What is Medical Billing and Coding? A Beginner’s Guide

Medical billing and coding may sound like background work, but without it, the entire healthcare system would fall apart.

Every time you visit a doctor, someone has to document what happened, translate it into universal codes, send it to your insurance, and make sure the provider gets paid. That’s where medical billers and coders come in.

What Exactly is Medical Billing and Coding?

Medical billing and coding are two closely related processes that help healthcare providers receive payment for the services they offer.

• Medical Coding is the process of converting medical procedures, diagnoses, and treatments into standardized codes (like ICD-10 or CPT).

• Medical Billing involves creating insurance claims based on those codes and submitting them for payment, then tracking and managing those payments.

Think of coders as translators, and billers as financial messengers.

So, What’s the Difference?

Even though they work hand-in-hand, their roles are different:

• Coders read clinical documents and assign the correct medical codes.

• Billers use those codes to prepare claims and ensure payments are processed correctly.

Here’s a quick comparison:

Where Do They Work?

You’ll find medical billers and coders working in:

• Hospitals

• Private practices

• Outpatient clinics

• Health insurance companies

• Government agencies

• And increasingly... from home

💻 Remote coding and billing jobs have surged in popularity thanks to cloud-based EHR systems.

How the Billing & Coding Process Works (Step-by-Step)

Let’s say a patient visits a clinic for a sprained ankle. Here’s what happens behind the scenes:

1. Doctor documents the visit in the EHR.

2. Medical coder reviews the note and assigns:

   • ICD-10 code for the sprain

   • CPT code for the evaluation or imaging

3. Medical biller creates an insurance claim with those codes.

4. Claim is submitted to insurance.

5. Insurance processes the claim and sends payment (or denies it).

6. Biller follows up if payment is delayed or denied.

It sounds simple — but it requires precision, knowledge, and sometimes persistence.

What Are the Codes Used?

There are three major coding systems you’ll hear about:

• ICD-10 – International codes for diagnoses (e.g. M25.571 – Ankle pain)

• CPT – Codes for procedures and services (e.g. 99213 – Office visit)

• HCPCS – Codes for medical equipment, drugs, supplies

A skilled coder must know how to apply the right code based on clinical documentation. Even one wrong digit can lead to denied claims.

Do You Need a Degree?

Nope. A college degree isn’t required — but proper training and certification definitely are.

Here’s what most professionals do:

• Enroll in a 4 to 12-month coding/billing program (online or in-person)

• Learn medical terminology, coding systems, and healthcare compliance

• Prepare for certification exams like:

  • CPC (Certified Professional Coder – AAPC)

  • CCA or CCS (AHIMA)

  • CPB (Certified Professional Biller)

Key Skills You’ll Need

Not everyone is cut out for this field, but if you have these traits, you're on the right track:

• Detail-oriented and organized

• Love working with data and structure

• Comfortable with tech and digital systems

• Strong reading comprehension

• Can handle insurance terms and healthcare lingo

Salary and Career Outlook

Medical billing and coding is one of the most stable, remote-friendly healthcare careers right now.

Here’s what you can expect in the U.S.:

• Medical Coder: $45,000–$65,000/year

• Medical Biller: $40,000–$55,000/year

According to the U.S. Bureau of Labor Statistics, jobs in this field are projected to grow 8% through 2032 — faster than average.

Many professionals start small and work their way up to remote positions, management roles, or even freelance coding businesses.

Tools and Software in the Industry

You’ll use a variety of digital tools daily. Common ones include:

• EHR/EMR Systems: Epic, Cerner, Athenahealth

• Coding Software: EncoderPro, 3M Codefinder

• Billing Platforms: Kareo, AdvancedMD, CollaborateMD

Training often includes exposure to these systems so you’re job-ready from day one.

Real-World Example

“I started medical billing as a side hustle during nursing school. Now, I work full-time from home for a telehealth clinic and make $52K a year — no commute, no scrubs.”
— Dee, CPB in Texas

Common Questions

Is medical billing and coding hard?
It takes focus, but it’s very doable — especially with proper training.

Can I work from home?
Yes! In fact, remote jobs are increasing fast in this industry.

Do I need to memorize all the codes?
No — you’ll use software tools and references daily. Understanding how to use codes matters more than memorization.

Final Thoughts

Medical billing and coding is a rewarding career path that blends healthcare with technology and finance. Whether you want a stable job, the flexibility to work from home, or an entry point into the healthcare industry — this field checks all the boxes.

Ready to dive in? Start with training, get certified, and you could be earning within the year.