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How Do I Become a Clinical Coder?

T. Carrier
T. Carrier

Clinical coders are responsible for translating and recording medical information into an electronic format for the purposes of data entry, processing insurance claims, and other clinical duties. An individual who has successfully become a clinical coder will have completed at least two years of higher education in Health Information Management or a related discipline. A coder will be proficient in science and coding-specific classes and have sharp analytical and computer skills. Once a coder has obtained certification, advancement can take place in medical facilities ranging from acute care facilities to hospitals.

Utilizing information learned about medical terminology and the human body, these professionals assign various medical diseases and testing procedures an electronic code. The codes are used to determine the reimbursement level that medical insurance will cover and for data storage. Coders must learn classification systems, so constant familiarity with changing rules and regulations is essential. Individuals in this field may also be asked to compile statistical information and research reports.

A clinical coder ensures the proper medical billing.
A clinical coder ensures the proper medical billing.

When a college-bound student or someone wishing to change careers chooses to become a clinical coder, he or she should enroll in an accredited program. Such an educational path will likely focus on classes in the following disciplines: physiology, anatomy, medical terms, mathematics, and microbiology. Courses in coding classifications would be a major part of the curriculum as well. Many colleges offer two-year programs in Health Information Technology or a similar area of study leading to an associate’s degree. Some distance learning organizations may also make accredited programs available.

In most regions, the last step to become a clinical coder involves passing certification exams. A strong test score will likely separate a candidate from competitors. As coding regulations are ever-evolving, it is vital that a clinical coder consistently completes new courses. Required certification renewal is commonplace.

An individual wishing to become a clinical coder may seek employment in various medical settings. Most hospitals contain a health information department that employees clinical coders, both on a full-time and a part-time basis. Outpatient clinics may afford similar opportunities, particularly in areas of acute care. In addition, many privately practicing physicians will be in need of at least one individual to manage patient records.

In order to become a clinical coder, an individual should ideally have certain skill sets and expectations. For one, a high level of comfort with using and navigating computer programs is essential. Prospective candidates should also possess analytical skills, a keen eye for detail, and a strong memory, as proper input of information is a key job requirement. The work will be conducted indoors with long periods of sitting and varying levels of communication with doctors, insurance representatives, and regulation agencies. Individuals with a passion for the medical profession and with strong electronic and research skills are prime fits for these positions.

Once an individual has become a clinical coder, career advancement is possible. Prospects usually begin as entry level coders under the supervision of intermediate coders. While those at the intermediate level can work as independent coders, they must occasionally be evaluated by advanced coders. In order to attain advanced status, one typically must have a minimum experience of five years and must also be specially certified. Others opt to work in various medical organizations as a traveling medical coder, but this step in general requires at least one year of experience and specialized certification.

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    • A clinical coder ensures the proper medical billing.
      By: Lisa F. Young
      A clinical coder ensures the proper medical billing.