What Does a Medical Billing and Coding Specialist Do During a Typical Workday?
What does a medical billing and coding specialist do during a typical workday? These healthcare professionals review clinical documentation, assign standardized diagnosis and procedure codes, prepare insurance claims, investigate rejected or denied claims, protect patient information and help healthcare organizations receive appropriate reimbursement.
Although medical billing and medical coding are closely connected, they are not exactly the same:
Medical coding converts diagnoses, services, procedures and supplies into standardized healthcare codes.
Medical billing uses those codes and other patient information to prepare claims, communicate with insurance payers, track payments and resolve reimbursement problems.
In smaller medical practices, one employee may perform both functions. Hospitals, insurance companies and larger healthcare organizations may divide the work among specialized coding, billing, payment-posting, auditing and denial-management teams.
Medical billing and coding can be an appealing healthcare pathway for detail-oriented people who want to support patient care without performing hands-on clinical procedures.
Clinical Skills Institute offers an online Medical Billing and Coding program designed to prepare eligible students for the NHA Certified Billing & Coding Specialist examination in approximately three months. Published standard tuition is $900 and includes online coursework, learning materials, CBCS exam preparation, practice examinations, coding simulations, the eligible exam fee and career support.
Quick Answer: What Does a Medical Billing and Coding Specialist Do?
A medical billing and coding specialist helps transform a patient encounter into an accurate medical record and a properly prepared insurance claim.
Common responsibilities include:
Reviewing patient and provider documentation
Confirming that records are complete
Identifying diagnoses, procedures and services
Assigning applicable medical codes
Verifying insurance eligibility and benefits
Checking authorization information
Entering charges into billing software
Preparing and submitting claims
Reviewing claim-edit reports
Correcting rejected claims
Investigating denied claims
Posting or reviewing insurance payments
Following up on unpaid balances
Communicating documentation questions
Protecting confidential patient information
Following payer, regulatory and organizational requirements
Specific duties depend on the employer, job title, specialty and size of the healthcare organization.
A Typical Medical Billing and Coding Specialist Workday
No two employers organize the revenue cycle in exactly the same way. However, a typical workday may follow this general pattern.
8:00 a.m.: Review Work Queues and Priorities
The specialist may begin by signing into the electronic health record, practice-management system, coding platform or payer portal.
The morning review may include:
New patient encounters waiting to be coded
Claims that require correction
Rejected electronic claims
Insurance denials
Requests for additional documentation
Claims approaching filing deadlines
Messages from providers or billing-team members
Outstanding patient-account questions
Compliance or coding updates
Organizing these priorities early helps prevent avoidable delays in claim submission and reimbursement.
8:30 a.m.: Review Clinical Documentation
Before assigning codes, the specialist reviews the healthcare provider’s documentation.
Records may include:
Patient demographics
Medical histories
Provider notes
Diagnoses
Operative reports
Laboratory results
Imaging reports
Medication information
Discharge summaries
Procedure documentation
Medical-necessity information
The specialist checks whether the documentation is accurate, complete and sufficient to support the services being coded.
A coder should not guess what a provider intended. If information is missing or unclear, the appropriate next step may be to submit a compliant documentation query or request clarification according to employer policy.
9:30 a.m.: Assign Diagnosis and Procedure Codes
The coding portion of the workday involves translating healthcare documentation into standardized codes.
Depending on the setting and position, the specialist may work with:
ICD-10-CM for diagnoses
CPT for many physician services and procedures
HCPCS Level II for certain products, supplies, medications and services
ICD-10-PCS for inpatient hospital procedures
The correct code depends on the documented service, applicable guidelines, specificity of the diagnosis, care setting and payer requirements.
Accurate coding matters because codes affect:
Insurance reimbursement
Patient records
Medical-necessity review
Quality reporting
Compliance
Healthcare data
Public-health statistics
Organizational planning
The U.S. Bureau of Labor Statistics explains that medical records specialists review records for accuracy, assign clinical codes and maintain information used for reimbursement and data analysis. Review the BLS description of medical records specialists.
11:00 a.m.: Review Charges and Prepare Claims
After coding is complete, billing information must be checked before a claim is sent to the payer.
