve certification at the professional level. Some programs include valuable externship experiences which help students be career-ready. One will sometimes see job postings for trainees. Renown Health posted a recent one, noting that an entry-level credential CCA will be expected within 90 days. Often, though, companies want those who have already proved themselves in the field. They don’t necessarily want to spend a lot of time training (http://www.nnbw.com/news/training-future-healthcare-professionals/).

Some employers list competencies that correspond with post-secondary courses, for example, medical terminology, medical office procedures, and human anatomy and physiology. Medical terminology and anatomy and physiology are among the courses suggested by AHIMA, even at the most basic certification level. (A candidate who wishes to take a higher level certification through AHIMA will need to take these and other courses unless he or she qualifies by another pathway).

Most Nevada programs award certificates. Students also have the option of earning a diploma or associate's degree. Program extras can include computer applications, career success, and business writing. (Some job positions, notably, are dependent on passing a computer skills test.) There may be advanced health information coursework.

Education programs may be tiered. Students may enroll in short programs at the onset. Coders can take specialized coursework such as preparation for risk adjustment coder credentialing; risk adjustment coding is available in Nevada as a six month online course.

Some prospective medical coders even have a chance to pick up foundational medical office skills in high school (http://www.nevadaappeal.com/news/local/pioneer-launches-nevadas-first-ctehs-program/). The specialized training, though, comes later.

Earning Professional Medical Billing and Coding Certifications

There can be a sort of tiering to certifications as well. AHIMA offers a Certified Coding Associate (CCA) credential that measures basic competency across settings. The Certified Coding Specialist (CCS) measures expertise in hospital settings; the CCS has traditionally been viewed as the premier coding specialist certification for these settings. The Registered Health Information Technician (RHIT) and Registered Health Information Administrator (RHIA) are more broadly focused health information credentials. They are among the favored certifications for coders in some settings. A professional who holds the RHIA or RHIT can test for CCS without meeting additional prerequisites. (A professional who holds no other qualifying certificate may qualify to test as a CCS on the basis of education or experience.)

The AAPC does not offer a separate entry-level certification. However, some individuals who pass AAPC tests hold certification first at the apprentice level. This is the case for new graduates or career professionals who attempt the Certified Professional Coder (CPC), Certified Professional Coder-Payer (CPC-P), or Certified Outpatient Coder (COC) examinations. If they have completed an 80 hour educational program, the experience requirement is just one year. Practicum can be credited as experience. (The AAPC’s own online practicum can be counted as a year – at least from a certification standpoint.)

The AAPC Certified Medical Biller (CMB) credential does not have a formal experience requirement. Nor does the new credential, Certified Risk Adjustment Coder (CRC). However, CRC examination is recommended only for those who have completed a formal course in risk adjustment coding or have two years of experience performing it. The new Certified Inpatient Coder (CIC) is noted as appropriate only for those with experience, though again, this is not a formal requirement.

Additional Resources

The Nevada Health Information Management Association is the state AHIMA chapter (http://www.nvhima.org). There are two regional Nevada associations: Northern Nevada (NNvHIMA) and Southen Nevada (SNvHIMA). Professionals can attend coding roundtables.

There are two local AAPC chapters, located in Las Vegas and Reno (https://www.aapc.com/localchapters/local-chapter-info.aspx?id=01008028). AAPC members may also find ‘coding roundtable’ opportunities through the AAPC. Local meetings offer the opportunity to pick up skills as well as socialize. The following are among the 2017 meeting topics:

  • CERT and Medical Review; claim finding for Nevada
  • Hernias Are Like A Box of Chocolates

There are far more continuing education classes at the national level. Continuing education, like so many other opportunities, is available online.