What Do Medical Billers and Coders Do? Job Roles & Responsibilities for 2025

by Imed Bouchrika, Phd

Co-Founder and Chief Data Scientist

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Medical billers and coders play a critical role in keeping the healthcare system running smoothly, yet many people do not fully understand what these professionals actually do. From processing patient data to translating diagnoses into standardized codes, their work is essential for ensuring healthcare providers are accurately reimbursed and that medical records remain consistent and compliant. Despite the growing demand for these roles, the job responsibilities can often seem unclear or confusing to those just starting their research.

This guide is designed to clear up that confusion by breaking down the key roles, daily tasks, and career expectations of medical billers and coders. Whether you are a student exploring career paths, a job seeker looking for a stable role in healthcare, or simply curious about how medical billing and coding fit into the bigger picture, this resource will give you the expert insight you need to move forward with confidence.

Key things you should know about medical billers and coders:

• Medical billers and coders translate healthcare services into standardized codes used for documentation and insurance claims.
• Medical billers and coders earn an average of $55,000 per year, with higher pay for those with certifications or specialized experience.
• Opportunities exist in hospitals, private practices, insurance companies, and remote work environments.

Table of Contents:

1. What do medical billers and coders do on a daily basis?
2. What is the difference between medical billing and medical coding?
3. How much is the average salary for medical billers and coders in the U.S.?
4. What software do medical billers and coders use regularly?
5. What education is needed to become a medical biller or coder?
6. Which certifications are best for medical billing and coding?
7. What are the highest-paying industries for medical coders and billers?
8. What are the career growth opportunities in medical billing and coding?
9. Are medical billing and coding in high demand?
10. Why is medical billing and coding important in healthcare?
11. What essential skills do employers seek in medical billing and coding professionals?
12. What emerging trends and challenges shape the future of medical billing and coding?
13. What factors should you consider when choosing a medical billing and coding education program?
14. Could the quickest healthcare administration degree online fast-track your healthcare career?
15. Other things you should know about medical billers and coders

What do medical billers and coders do on a daily basis?

Medical billers and coders work behind the scenes to keep healthcare documentation and payments running smoothly. While their roles are different, their daily tasks often overlap and are essential to making sure healthcare providers get paid accurately and on time. For those looking to quickly gain expertise, a 4-week online course for medical coding and billing can provide a solid foundation and help you start your journey in these in-demand professions.

• Review patient medical records: Coders carefully examine clinical documents to identify diagnoses, treatments, and procedures. This step ensures that every detail is accurately captured for proper coding and billing.
• Assign standardized medical codes: Using classification systems like ICD-10, CPT, and HCPCS, coders translate medical services into universal codes. These codes are essential for insurance claims, healthcare analytics, and regulatory compliance.
• Create and submit insurance claims: Billers take the coded information and generate claims to submit to insurance companies for reimbursement. They ensure each claim is accurate and complete to avoid delays or denials.
• Follow up on unpaid or denied claims: When claims are rejected or go unpaid, billers investigate the issue, correct errors, and resubmit the documentation. This helps maintain a steady flow of revenue for the healthcare provider.
• Verify insurance and communicate with patients: Billers often contact insurance companies to confirm coverage details and eligibility. They may also explain charges to patients, answer billing questions, and set up payment plans if needed.

What is the difference between medical billing and medical coding?

Understanding the difference between medical billing and medical coding is essential if you're considering a career in this field. While the two roles are closely connected and often overlap, they involve distinct responsibilities within the healthcare revenue cycle.

• Medical coding focuses on translating healthcare services into standardized codes: Coders review patient records and assign specific codes (ICD-10, CPT, HCPCS) to diagnoses, procedures, and treatments for documentation and billing purposes.
• Medical billing involves processing and submitting insurance claims: Billers use the codes provided by coders to create claims, submit them to insurance companies, follow up on payments, and manage patient billing.
• Coders work more with clinical data, while billers handle financial transactions. While both roles work closely together, coders concentrate on medical accuracy, and billers ensure proper reimbursement and payment collection.

Check out our article on how to become a medical biller and coder from home. You will learn about online medical billing and coding programs that you can pursue while you attend to your other commitments.

How much is the average salary for medical billers and coders in the U.S.?

