When a patient enters the medical care system, records are maintained of
their health care status, and all the tests,
diagnoses and other treatments that they
undergo. It is imperative that all medical
records are accurate and up-to-date to
ensure that patients get the best care possible. Accurate records are also important so that the patient gets billed for the correct
amount from the health insurance company and from the health care facility. A certified coding specialist ensures that when a patient gets health care, a code is assigned to each diagnosis and procedure. They consult classification manuals and then utilize computer software to assign the
patient to one of several hundred “diagnosis related groups” or DRGs. This DRG then determines the amount for which the hospital or clinic will be reimbursed if the patient is covered by insurance or some other program.
 Areas of Specialization
Depending on the size of the health care facility in which they are employed,
the certified coding specialist may
specialize in one area of health coding. If
they work in a smaller facility, they may
be responsible for the administration of
the entire coding department.
Work Environment
Certified coding specialists may work
in a large hospital or a small physician's
office, but wherever they work, it's likely
that there will be little to no patient contact.
In some health care facilities, they may be
in an office separate from the health care
facility for which they are doing the coding.
Length of Training
Most employers will choose to hire
someone with an Associate's degree from
a community college or similar in health
information management or similar.
However, in rare cases, some employers
will take someone with a high school
diploma and then ask them to complete some
in-house training.
Licensure/Certification
Entry-level applications should pass
the exam offered by the American Health
Information Management Association (AHIMA) to
be a Certified Coding Assistant (CCA).
The AHIMA also offers a second-step
certification called a Certified Coding
Specialist (CCS) which offers more
advanced training, and then finally a
Certified Coding Specialist-Physician Based
(CCS-P) which means that the individual
has been trained to work effectively in a
physician's office or practice.
Education Programs
C=Certificate, A=Associate's, B=Bachelor's, M=Master's, D=Doctorate
Professional Associations
American Health Information Management Association (AHIMA)
www.ahima.org
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