Medical billing and coding professionals serve as the critical link between healthcare providers, insurance companies, and patients. The educational requirement for medical billers and coders is a high school diploma or GED, though some employers require an associate degree. Understanding these educational pathways is essential for entering this growing healthcare field.
What is Medical Billing and Coding?
Medical billing and coding encompasses two distinct but interconnected functions within healthcare administration. Medical billers handle the financial and administrative side of healthcare, ensuring accurate payments and smooth insurance processes, while medical coders translate medical records into standardized codes.
Medical coders work directly with patient charts, interpreting physician documentation to assign diagnostic and procedural codes using systems like ICD-10, CPT, and HCPCS. Coding specialists create coded data used by hospitals and medical providers to obtain reimbursement from insurance companies or government programs. Medical billers then take these codes to create insurance claims and patient bills, ensuring proper reimbursement.
Medical billers and coders are responsible for reading and transcribing patient charts, turning that into the correct codes, and submitting the billing as an insurance claim. Daily tasks include analyzing operative reports, verifying diagnoses, processing claims, managing denials, and maintaining HIPAA compliance. To better understand the distinct roles and responsibilities of each profession, explore our guide on medical billing vs medical coding differences.
What Education Do You Need for Medical Billing and Coding?
Minimum Educational Requirements
To become a medical biller and coder, you first need to obtain a high school diploma or equivalent. This foundational requirement ensures candidates possess basic literacy, mathematics, and critical thinking skills necessary for the profession. However, the vast majority of employers require or encourage certification for medical billing & coding specialists, making additional education practically essential.
Most educational options for becoming a medical biller and coder offer a relatively fast and flexible way to begin a career in the medical field. While a high school diploma meets minimum requirements, specialized training through formal education programs has become the industry standard.
Educational Pathways
Certificate Programs: Certificate and diploma programs generally take nine months to one year to complete. These programs focus intensively on medical terminology, coding systems, billing procedures, and basic anatomy. ACC's Medical Billing program takes approximately 7 months to complete and provides comprehensive medical billing training with supplementary coding education, with 100% online coursework and a 180-hour in-person externship.
Associate Degrees: The Associate of Applied Science (AAS) in Medical Billing and Coding is the most common associate degree specifically designed for this career path. These 60-credit programs, which take approximately two years, provide deeper insight into healthcare regulations, ethics, revenue management, and patient interaction. Students complete general education requirements alongside specialized coursework focused directly on medical billing and coding skills. Other degree titles include Associate of Science (AS) in Medical Administrative Billing & Coding or Associate of Applied Science in Medical Reimbursement and Coding.
Bachelor's Degrees: It's important to note that there are no bachelor's degrees specifically titled "Medical Billing and Coding." Instead, if you want to earn a bachelor's degree, you will major in Health Information Management (HIM) or Healthcare Administration. These 120-credit, four-year programs are much broader than associate degrees, incorporating medical billing and coding as part of a comprehensive curriculum that includes healthcare business operations, leadership, strategic planning, and organizational management. These degrees prepare graduates for a wider variety of career options within the healthcare field, particularly leadership and management positions.
Types of Degrees and Programs
Certificate Programs in Detail
ACC's Medical Billing program provides comprehensive medical billing training with supplementary coding instruction, including in-depth instruction in industry-standard coding systems such as ICD 10, CPT, and HCPCS. For complete details on education and certification requirements, prospective students should review program prerequisites. Those new to the field should understand medical coding basics before diving into advanced certification preparation. Certificate programs typically include focused coursework covering:
- Medical terminology
- Anatomy and physiology
- Medical billing procedures and foundational coding
- Healthcare reimbursement methodologies
- Hands-on software training
With coursework covering applied billing and coding principles along with medical terminology, graduates will be well-prepared to sit for billing certifications including the Certified Medical Reimbursement Specialist (CMRS) and Certified Professional Biller (CPB) exams. While ACC's program focuses on CMRS and CPB preparation, graduates interested in additional coding certifications may choose to pursue credentials like CPC or CIC independently.