The average salary for medical billers and coders in the United States typically falls within a range of $43,000 to $70,000 per year, with a median total pay of around $55,000 annually. This compensation includes base pay along with bonuses, overtime, and other benefits. Entry-level professionals often start on the lower end of the scale, while experienced or certified coders, particularly those with specialized credentials, can earn a higher medical coder salary, reflecting their expertise and advanced skills.

Several factors influence how much a medical biller or coder earns. Location plays a major role, salaries are generally higher in metropolitan areas or states with a higher cost of living. Certification and education level significantly impact earnings as well, with credentialed professionals earning notably more than their non-certified peers. Work setting also matters: hospitals, government agencies, and large healthcare systems often offer higher compensation compared to private practices or third-party billing companies. Lastly, experience and specialization, such as working in inpatient coding or mastering complex coding systems, can substantially boost income over time.

What software do medical billers and coders use regularly?

Medical billers and coders use a variety of specialized software tools to perform their daily tasks efficiently and accurately. These programs help manage patient data, assign medical codes, and process insurance claims, all while maintaining compliance with healthcare regulations.

• Electronic Health Records (EHR) systems: Platforms like Epic, Cerner, and Allscripts store patient information, clinical notes, and treatment histories. Coders use EHRs to review documentation and extract details needed for coding.
• Medical coding software: Tools such as 3M CodeFinder, TruCode, and Optum EncoderPro assist coders in selecting the correct ICD-10, CPT, and HCPCS codes. These programs streamline the coding process and reduce the risk of errors.
• Billing and practice management software: Systems like Kareo, AdvancedMD, and AthenaCollector help billers create and submit claims, manage payments, and track revenue cycles. They also handle scheduling, insurance verification, and patient billing.
• Clearinghouse platforms: Software such as Availity or Change Healthcare acts as intermediaries between healthcare providers and insurance payers. They check claims for errors before submission and speed up reimbursement processes.
• Compliance and audit tools: Programs like Audit Manager or Compliance Checker help ensure coding accuracy and adherence to healthcare regulations. These tools are especially useful in large facilities or when dealing with complex cases.

What education is needed to become a medical biller or coder?

If you are considering a career in medical billing and coding, it is important to understand the educational path that prepares you for success in this field. While you don’t need a four-year degree, completing the right training and earning certifications can greatly improve your job prospects and earning potential.

• High school diploma or GED: A high school diploma or equivalent is the minimum educational requirement to enter the field. It serves as the foundation for further training in medical billing and coding.
• Postsecondary training program: Most aspiring billers and coders complete a certificate or diploma program at a community college, technical school, or online institution. These programs typically take between 4 months and 2 years and cover subjects like medical terminology, anatomy, and coding systems. For those seeking an affordable option, a low-cost medical coding and billing online program can provide a flexible and budget-friendly path to entering the field.
• Associate degree (optional but preferred): Some students choose to pursue an associate degree in health information technology or a related field. This option provides a broader education and may offer better long-term job prospects and advancement
• Medical coding and billing certifications: Certifications such as the Certified Professional Coder (CPC) from AAPC or Certified Coding Specialist (CCS) from AHIMA are highly valued by employers. These credentials prove that you’ve mastered standardized coding practices and are prepared for the demands of the job.
• Continuing education and updates: Many certified professionals are required to complete continuing education units (CEUs) annually to maintain their credentials. Just as those in specialized fields, such as ultrasound technicians who attend the best ultrasound tech schools for their training, medical billers and coders must keep up-to-date with the latest developments to ensure they remain competitive and compliant in their careers.

Becoming a medical biller or coder typically takes 1 to 3 years, depending on the educational path and certification goals. Many students complete a certificate or diploma program in about 12 to 18 months, while those pursuing an associate degree may take up to 2 years. Adding time for certification exam preparation, the entire process can range from one to three years, making it a relatively quick route into a healthcare career.

You can check out our separate article on medical billing and coding bachelor's degree vs certificate program for a better understanding of their differences.

Which certifications are best for medical billing and coding?