The specialist may verify:
Patient name and identifying information
Insurance policy information
Dates of service
Rendering and referring providers
Place of service
Diagnosis and procedure codes
Modifiers
Units of service
Authorization or referral information
Charge amounts
Coordination of benefits
Payer-specific filing rules
The goal is to create a clean claim—a claim that can be processed without preventable errors or missing information.
Even a small mistake can cause a rejection, delay or denial. For example, an incorrect policy number, missing modifier, invalid code combination or mismatched date of service may prevent successful processing.
12:30 p.m.: Respond to Rejections and Claim Edits
An electronically submitted claim may be rejected before the insurer formally processes it.
A rejection can occur because of:
Missing patient information
Invalid insurance details
Incorrect provider identifiers
Coding-format problems
Missing required fields
Incompatible codes
Duplicate claim information
Electronic submission errors
The specialist reviews the rejection message, identifies the problem, corrects the claim and resubmits it when appropriate.
A rejected claim is different from a denied claim. A rejection generally means the claim could not enter or complete the payer’s adjudication process. A denial generally means the payer processed the claim but determined that payment would not be made as submitted.
1:30 p.m.: Investigate Denied or Underpaid Claims
Denial management is an important part of the revenue cycle.
A specialist may investigate denials involving:
Eligibility
Medical necessity
Prior authorization
Timely filing
Noncovered services
Duplicate claims
Bundled services
Incorrect modifiers
Coordination of benefits
Missing documentation
Coding discrepancies
The specialist may compare the denial with the medical record, payer policy and original claim. Depending on the findings and employer procedures, the next step may involve correcting the claim, submitting supporting records, preparing an appeal or routing the account for further review.
The objective is not to maximize reimbursement regardless of the facts. The objective is to support accurate, compliant reimbursement for documented and covered services.
2:30 p.m.: Communicate With Providers, Payers and Team Members
Medical billing and coding specialists may spend much of the day at a computer, but communication remains essential.
They may communicate with:
Physicians
Nurses
Medical assistants
Front-office employees
Health-information professionals
Insurance representatives
Practice managers
Compliance teams
Patients
Other billing and coding specialists
Common questions may involve missing documentation, insurance eligibility, authorization, coding specificity, claim status or patient responsibility.
Strong specialists communicate clearly while remaining within their role. They should not alter a provider’s documentation, select an unsupported code or misrepresent a service to obtain payment.
3:30 p.m.: Review Payments and Outstanding Accounts
Depending on the position, the specialist may review electronic remittance information and compare payments with expected reimbursement.
Tasks may include:
Reviewing insurance payments
Identifying contractual adjustments
Checking patient responsibility
Researching underpayments
Following up on unpaid claims
Reviewing aging reports
Identifying recurring denial patterns
Escalating payer problems
Updating account notes
Routing balances to the appropriate team
Some organizations assign these responsibilities to dedicated payment-posting or accounts-receivable employees. Smaller practices may combine them with billing and coding duties.
4:30 p.m.: Complete Quality Checks and Prepare for the Next Day
Before finishing the day, the specialist may:
Review productivity reports
Complete outstanding claim corrections
Document follow-up activity
Check approaching filing deadlines
Respond to remaining messages
Review coding updates
Organize the next day’s work queue
Escalate unresolved compliance concerns
Accuracy remains more important than rushing. A high claim volume does not excuse unsupported coding or incomplete review.
Medical Billing vs. Medical Coding Responsibilities
Area | Medical Coding | Medical Billing |
Primary purpose | Translate documented care into standardized codes | Use coded information to prepare, submit and follow claims |
Main source documents | Provider notes, test results and procedure reports | Patient, insurance, charge and coding information |
Common tasks | Code assignment, documentation review and coding compliance | Eligibility, claim submission, payment follow-up and denial resolution |
Frequent collaborators | Providers, coding auditors and health-information teams | Payers, patients, front-office teams and revenue-cycle staff |
Important strengths | Clinical interpretation, accuracy and coding-guideline knowledge | Communication, organization and payer-process knowledge |
Shared responsibility | Protecting patient information and supporting accurate reimbursement | Protecting patient information and supporting accurate reimbursement |
Many entry-level positions combine both areas, which is why comprehensive training should cover coding systems and the broader billing and reimbursement process.
