Becoming certified is mandatory with some careers, while in others, it is recommended or simply considered voluntary. Even when it is not required, obtaining a certification can give a job seeker the edge with a prospective employer. For those who already have a job, it can increase the chance for promotion. Medical billers and coders sometimes wonder if getting a voluntary medical billing and coding certification is worthwhile.
First, a bit about certification, which is usually obtained after graduation from a formal educational program. Individuals must take and pass a certification exam to demonstrate that they meet a minimum competency level. Several organizations offer certifications in different areas of the medical billing and coding field. Most of them are professional membership-based societies and in nearly all cases, the certification is valued for a certain period, typically one year. To renew the certification, the individual must earn a specified number of continuing education units.
It is important to distinguish this voluntary certification process from a state-mandated licensing requirement. Currently, no U.S. state requires a license to practice as a medical biller or coder. Though certification is also not required, it helps people illustrate their commitment to this profession and increases potential income and advancement opportunities. By holding a certification, individuals have hard evidence that they possess the basic level of knowledge important to performing well within this career.
The American Medical Billing Association, AMBA, offers the Certified Medical Reimbursement Specialist (CMRS) certification. The required exam, which costs $325 plus the cost of AMBA membership, features 16 sections containing 700 questions. The questions cover medical terms, medical coding, insurance reimbursement, federal compliance, and claim appeals. To receive the CMRS designation, a person must score at least 85 percent on the exam.
Both the Certified Medical Billing Associate (CMBA) and Certified Healthcare Billing and Management Executive (CHBME) designations are offered by the Healthcare Billing and Management Association. These are designed for supervisors, managers, and executives in medical billing and coding. The American Health Information Management Association (AHIMA) offers the highest credentials in medical billing, RHIA and RHIT. RHIA, a Registered Health Information Administrator, manages medical records and other patient health information. An RHIT, Registered Health Information Technician, is an information technician who specializes in medical records and related computer systems and applications.
In the field of medical coding, certifications are offered by both AHIMA and the American Academy of Store Coders (AAPC). Deciding which credentials to obtain requires determining the desired career path and which designations a relevant employer will prefer. AAPC certifications include Certified Store Coder (CPC) and AHIMA certifications include Certified Coding Associate (CCA) and Certified Coding Specialist (CCS).
Whether individuals are medical billers or coders, their level of experience, type of employer, and other factors determine which type of medical billing and coding certification is appropriate. The good news is there are plenty of certifications to choose from and none of them are currently voluntary. People can spend time obtaining multiple certifications to give themselves a competitive edge for hiring, pay, and promotions.