If you are looking to advance in medical billing and coding, earning a certification is one of the best ways to boost your credibility, job prospects, and salary. While certification isn’t always required, most employers strongly prefer candidates who hold industry-recognized credentials. Below are some of the most respected and widely accepted certifications in the field:

• Certified Coding Specialist (CCS) – AHIMA: The CCS is ideal for those who want to work in hospital or inpatient settings. It demonstrates mastery in classifying medical data from patient records using ICD-10-CM/PCS and CPT coding systems.
• Certified Billing and Coding Specialist (CBCS) – National Healthcareer Association (NHA): The CBCS covers both billing and coding functions and is a good entry-level option for those seeking a broad foundation. It’s especially helpful for those working in smaller practices where staff may handle both roles.
• Certified Professional Coder (CPC) – AAPC: The Certified Professional Coder (CPC) certification is one of the most recognized certifications in outpatient coding. It focuses on coding for physician services and includes knowledge of CPT, ICD-10-CM, and HCPCS Level II codes.
• Certified Inpatient Coder (CIC) – AAPC: This certification is specifically for coders who want to specialize in inpatient hospital coding. It focuses on ICD-10-CM and ICD-10-PCS and is ideal for those working in acute care settings.
• Certified Outpatient Coder (COC) – AAPC: The COC is designed for coders who work in outpatient facilities like ambulatory surgical centers and hospital outpatient departments. It emphasizes billing and coding for services that don’t require hospital admission.

You can also check out other healthcare certifications online in case there are other medical fields you want to explore.  

What are the highest-paying industries for medical coders and billers?

Salaries for medical billers and coders can vary widely depending on the type of industry they work in. While many professionals begin their careers in doctors’ offices or clinics, some sectors offer significantly higher pay due to the complexity of the work or the scale of the organization. Below are the top-paying industries for medical records specialists, along with their average annual salaries:

• Management of companies and enterprises: This industry offers the highest average salary for health information technologists and medical registrars at $77,170 per year. Professionals in this setting often work in corporate healthcare operations or centralized billing and coding departments for large organizations.
• Administrative and support services: Hospitals provide an average salary of $67,920 per year, making them one of the top-paying employers for medical coders and billers. These roles typically involve handling a wide variety of complex coding tasks and offer more opportunities for specialization and advancement. You can also find out the medical administrative assistant salary per hour.
• Professional, scientific, and technical services: Health information technologists and medical registrars working in this sector earn about $66,470 per year. Jobs in this category often include third-party billing services or companies that provide outsourced support to healthcare providers.
• Hospitals, state, local, and private: This industry pays an average of $62,580 per year and includes organizations such as healthcare consulting firms, research institutions, and legal services. Coders in this field may be involved in compliance, auditing, or data analysis tasks.
• Offices of physicians: While this is a common entry point into the profession, it has a lower average salary of $50,790 per year. Medical billers and coders in physician offices often perform a broad range of duties in smaller team environments.

If you are exploring a career in medical billing and coding, it is helpful to know which industries offer the highest pay. The following salary data applies to medical records specialists, which includes both medical billers and coders. Your earning potential can vary based on the work setting, with some industries offering significantly higher average salaries than others. The chart below shows the average salary for medical records specialists working in the top industries in the U.S.:

What are the career growth opportunities in medical billing and coding?

Medical billing and coding offer several career growth opportunities as professionals gain experience and further certifications. With the healthcare industry constantly evolving, there are numerous paths to specialization and advancement.

• Specialized coding roles: As you gain experience, you can specialize in specific areas of coding, such as inpatient coding, outpatient coding, or psychiatric coding. These specialties often come with higher salaries and more complex responsibilities, providing both career growth and job security. To pursue these advanced roles, it is important to complete accredited medical coding programs that offer specialized training and prepare you for certification in these specific areas.
• Health Information Manager: With additional training and certifications, medical billers and coders can transition into roles like health information manager or health information technician. These positions involve overseeing the management of medical records, ensuring compliance with regulations, and supervising coding and billing staff.
• Compliance Auditor: As a medical coding auditor, you would review coded data to ensure it complies with federal and state regulations. This role requires a deep understanding of coding systems and healthcare policies, offering an advanced career track for those with strong attention to detail.
• Medical Billing Supervisor or Manager: Experienced billers can move into supervisory roles where they manage teams of billers and coders. These positions require leadership skills and a comprehensive knowledge of billing practices, and they often come with higher salaries and more responsibilities.
• Consulting or Freelance Opportunities: Experienced medical billers and coders can also branch out as independent consultants or freelancers. By offering their expertise to healthcare providers, insurance companies, or other organizations, they can set their own schedules and increase their earning potential.
• Educator or Trainer: With sufficient experience and advanced certifications, seasoned professionals may become trainers or educators. These roles involve teaching future medical billers and coders, either at colleges or through online courses, contributing to the growth of the field while also enjoying a steady career path.