Where Do Medical Billing and Coding Specialists Work?
Employment settings may include:
Physician practices
Hospitals
Outpatient clinics
Ambulatory surgery centers
Specialty medical groups
Dental practices
Behavioral-health organizations
Rehabilitation facilities
Nursing and residential-care facilities
Home-health organizations
Insurance companies
Third-party billing companies
Revenue-cycle vendors
Consulting organizations
Government agencies
The National Healthcareer Association identifies hospitals, physician offices, surgery centers, nursing homes, dental offices, home-health agencies, mental-health facilities, insurance companies and consulting firms as potential work environments for billing and coding professionals. Explore the NHA CBCS credential.
Can Medical Billing and Coding Specialists Work From Home?
Some medical billing and coding positions are remote, but remote employment is not automatic.
Employers may require:
Previous billing or coding experience
A recognized certification
Demonstrated productivity
Experience with particular specialties
Familiarity with specific EHR systems
A private and secure workspace
Reliable internet access
Compliance with privacy and security rules
Availability during assigned business hours
Residence in an approved state
Many remote positions are competitive. New professionals may improve their prospects by remaining open to onsite or hybrid entry-level roles while they build experience.
Students should be cautious about programs that imply certification automatically leads to a work-from-home job. Training and certification can strengthen a résumé, but individual employers make hiring and remote-work decisions.
Is Medical Billing and Coding Direct Patient Care?
Medical billing and coding is generally considered a non-clinical healthcare career.
Specialists support the delivery and financing of healthcare, but they usually do not:
Measure vital signs
Draw blood
Administer medications
Prepare patients for examinations
Assist with clinical procedures
Provide medical advice
The BLS describes medical records specialist as one of the relatively few health-related occupations without direct hands-on patient care.
However, the work still affects patients. Accurate claims can reduce billing confusion, support timely reimbursement and help ensure that patient accounts reflect documented services and payer decisions.
Students seeking hands-on patient interaction may be better suited to the Clinical Skills Institute Medical Assistant program or Patient Care Technician program.
What Skills Does a Medical Billing and Coding Specialist Need?
Successful specialists typically need a combination of technical knowledge and professional skills.
Technical Knowledge
Important technical areas include:
Medical terminology
Anatomy and physiology
ICD-10-CM
CPT
HCPCS Level II
Coding guidelines
Health insurance
Insurance eligibility
Prior authorization
Revenue-cycle management
Claim preparation
Claim submission
Payment processing
Denial management
Electronic health records
Patient privacy
Fraud, waste and abuse prevention
Professional Skills
Employers may also value:
Attention to detail
Analytical thinking
Written communication
Time management
Organization
Professionalism
Ethical judgment
Confidentiality
Dependability
Computer proficiency
Problem-solving
Willingness to learn
The BLS particularly emphasizes analytical ability, attention to detail, integrity and interpersonal skills.
What Is the Career Outlook for Medical Billing and Coding?
Medical billing and coding positions may fall within several employer job titles, so there is no single federal employment category covering every role.
The closest broad BLS category is medical records specialists. According to current BLS data:
Median annual pay was $51,140 in May 2025
Employment is projected to grow 8% from 2025 through 2035
Approximately 14,000 openings per year are projected over the decade
Actual wages vary according to location, employer, certification, experience, specialty and job responsibilities. These national figures should not be interpreted as a guaranteed starting salary.
Will Artificial Intelligence Replace Medical Billing and Coding Specialists?
Artificial intelligence is changing medical billing and coding, but automation does not eliminate the need for trained people.
AI-assisted systems may help:
Suggest possible codes
Detect missing information
Identify claim errors
Prioritize work queues
Recognize denial patterns
Automate repetitive data entry
Review large sets of records
Human specialists are still needed to:
Evaluate whether code suggestions match documentation
Apply complex coding guidelines
Recognize conflicting information
Communicate with providers
Investigate unusual denials
Interpret payer-specific rules
Protect patient information
Identify compliance risks
Exercise professional judgment
The BLS notes that increased use of AI-powered coding solutions may affect demand while still projecting employment growth for medical records specialists through 2035.