Associate Degree Components
The Associate of Applied Science (AAS) in Medical Billing and Coding is a focused, 60-credit program designed specifically to prepare students for immediate employment in medical billing and coding roles. Prerequisites include high school diploma or GED, minimum GPA (often 2.0 or above), and some programs require prerequisite coursework such as anatomy and physiology. Many students wonder whether medical coders need to know anatomy and physiology – the answer is yes, as this knowledge is crucial for accurate code assignment.
The curriculum centers entirely on building expertise in medical billing and coding, with core courses including:
- Medical terminology, pharmacology, diagnostic coding, procedural coding, and ethics
- Healthcare delivery systems
- Health information management
- Electronic health records
- Quality assessment
- Insurance and reimbursement methodologies
- ICD-10-CM, CPT, and HCPCS coding systems
With this specialized training, graduates are prepared to work directly as medical billing specialists, medical coding specialists, or claims processors. Some may qualify for supervisory roles, including billing managers or reimbursement specialists, after gaining experience.
Bachelor's Degree Advantages
If you intend to pursue management positions down the line, a bachelor's degree in Health Information Management (HIM) or Healthcare Administration will help. It's crucial to understand that these 120-credit bachelor's programs are not simply extended versions of medical billing and coding programs—they are comprehensive healthcare business degrees that prepare graduates for leadership roles across the entire healthcare administration field.
A Bachelor of Science in Health Information Management includes medical billing and coding knowledge but goes far beyond it, encompassing:
- Healthcare informatics and information systems
- Database management and data analytics
- Strategic planning and policy development
- Organizational leadership and personnel management
- Healthcare economics, finance, and accounting
- Legal and regulatory compliance
- Quality improvement and performance management
Similarly, a Bachelor of Science in Healthcare Administration or Healthcare Management prepares students for executive and managerial positions throughout healthcare organizations. Many bachelor's degrees in these fields require in-field work experience such as internships, providing valuable networking and practical experience. While graduates can certainly work in medical billing and coding roles, the degree opens doors to diverse leadership positions including health information manager, revenue cycle director, compliance officer, and healthcare administrator.
Medical Billing and Coding Certification Requirements
CMRS and CPB Certifications
ACC's Medical Billing program specifically prepares students for two industry-recognized certifications:
CMRS (Certified Medical Reimbursement Specialist): Offered by the American Medical Billing Association (AMBA), this certification validates expertise in medical billing and reimbursement processes. The CMRS credential demonstrates proficiency in claims processing, denial management, and healthcare reimbursement methodologies.
CPB (Certified Professional Biller): The CPB certification from AAPC is a nationally recognized credential that focuses on medical billing on the provider side of healthcare. This certification teaches coding basics while emphasizing billing expertise.
CPC (Certified Professional Coder) Certification
The CPC certification from AAPC represents the gold standard for medical coding professionals. For comprehensive details on all available certifications and their requirements, review our comprehensive certification guide. The CPC examination tests your ability to correctly apply CPT, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis codes used to report professional medical services.
When you pass the CPC exam, you receive your CPC-A credential, which signifies apprenticeship standing. To remove the apprentice designation:
- Two years of on-the-job experience using the CPT, ICD-10-CM, or HCPCS Level II code sets is required
- Completion of at least 80 contact hours of a coding preparation course equates with one year of coding experience
CCS (Certified Coding Specialist) Certification
The CCS certification from AHIMA is designed for individuals skilled in classifying medical data from medical records. CCS professionals demonstrate a practitioner's tested skills in data quality and accuracy as well as mastery of coding proficiency.
It is recommended to have complete courses in anatomy & physiology, pathophysiology, pharmacology, medical terminology, reimbursement methodology, intermediate/advanced ICD diagnostic coding, and procedural coding plus one year of coding experience.
Additional Certifications
CCA (Certified Coding Associate): The only requirement for the CCA exam, in addition to AHIMA membership and an application fee, is a high school diploma or an equivalent educational background. This entry-level certification is ideal for new professionals.
CBCS (Certified Billing and Coding Specialist): Offered by NHA, this certification requires a high school diploma or GED/high school equivalency and either completed medical billing and coding training within the last 5 years or 1 year of supervised work experience.
Timeline to Become a Medical Biller and Coder
Education Timeline
- Certificate/Diploma: ACC's Medical Billing program, which includes supplementary medical coding training, takes about 7 months to complete
- Associate Degrees: Typically completed in two years of full-time study or longer for part-time students
- Bachelor's Degrees: Generally require four years of full-time study or longer for part-time students
For a detailed breakdown of program durations and what to expect at each stage, explore our guide on how long medical billing and coding school takes.