Are medical billing and coding in high demand?

​Yes, medical billing and coding are in high demand. According to the U.S. Bureau of Labor Statistics, employment of health information technologists and medical registrars, which includes medical records specialists, is projected to grow 16% from 2023 to 2033, much faster than the average for all occupations. This growth is expected to result in approximately 3,200 job openings each year over the decade, driven by the need to replace workers who transfer to different occupations or retire.

In 2023, there were about 39,100 health information technologists and medical registrars employed, with projections indicating this number will increase to 45,500 by 2033, reflecting a growth rate of 16%. This trend underscores the expanding role and necessity of health information technologists and medical registrars in the evolving healthcare industry. The table below shows the projected employment numbers for health information technologists and medical registrars within the next decade:

Why is medical billing and coding important in healthcare?

Medical billing and coding are crucial to the healthcare system for several reasons, as they ensure the accurate and efficient processing of healthcare services. These roles bridge the gap between healthcare providers, insurers, and patients, making sure that services are documented properly and reimbursed appropriately. For those seeking flexibility in their education, online medical billing and coding with financial aid offers a convenient option to pursue this career while managing costs.

• Ensuring accurate reimbursement: Medical coding and billing professionals ensure that healthcare providers are reimbursed correctly for the services they provide. Without accurate codes, insurance companies may reject claims, leading to financial losses for both healthcare providers and patients.
• Maintaining compliance and reducing fraud: Coding ensures that healthcare services are documented in compliance with regulations such as HIPAA and the Affordable Care Act. Accurate coding and billing help prevent fraud, abuse, and errors that could result in legal or financial penalties for healthcare providers.
• Improving healthcare data management: Proper coding of medical records allows for better data management and reporting, which is essential for patient care, research, and healthcare policy decisions. It enables hospitals and healthcare facilities to track patient outcomes, treatments, and trends more effectively.
• Facilitating communication among healthcare professionals: Medical coding standardizes the way information about patient diagnoses, treatments, and procedures is communicated across the healthcare system. This helps ensure that all healthcare professionals involved in a patient's care have a clear understanding of the services provided, improving overall care coordination.
• Supporting healthcare analytics: Accurate medical coding plays a key role in healthcare analytics, helping organizations understand trends, costs, and patient needs. This data can be used for improving clinical outcomes, resource allocation, and cost management in healthcare settings.

What essential skills do employers seek in medical billing and coding professionals?

A robust skill set is crucial for navigating the complex landscape of medical billing and coding. Employers consistently seek candidates with advanced analytical abilities to interpret and apply coding standards accurately, as well as a meticulous attention to detail that ensures data integrity. Proficiency in specialized billing software and a thorough understanding of regulatory guidelines, such as HIPAA, are indispensable. Furthermore, strong communication skills and an agile problem-solving mindset enable professionals to address discrepancies and streamline workflow effectively. For those aiming for managerial roles, exploring additional leadership training through the quickest online MBA in healthcare management can offer a strategic edge in driving organizational success.

Here’s what graduates have to say about their medical billing and coding degrees:

I decided to pursue medical billing and coding because I wanted a stable career with opportunities for growth. After earning my certification, I quickly found a job and now work from home, which gives me the flexibility I need to balance my personal life. It’s rewarding to know that I play a key role in helping healthcare providers get paid accurately for their services. — Hailey

I initially started as a medical biller and coder to get my foot in the door of the healthcare industry, but I never imagined how much I would enjoy it. The work is challenging yet fulfilling, and the demand for skilled professionals means job security is high. It’s incredibly satisfying to know that my work helps make healthcare more efficient and accessible. — Ben

Entering the medical billing and coding field was a decision I’ll never regret. The certification process was straightforward, and I found a job within months of completing my training. Not only has it provided me with financial stability, but the sense of contributing to something as important as healthcare is deeply meaningful to me. — Alec

What emerging trends and challenges shape the future of medical billing and coding?

Digital transformation and evolving regulatory frameworks are redefining the skill set required in this field. Industry shifts include the integration of artificial intelligence for enhanced coding accuracy and the need to adapt to frequent updates in healthcare policies. Continuous professional development—including participation in accredited programs such as medical assistant online classes—helps practitioners stay ahead in a competitive landscape.