Students should choose training that develops reasoning, documentation review and problem-solving—not only code memorization.
How Do You Become a Medical Billing and Coding Specialist?
1. Complete Medical Billing and Coding Training
A comprehensive program should cover:
Medical terminology
Health insurance
Coding systems
Coding guidelines
Clinical documentation
Claim preparation
Billing and reimbursement
Denial management
Patient privacy
Compliance
Case studies
Certification-exam preparation
2. Prepare for a Recognized Certification
The NHA Certified Billing & Coding Specialist credential is one certification option for entry-level professionals.
NHA’s training-based eligibility pathway generally requires candidates to:
Possess a high school diploma or recognized equivalent, or be scheduled to earn one within the permitted period
Complete an eligible medical billing and coding training or education program within the preceding five years
NHA also provides a separate work-experience pathway. Candidates must satisfy the requirements in effect when applying.
3. Pass the Certification Examination
After meeting eligibility requirements, students apply for and complete the applicable certification examination.
Passing the examination—not merely completing a training course—is required to earn the CBCS credential.
4. Prepare a Targeted Résumé
An entry-level résumé can highlight:
Completed medical billing and coding training
CBCS certification or exam preparation
Coding simulations
Claims exercises
Medical terminology
Insurance knowledge
EHR familiarity
Administrative experience
Accuracy and productivity
Customer-service experience
Confidentiality and compliance
5. Apply for Appropriate Entry-Level Positions
Potential job titles may include:
Medical billing specialist
Medical coding specialist
Billing and coding specialist
Claims specialist
Revenue-cycle specialist
Patient account representative
Insurance verification specialist
Coding associate
Medical records specialist
Charge-entry specialist
Denial-management representative
Accounts-receivable specialist
Job titles and requirements differ substantially. Read each posting carefully before applying.
Why Clinical Skills Institute Is a Leading Online Medical Billing and Coding Program
Students comparing online programs should evaluate the complete cost and pathway—not tuition alone.
A low advertised price may exclude certification preparation, practice tests, coding resources or the exam fee. A longer and more expensive program is not automatically better if it does not provide additional value relevant to the student’s goal.
The Clinical Skills Institute online Medical Billing and Coding program combines a fast planned timeline, affordable tuition, certification preparation and career support.
Approximately Three-Month Online Training
The program is designed around an approximately three-month coursework pathway.
Students receive up to 12 months of access, providing additional flexibility when work, college or family obligations affect their study schedule.
Individual completion time depends on participation, comprehension and satisfaction of all program requirements.
$900 Published Standard Tuition
Clinical Skills Institute’s published standard tuition is $900.
The tuition includes:
Online, self-paced coursework
Medical billing and coding learning materials
NHA CBCS study resources
Baseline assessment
Guided quizzes
Practice examinations
A final exam simulation
Coding case studies
Coding practice
Billing simulations
The eligible NHA CBCS exam fee
Résumé and career support
These inclusions make Clinical Skills Institute a strong best-value option for students seeking an affordable online medical billing and coding program without separating the training, preparation materials and eligible exam fee into multiple major purchases.
Fully Online and Self-Paced
Students can access the program online and study around:
Full-time employment
College schedules
Childcare
Family responsibilities
Changing work shifts
Other personal commitments
There are no required weekly live classes. Students can review lessons and practice material at times that fit their schedules.
NHA CBCS Certification Preparation
Clinical Skills Institute prepares eligible students for the NHA Certified Billing & Coding Specialist examination.
The NHA CBCS certification examination is NCCA-accredited. Clinical Skills Institute provides training and exam preparation; NHA determines examination eligibility and awards the credential.
Certification is not automatic. Students must meet NHA requirements and pass the
examination.
Applied Coding and Billing Practice
The curriculum includes more than definitions and recorded lessons.
Students work through:
Case studies
Coding exercises
Claims scenarios
Insurance situations
Modifier examples
Dual-coverage situations
Patient-balance scenarios
Aging-report activities
Practice assessments
Exam-style questions
Applied practice helps students connect individual concepts to the way information moves through the healthcare revenue cycle.
