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Medical Billing and Coding in Massachusetts

Medical billing and coding specialists attach codes, or strings of characters, to medical diagnoses and procedures. In order to do so correctly, they must abstract and sequence complex medical information found in patient medical charts. This requires more than just knowledge of coding taxonomies and insurance policies. Medical coders must also understand the medical diagnoses, policies, and procedures involved. Sometimes medical billing and coding specialists in Massachusetts perform related tasks like preparing attestation statements for government health programs. Medical billing and coding is a surprisingly complex task, and many employers use a coding test as part of their hiring process.

Who becomes a medical billing or coding specialist? Sometimes nurses who want to transition out of clinical work become medical coders. People with experience in the medical front office may also find themselves with an easier transition into the field. Other people, though, pursue degrees in medical billing and coding or health information technology because it’s what they love. They’re good analytical thinkers, and they enjoy classes in anatomy or health. They take pride in becoming experts in narrow branches of knowledge and take pleasure in helping people by getting claims pushed through. The medical billing and coding profession is competitive and requires formal training in the medical billing and coding fields.

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Medical Billing and Coding Training in Massachusetts

Medical coding certification is not mandated by the state, but it is often required by employers. A prospective medical billing and coding specialist should begin by enrolling in a medical billing and coding training or related program that will prepare her or him to sit for board examinations. Usually this is through one of the best known national agencies, AHIMA or AACP. Massachusetts employers generally value credentialing through either of the two, although some may state a preference. AHIMA certifies a range of health information technologies. A prospective coder can demonstrate mastery by passing either a test focused specifically on billing and coding or a broader one which encompasses health information technology (HIT) or management (HIM). HIT and HIM exams have, as prerequisites, graduation from an accredited program. Exams focused exclusively on coding do not.

AAPC offers more than twenty coding credentials, from entry-level to advanced. Medical coding credentialing is open to candidates with even a high school diploma, but AAPC does recommend a two year college degree. Coding can prove a difficult task for a person who lacks a comprehensive educational program or significant work experience.

Medical coding experts sometimes pursue specialty certifications to demonstrate mastery in particular branches (usually medical, but sometimes regulatory). CEMC (Certified Evaluation and Management Coder) is a credential that is sometimes viewed as desirable in Massachusetts. The exam focuses particularly on MDM, or Medical Decision Making. A CEMC specialist would be expected to understand issues like the difficulty and complexity of decision making in emergency room settings and whether or not presenting problems would be considered self-limiting or critical.

Medical Billing and Coding Salary and Job Outlook in Massachusetts

What are some possible jobs for a medical biller and coder who is just breaking into the field? One is emergency department biller. A recent posting asked for, in addition to a two year degree, the level of experience that is usually acquired through 3-6 months coding. Many Massachusetts employers preface the preferred number of months or years of experience with the phrase “generally acquired through”. This suggests there may be opportunities for especially well qualified candidates who have been in the field a shorter period of time.

Some employers of medical billing and coding specialists in the state of Massachusetts include the largest employers in the state's health care sector. These employers are, but not limited to, Massachusetts General Hospital with 9 locations in the Boston area, Winchester Hospital in Winchester, Marlborough Hospital and Harvard Medical School in Boston.

What can an experienced medical billing and coding expert hope to earn in Massachusetts? The BLS has released detailed information on the salaries of medical billers, coders, and other workers in related health technology fields. Framingham leads the state at $43,000. The Boston-Cambridge-Quincy metropolitan area, which of course employs far more workers, is not far behind; it’s listed at $41,050. Barnstable reports $38,900 and New Bedford $29,160. Some rural regions and small towns also report salaries below the state average. Salaries in the northwestern part of Massachusetts are listed at $33,910. Similar types of trends can be observed in other related industries.

You may also be interested in the Medical Assisting programs in Massachusetts. Learn more about the benefits of a medical billing and coding career.

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