What qualifications do you need to be a clinical coder?

Are you thinking about pursuing a career in medical coding and billing? If so, becoming a clinical coder may be the perfect fit for you. As a matter of fact, qualified professional coders are a pillar of the healthcare system and are highly valued by medical organizations because they handle the complications, such as compliance, efficiency, time, accuracy, etc., of their revenue system and boost the financial status by maintaining the integrity of medical records using their expertise. They help medical facilities escape from getting delayed reimbursement by applying accurate procedural and diagnostic coding and by adhering to insurance companies’ rules. But what qualifications do you need to become a clinical coder? This article will delve into the education, experience, and skills necessary to succeed in this rewarding career.

How to become a medical coder? Educational Requirements & Qualifications

A medical coder is a person that is responsible for examining and transcribing the reimbursable information (diagnosis, treatment, etc) from a patient’s chart into coding language and implementing correct codes by adhering to insurers’ and HIPAA rules.
They generally use three types of coding:

• International classification of diseases (ICD) codes
• HCPCS (levels I & II)
• Current procedural terminology (CPT)

Now, the primary question arises here how to become a clinical coder? Below, we have given the steps and requirements contributing to making a clinical coder.

Earn the right education

One of the most crucial requirements for clinical coders is a strong background in medical terminology, which may be acquired through an educational program such as a high school diploma or its equivalent or a Bachelor’s degree in a relevant discipline. Several colleges and universities offer these programs, which typically take one to two years to complete. During these programs, aspirants gain knowledge of anatomy, medical terms, physiology, and other sections, along with understanding how to correctly apply procedural and diagnostic codes, including ICD and CPT coding.

Obtain your medical coding certification

Medical coders may need to explain to patients how their medical treatment will be coded and billed, especially if the patient has questions or concerns about their insurance coverage or out-of-pocket expenses

Certification for medical coders

The Certified Professional Coder certification awarded by AAPC is a well-known and reputable credential in the field of coding. A study published in the Journal of the American Health Information Management Association found that CCAs are more prone to have greater job satisfaction and career advancement opportunities than non-certified coders. Applicants need to have at minimum two years of experience in professional coding and pass a CPC exam to be eligible for the CPC certification.

CPC credential

If the patient cannot pay the total amount due on the EOB, the medical coder may need to speak with the patient to discuss payment arrangements or options for financial assistance.

Certified coding associate (CCA)

The American Health Information Management Association provides this certification, which is intended for people who are new to coding or don’t have any prior expertise. This certificate requires renewal after three years, and to do this process candidate must pass a recertification exam and complete at least 20 continuing education units in coding.

Certified coding specialist (CCS)

The CCS certification will help you grow your career and open up more work chances because it is widely acknowledged in the healthcare sector. The certification is intended for expert medical coders who wish to portray their coding knowledge and includes complex coding concepts, clinical categorization approaches, and legal standards. The possessor must renew the CCS certification every two years by recertifying and obtaining continuing education units.

Certified outpatient coder (COC)

It is targeted at medical coders who operate in outpatient settings like clinics and doctor’s offices and addresses coding fundamentals and principles as well as outpatient-specific regulatory needs for recordkeeping.

Certified inpatient coder (CIC)

A CIC accreditation can open doors for job progression in the healthcare sector. It is highly esteemed because many hospitals and in-patient settings demand it; therefore, it is obtained explicitly by coders who want to render in-patient coding services. Regarding maintenance, candidates must recertify and renew it every three years.

Get medical coding experience

In addition to education and certification, clinical coders require practical experience.

• Most organizations appreciate recruiting medical coders with at least a few years of experience in the health sector.
• To gain experience, you can start doing an internship or other hands-on training opportunities because it can provide you with the following perks:
• It will provide you with training that will improve and strengthen the effectiveness of your portfolio.
• You will learn more about your priorities in coding work to make it easier for you to perform coding tasks proficiently.

Required skills

To be a qualified medical coder, a candidate must possess a set of skills. So, here is the medical coder skills checklist:

Transferable skills for medical coders

• Attention to detail: Clinical coders must be highly detail-oriented since they precisely transcribe and assign codes according to patient medical information. Nobody wants to deal with errors or inconsistencies since they may seriously affect patients and healthcare professionals. According to research in the Journal of AHIMA, clinical coders with solid attention to detail were more inclined to assign codes correctly and made fewer mistakes.
• Good communication skills: In addition to technical skills, clinical coders need strong communication skills to be successful in their roles. They may need to communicate with healthcare providers, insurance companies, and other stakeholders to clarify coding issues and ensure that all parties are on the same page. A study in the Journal of Medical Coding and billing for Information Management discovered that good communication is essential for medical coders to accurately record patient service and ensure that the coding is efficient and precise.
• Deal well with change: The healthcare industry is constantly evolving, and clinical coders must stay up-to-date on the latest coding guidelines and changes to the healthcare system. This requires a willingness to learn and adapt to new information continuously.
• Organization skills: There are some critical reasons why clinical coders must possess organizational skills. Among them, the significant reasons are:
1. The fact that medical coders frequently deal with vast amounts of data and information is one reason why they need good organizational abilities. Medical coders should be capable of systematically and efficiently managing this data to code this information.
2. The fact that medical coders routinely have to comply with strict deadlines and work under extreme stress is another rationale for why organizational skills are crucial.
3. They must prioritize tasks wisely, maintain an organization to finish their work on time, and fulfill these deadlines using their skills.

Technical skills for medical coders

• Knowledge of medical terminology: Clinical coders need to have a firm grasp of medical language, anatomy, and physiology to accurately interpret and assign codes to patient records. This knowledge is typically gained through education or experience in the healthcare field.
• ICD-10: This coding is the must that you must have a solid grasp for applying to the code of disorders and illness.
• Computer skills: As they frequently employ electronic health records (EHRs) and coding software to allocate and administer codes, medical coders must be familiar with computer systems and software. Excellent typing skills and awareness of computers are a must.
• Data entry skills: As clinical coders regularly deal with data and records of patients and then enter these details into computer software for coding purposes, they must have appealing data entry skills. Moreover, practical entry skills will provide the advantage of accurate document entry and identifying missing information.