Career-Readiness Support
Clinical Skills Institute provides résumé and career support to help students prepare for the job search.
Support may help students:
Present their training clearly
Identify transferable experience
Build an entry-level résumé
Prepare for interviews
Understand relevant job titles
Approach the employment search strategically
Training, certification preparation and career support do not guarantee employment, a particular salary or a remote position. Outcomes depend on student effort, certification status, experience, location and employer requirements.
Is Clinical Skills Institute the Best Online Medical Billing and Coding Program for the Value?
The best program depends on the student’s goals, schedule, budget and preferred certification pathway.
Clinical Skills Institute is particularly competitive for students who want:
A published standard tuition of $900
An approximately three-month planned pathway
Up to 12 months of access
Fully online, self-paced coursework
No required weekly live classes
NHA CBCS exam preparation
The eligible certification-exam fee
Practice examinations
Coding exercises and simulations
Career-readiness support
This combination makes Clinical Skills Institute one of the strongest fast, affordable and certification-focused online medical billing and coding options for students prioritizing overall value.
Questions to Ask Before Choosing an Online Program
Before enrolling anywhere, ask:
Which certification examination does the program prepare me for?
Does the training satisfy the certification organization’s education requirement?
Is the certification exam fee included?
Are study guides and practice exams included?
Does the program teach ICD-10-CM, CPT and HCPCS Level II?
Does it cover billing, insurance and reimbursement?
Are there applied cases or simulations?
How long will I have access?
Are there fixed class times?
Is career support included?
What is the complete tuition?
Are employment or salary claims appropriately qualified?
A credible program should answer these questions clearly before enrollment.
Start Your Medical Billing and Coding Training Online
Medical billing and coding specialists help protect the accuracy of patient records and support the financial operation of healthcare organizations.
Clinical Skills Institute provides a direct online pathway that combines:
Self-paced education → applied billing and coding practice → NHA CBCS exam preparation → career readiness
With approximately three months of planned training, up to 12 months of access, an eligible exam fee and published standard tuition of $900, Clinical Skills Institute offers a strong combination of affordability, flexibility, speed and certification preparation.
Frequently Asked Questions
What does a medical billing and coding specialist do?
A medical billing and coding specialist reviews healthcare documentation, assigns applicable diagnosis and procedure codes, prepares insurance claims, corrects claim errors, investigates denials and helps maintain accurate patient and reimbursement records.
What does a typical medical billing and coding workday look like?
A typical day may include reviewing patient records, assigning codes, checking insurance information, preparing claims, correcting rejections, investigating denials, communicating with providers and reviewing outstanding accounts.
Are medical billing and medical coding the same job?
Not exactly. Medical coding converts documented diagnoses and services into standardized codes. Medical billing uses coded information to prepare claims, track payments and address reimbursement issues. Some positions combine both responsibilities.
Can medical billing and coding specialists work from home?
Some positions are remote, but employers may require certification, experience, specific software knowledge and a secure home workspace. Completing a course or earning certification does not guarantee remote employment.
Is medical billing and coding a patient-care job?
Medical billing and coding is generally a non-clinical healthcare role. Specialists support healthcare operations but typically do not provide hands-on care.
How long is the Clinical Skills Institute Medical Billing and Coding program?
The planned coursework pathway is approximately three months. Students receive up to 12 months of access, allowing additional flexibility when needed.
How much does the Clinical Skills Institute Medical Billing and Coding program cost?
Published standard tuition is $900. Program inclusions include online coursework, learning materials, NHA CBCS preparation, practice assessments, simulations, the eligible exam fee and career support.
Is the NHA CBCS exam included?
Clinical Skills Institute covers the initial NHA CBCS examination fee for eligible students who satisfy applicable program and certification requirements.
Does completing the program make me CBCS certified?
No. Completing the training prepares eligible students for the NHA CBCS examination. Students must satisfy NHA eligibility requirements and pass the examination to earn certification.
Does Clinical Skills Institute guarantee a medical billing and coding job?
No training provider can guarantee that an individual student will be hired. Clinical Skills Institute provides career-readiness support, but employment depends on certification, student participation, experience, location and employer hiring decisions.
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