Ads about becoming a medical biller or coder may catch your attention for good reason. With an attractive medical billing and coding salary and a sought-after career in healthcare, there’s a lot to like about the field. According to the Bureau of Labor Statistics, the job outlook is strong, with an expected growth of 9% through 2033, which is faster than the average. Plus, medical billing and coding programs may take only a few months to complete.
Medical billing and coding sounds can be a great career choice. But with so many claims floating around, you might wonder what’s actually true. After all, it’s important to know what you’re getting into, both during school and on the job. Let’s sort through eight medical billing and coding myths so you can make an informed decision about your future.
Myth 1: Schooling Is Easy
A lot of people believe that medical billing and coding schooling is a breeze, especially with online programs offering self-paced learning and flexible schedules. Plus, you can find accelerated medical billing and coding programs. Since there’s no hands-on patient care, coursework might seem easy to complete in your spare time and be job-ready in just a few weeks.
The Truth
Sure, schooling is often self-paced, and many online medical billing and coding programs offer flexible schedules. But don’t underestimate the coursework. There’s a lot to learn, including medical terminology, anatomy and physiology, insurance policies, and coding systems like International Classification of Diseases (ICD) for diagnoses, Current Procedural Terminology (CPT) for medical procedures, and Healthcare Common Procedure Coding System (HCPCS) for services and supplies.
The material builds on itself, so you must understand core concepts before moving to more advanced topics. Rushing through the program can leave you unprepared for certification exams and the job.
However, many people successfully complete medical billing and coding schooling while working full-time, so don’t let that discourage you. You need to ensure you have good study skills and stick with regular study time each week.
Myth 2: Jobs Are Always Remote
The ability to work from home is one of the biggest attractions in medical coding and billing. Schools often promote this perk, and many job postings offer remote opportunities. It might seem like working from anywhere is practically guaranteed once you graduate.
The Truth
If remote work is your goal, be prepared to gain experience in an office setting first. Remote medical billing and coding jobs exist, but they’re usually not entry-level positions. Many employers prefer new hires (whether they’re experienced coders or recent graduates) to start in an office setting to gain hands-on training and supervision.
While working on-site, you’ll learn your employer’s coding and electronic health record (EHR) systems and get to work with the healthcare providers and your direct team members. Many facilities also have strict privacy requirements that are easier to maintain in an office setting.
If you do land a remote position, you still need to meet productivity goals and follow security guidelines.
Myth 3: Billers and Coders Do the Same Work
When you hear “medical billing and coding,” you might think it’s all one job. Training programs usually bundle them together, and many job listings combine these titles. It’s easy to assume that there’s no difference between both roles.
The Truth
Medical billing and coding are, in fact, two separate roles with different responsibilities, although some areas overlap. Coders review medical records and translate medical procedures, diagnoses, and treatments into codes. Billers use these codes to submit claims and work with insurance companies to secure payment for services.
However, small medical practices might have one person do both jobs, while larger facilities tend to split these roles. This is good to know early on as you might find you prefer one role over the other, which can help you decide the type of facility you’d like to work in.
Myth 4: It’s Only Data Entry
Many people picture medical billers and coders simply copying information from medical records and submitting insurance paperwork. The job title might make it sound like basic data entry and something that doesn’t require specialized knowledge.
The Truth
Medical billing and coding involves good decision-making, problem-solving, and communication skills. Those in these roles analyze medical documentation, understand treatment contexts, and often work like a detective to make sure the codes and billing are accurate.
This often involves communicating with healthcare providers and other departments, depending on the size of the practice, to obtain all necessary information. One coding or billing mistake can affect patient care, provider and facility reimbursement, healthcare statistics, and healthcare operations. It’s a detail-oriented job that requires critical thinking.
Myth 5: Medical Billers Only Deal with Insurance Companies
When you think about medical billing, insurance claims probably come to mind first. You might imagine spending your day submitting claims and following up with insurance companies, with limited interaction with providers, other staff members, or patients. After all, most healthcare payments come from health plans.
The Truth
A medical biller’s day involves much more than insurance paperwork and communicating with insurers. They interact with healthcare providers and patients regularly.
In this position, you’d likely work with patients to clarify billing issues, set up payment plans, and answer questions about insurance coverage. However, some facilities have dedicated financial counselors who handle patient questions.
Billers also work closely with healthcare providers (and with coders, if they’re separate roles) to confirm that documentation and coding are correct before submitting claims. This is especially true when claims get flagged by software scrubbers (automated systems that check for errors before insurance submission).
You might find yourself communicating with collection agencies and other members of your facility’s revenue cycle department, too. Medical billers are often the bridge between patients, providers, and payers, which is one of the many reasons strong communication skills are essential.
Myth 6: You Don’t Need Ongoing Education Once Certified
Many students believe that once they complete their programs and pass their certification exams, they’re set for their entire careers. The coursework covers things you need to know and do in all sorts of healthcare settings. After putting in the work to learn so many codes and procedures, it may feel like there’s nothing left to learn.
The Truth
Healthcare changes over time, and medical billing and coding practices change along with it. New medical codes may be added every year, such as Category III codes that track new technologies and experimental procedures. ICD and CPT codes also get regular updates.
You need to keep learning to stay current in this field. That means taking continuing education classes and attending workshops. Sure, you need these to maintain your certification. Beyond that, regular learning helps you stay up-to-date and grow your career. The good news is that many employers support and pay for this ongoing learning as it helps their facility remain compliant and efficient.
Myth 7: Medical Coding Is the Same No Matter Where You Work
As a medical billing and coding student, you might think the job looks the same everywhere. After all, a broken arm is a broken arm, whether it’s treated in a small clinic or a large hospital.
The Truth
In reality, medical coding can vary greatly depending on the setting. For instance, hospital coders often work with Diagnostic Related Groups (DRGs) for inpatient stays and ICD-10-PCS for inpatient procedures. Meanwhile, outpatient coders may focus more on ICD-10-CM and CPT codes.
These different settings often look for various certifications, too. Physician offices typically want a certified professional coder (CPC) certification. Hospitals prefer the certified coding specialist (CCS) or certified inpatient coder (CIC) credential. Understanding this can help you choose which certification to pursue based on where you want to work.
Myth 8: Artificial Intelligence (AI) Will Soon Replace Human Coders
With all the buzz about AI in healthcare, you might worry about job security in medical coding. AI has already entered the healthcare coding space, with computer-assisted coding (CAC) software suggests codes based on medical documentation, and AI seems to be getting smarter every day. This can make it feel like human coders will soon be replaced.
The Truth
There’s no question AI can help speed up some tasks in many fields, including medical coding. But AI is a tool for medical coders to use; it’s not intended to replace them. Human coders are needed to verify machine-suggested codes, catch documentation gaps, and handle unusual cases that don’t fit standard patterns. The technology makes coding more efficient, but it can’t replace the critical thinking and expertise that human coders bring to the job.
