Navigating Medical Billing's Training vs. Experience Conundrum

by  Find-A-Code™
Sep 5th, 2022

Imagine the following scenario: a young person goes to school to earn certification as a medical coder or billing specialist. Upon completion, every job the recent graduate applies for requires experience. But how is this person supposed to get experience without landing that first job? It is a conundrum faced by certificate holders around the country.

Companies want trained and certified coders and billers. That is understandable. But they also want experience. All the training and certification in the world doesn't much matter if a new medical coder isn't given the chance to get their foot in the door. Something has got to give. Somewhere, there needs to be employers willing to hire coding and billing specialists who have training and certification but no practical job experience.

Training Only Goes So Far

Certification courses are excellent tools. They teach students all the ins and outs of medical billing. Students learn about ICD-10 and 11 codes, NPI lookup, CPT codes, and on and on. Training teaches them the fastest and most accurate way to pursue diagnostic code lookup. It even teaches them about HIPAA compliance.

The only downside is that classroom training only goes so far. Everything learned in the classroom works in the classroom setting. It doesn't necessarily work in the real world. And by the way, this is true in just about every industry. It is not limited to medical billing and coding.

The challenges faced by newly certified billing specialists are observed across many other industries. Take truck driving. Despite the trucking industry being short tens of thousands of drivers, many companies are reluctant to hire newly licensed applicants who have no over-the-road experience. Yet without a job, drivers cannot gain the experience employers want.

Formal Training Is Still Valuable

Do not misunderstand and assume that training and certification are not valuable. They are. They go a long way toward helping medical coders and billers go from entry-level jobs to more advanced positions. Without training, the career road is a lot more bumpy.

In theory, it is possible to break into medical coding or billing without any formal training at all. You might start working as an office assistant in a local practice. While on the job, you learn the basics of coding and billing. You might even lend a hand when things get a little bit busy.

Over time, gradually learning more details about administrative and diagnostic codes gives you confidence to take a certification exam. You do so, pass, and become a certified medical coder. But how long did the process take? Furthermore, how limited is your knowledge of the entire medical billing spectrum?

Training Offers the Big Picture

Undergoing formal training gets you on a career path faster. It offers the big picture that on-the-job experience takes longer to achieve. For example, a formal education program familiarizes students with all the most important concepts of medical coding.

The differences between ICD-10 and 11 is but one example. Just within these two different coding systems, there are tens of thousands of codes to be familiar with. Medical coders are not expected to memorize them all, but familiarity does make the job easier.

There really is no substitute for formal education prior to being certified as a medical coder or biller. Formal training prepares you for a career that is detail oriented and constantly evolving. Unfortunately, training does not equal real-world experience.

This leads to the conundrum of not being able to get a job for lack of experience. And yet, that first job will give you some of the experience you need to advance in your career.