Certification Preparation
The AAPC course for billers is a total of 80 hours and can be completed at the student's pace, within a four-month period or less. After completing education, most candidates dedicate additional time to intensive exam preparation. Once Authorization to Test email arrives from Pearson Vue, candidates must schedule an exam within their 120-day eligibility window.
Program Costs and Options
Online vs. Traditional Programs
ACC's Medical Billing diploma program exemplifies the benefits of online education, offering an accelerated pathway to becoming skilled in medical billing with foundational coding knowledge with 100% online coursework. Online programs eliminate commuting costs and offer flexibility for working students. Programs include 100% online coursework and a 180-hour in-person externship for hands-on experience, demonstrating effective hybrid models. Medical billing and coding is among several healthcare programs that can be completed in under a year, making it an attractive option for career changers.
Community colleges typically offer affordable certificate and associate degree options. Career college programs like those at ACC usually have a faster time to completion, which can offset costs through earlier workforce entry.
Career Paths by Education Level
Entry-Level with Certificates
Graduates may qualify for entry-level billing and coding roles in physician offices, outpatient clinics, and billing companies. Common positions include medical coding specialist, billing specialist, and claims processor. To explore the full range of opportunities available, discover what jobs you can get with a medical coding certificate.
Mid-Level with Associate Degrees
Graduates may qualify for supervisory roles, including billing managers or reimbursement specialists. These positions require comprehensive understanding of healthcare regulations and quality assurance processes. Many professionals in these roles appreciate the flexibility to work from home as medical coders, especially after gaining experience.
Advanced with Bachelor's Degrees
Holders of bachelor's degrees in Health Information Management (HIM) or Healthcare Administration access leadership positions including health information manager, revenue cycle director, and compliance officer. These roles involve strategic planning, policy development, and organizational leadership. While these degree programs include medical billing and coding as part of the curriculum, they prepare graduates for much broader responsibilities across healthcare administration.
Key Considerations
Do You Need Certification?
While not legally required, most employers require or encourage certification. Certifications enhance a candidate's qualifications and employability and demonstrate professional competency.
Can You Work Without a Degree?
Yes, through certificate programs and certifications. A variety of educational paths are available, including diploma, certificate, and degree programs. However, formal education combined with certification provides the best employment prospects. For those wondering whether medical billing and coding is hard, the answer depends on your dedication and the quality of your training program.
American Career College Programs
American Career College offers a comprehensive Medical Billing program that includes supplementary medical coding training, designed to prepare students primarily for billing roles with coding capabilities. ACC's program features:
- Comprehensive medical billing training with an introduction to coding fundamentals
- 100% online coursework for maximum flexibility
- Hands-on training with industry-standard software and forms
- Preparation for CMRS and CPB certifications
- 180-hour externship for real-world experience
- Completion in as little as 7 months
To enroll in ACC's Medical Billing program, students must show proof of high school graduation or a recognized equivalent and pass an entrance exam. Prospective students also meet with an admissions advisor to ensure the program aligns with their career goals.
Conclusion
Medical billing and coding offers multiple educational pathways from certificates to bachelor's degrees. While a high school diploma is the minimum requirement, specialized training has become essential for employment. Certificate programs offer the fastest entry at 6-12 months, associate degrees (such as the AAS in Medical Billing and Coding) provide specialized education over two years, and bachelor's degrees in Health Information Management or Healthcare Administration prepare professionals for leadership roles across the healthcare field.
Professional certification from AAPC or AHIMA is crucial regardless of educational path, with most employers requiring or encouraging credentials. Success in this field requires commitment to continuous learning as codes, regulations, and technology evolve. Whether pursuing a certificate or degree, combining solid education with professional certification positions individuals for rewarding healthcare careers. To learn more about the medical billing field and how it can support professional growth, explore our career guide.
American Career College's Medical Billing program provides comprehensive medical billing training with integrated coding education, offering the hands-on experience, flexibility, and certification preparation needed to thrive in this growing field. With an accelerated 7-month timeline and comprehensive support, ACC helps students transition into healthcare careers efficiently and effectively.