What factors should you consider when choosing a medical billing and coding education program?

When evaluating educational programs, prioritize accreditation, curriculum depth, and the balance between flexibility and structure. Examine a program’s reputation for job placement and industry partnerships, as these directly affect your post-graduation opportunities. Consider how tuition costs and available financial aid options align with your budget, and compare alternatives such as the cheapest online health science degree. Analyze program length and completion rates to ensure timely credential attainment, and review faculty expertise to guarantee up-to-date industry practices are taught.

Could the quickest healthcare administration degree online fast-track your healthcare career?

Accelerated healthcare administration programs provide a streamlined curriculum that equips professionals with practical management skills and a comprehensive understanding of healthcare operations in a condensed timeframe. These programs support quicker transitions into supervisory and leadership roles by focusing on core competencies, real-world case studies, and strategic decision-making. For individuals looking to leverage an expedited educational path, enrolling in the quickest healthcare administration degree online can offer the competitive edge needed to advance their careers efficiently.

Key Findings

• It takes one to three years to become a medical biller and coder in the U.S.
• The average annual salary for medical billers and coders is around $55,000, with the potential for higher earnings depending on certifications and experience.
• Medical billers and coders can specialize in various areas, such as inpatient, outpatient, and psychiatric coding, offering opportunities for career advancement.
• Hospitals and management companies are the highest-paying employers, offering salaries averaging $52,350 to $53,320 for medical records specialists.
• Certifications are essential for career growth, with top credentials like the Certified Professional Coder (CPC) and Certified Coding Specialist (CCS) boosting job prospects and salary potential.

Other things you should know about medical billers and coders

How is hospital coding different from physician office coding?

Hospital coding and physician office coding differ primarily in the complexity and scope of the services provided. Hospital coding often involves inpatient coding, which requires more detailed knowledge of medical procedures, diagnoses, and patient care during an extended stay. Coders in hospitals use more extensive coding systems, such as ICD-10-PCS, and may deal with multiple departments and specialists. 

In contrast, physician office coding typically focuses on outpatient services, where the coding is more straightforward and based on routine visits, exams, and minor procedures. The coding systems used, such as ICD-10-CM and CPT, are similar but generally simpler for outpatient scenarios.

Do medical billers and coders work from home?

Yes, many medical billers and coders have the option to work from home, especially with the rise of remote job opportunities in the healthcare industry. Many healthcare providers and medical billing companies offer flexible work-from-home arrangements, allowing professionals to handle coding and billing tasks remotely. However, this often depends on the employer, the complexity of the work, and whether the position requires access to secure, on-site systems. With the right tools and software, including secure virtual platforms, remote work is becoming increasingly common in this field.

What is the difference between CPC and CCS certification?

The Certified Professional Coder (CPC) and Certified Coding Specialist (CCS) certifications both validate expertise in medical coding but differ in their focus and application. The CPC, offered by AAPC, is more commonly associated with outpatient coding and is ideal for those working in physician offices or ambulatory care settings. It focuses on coding for services such as office visits, diagnostic tests, and minor procedures. The CCS, offered by AHIMA, is focused on inpatient hospital coding, including more complex procedures and extended hospital stays. CCS-certified professionals are typically employed in hospitals or healthcare systems dealing with more intricate cases and require a deeper understanding of the healthcare delivery system.

How do billers and coders handle patient data and insurance claims?

Medical billers and coders handle patient data and insurance claims with utmost accuracy and confidentiality, ensuring compliance with healthcare regulations like HIPAA. Coders first review medical records to assign the appropriate codes for diagnoses and procedures. Billers then use these codes to create and submit insurance claims, ensuring that all necessary information is included for reimbursement. They also verify insurance coverage and communicate with both patients and insurers to resolve any issues or denials. Throughout this process, maintaining the privacy and security of patient information is a top priority, with professionals adhering to strict confidentiality standards and utilizing secure systems.

References:

• Glassdoor. (2025). Medical Billing Salaries. https://www.glassdoor.com
• NHTI Concord’s Community College. (n.d.). Medical Billing and Coding Training - NHTI. https://www.nhti.edu
• U.S. Bureau of Labor Statistics. (2024). OOH: Health Information Technologists and Medical Registrars. https://www.bls.gov