Medical Billing Career in Pennsylvania

PA medical billing & coding

Medical coding is an in-demand, rewarding career perfect for those who enjoy detail-oriented work and the healthcare industry. With a variety of educational paths and job options, it offers stability and growth opportunities.

Medical coders play a crucial role in healthcare administration by translating medical services into standardized alphanumeric codes used for billing insurance companies.

This growing field demands attention to detail, organization, and communication with healthcare providers, patients, and insurance companies.

What is Medical Billing & Coding?

Medical billing and coding are interconnected fields within medical administration, offering career opportunities with strong job prospects and earning potential.

Professionals skilled in both areas are often more employable and can secure higher-paying roles.

What Is Medical Billing?

Medical billing involves managing the financial aspects of healthcare by processing payments from insurance companies, patients, or legal entities. Billers ensure accurate billing by using medical records to create concise summaries of services provided.

They may work with healthcare providers or directly with insurance companies to resolve payment disputes and verify deductibles.

What Is Medical Coding?

Medical coding focuses on translating medical diagnoses, treatments, and procedures into standardized alphanumeric codes. Coders ensure that patient records are accurate and compliant with industry standards, facilitating seamless communication between healthcare providers, patients, and insurance companies.

How Are They Related?

Medical billing and coding are complementary skills. Billers rely on coders to accurately document medical information, while coders provide the data billers use for processing payments. Many training programs combine both fields, enhancing employability by equipping professionals with a versatile skill set.

Whether you choose to specialize or pursue both, excelling in medical billing and coding can open the door to a rewarding and in-demand career.

How to Become a Medical Coder: Three Main Steps

Here’s how to start your journey as a medical coder:

1. Educational Foundations
A high school diploma is the first step, with coursework in biology, anatomy, math, and writing providing a helpful foundation.

2. Medical Coding Training
Pursue medical coding courses through four-year colleges, community colleges, or online programs. Certifications like those offered by the American Academy of Professional Coders (AAPC) enhance job prospects. While state exams are not required, institution-specific exams often demonstrate competency.

3. Job Search and Opportunities
After completing your training, create a resume showcasing your qualifications and search for opportunities in hospitals, clinics, or insurance companies. Freelance opportunities also exist, allowing coders to work independently from home, providing flexibility and additional income potential.

Medical Coding Classification Systems

Medical coding relies on various classification systems to organize health information into four primary categories: diagnoses, procedures, medications, and anatomy.

Below are the most commonly used coding systems:

1. Diagnostic and Procedural Codes

  • International Statistical Classification of Diseases (ICD): Originating in 1893, the ICD is maintained by the World Health Organization (WHO) and is one of the most widely used systems. Initially focused on mortality classification, it expanded to include diagnostic and procedural codes. The ICD-10 is the most recent version, though ICD-9-CM remains in use for clinical modifications.
  • CPT and HCPCS Codes: The American Medical Association publishes the Current Procedural Technology (CPT) codes, mandated by HIPAA for use in Medicare and Medicaid claims. The Healthcare Common Procedure Coding System (HCPCS) is an extension of CPT, ensuring compatibility for insurance processing.

2. Pharmaceutical Codes

  • ATC (Anatomical Therapeutic Chemical Classification): Administered by WHO, this system categorizes drugs based on body systems and therapeutic effects.
  • National Drug Code (NDC): Enforced by the FDA under the Drug Listing Act of 1972, the NDC provides unique identifiers for all drugs in the U.S.

3. Topographical Codes

  • Nomina Anatomica: This reference for anatomical terminology informs classification systems that relate anatomy to diagnoses and procedures. While not a coding system itself, it underpins anatomical categorization in medical records.

Medical coders must master these systems and others to ensure accurate, consistent, and dispute-resistant medical records. Understanding and linking codes properly is essential to facilitate insurance claims and maintain clear healthcare documentation.

Certification

Becoming certified in medical coding often requires passing specialized exams. These certifications demonstrate your knowledge and competency in the field, and preparation through review courses and study materials is key. Below are some of the most commonly recognized medical coding exams and resources for success:

1. Certified Coding Assistant (CCA) Exam

2. Certified Professional Coder (CPC) Exam

3. RHIT and RHIA Exams

  • The Registered Health Information Technician (RHIT) and Registered Health Information Administrator (RHIA) exams are advanced certifications typically pursued after Associate’s or Bachelor’s degree programs.
  • Both exams, offered by AHIMA, cover medical billing and broader health information management topics.
  • Study guides such as Professional Review Guide for the RHIA and RHIT Examinations by Patricia Schnering are highly recommended.

Preparation Tips

  • Review courses: Many community colleges and online programs offer review sessions that provide context and structure for exam preparation.
  • Use your codebooks: Most coding exams allow and require you to use codebooks during the test. Familiarize yourself with these resources to locate codes quickly.
  • Self-study: Supplement coursework with dedicated guides and online practice materials to reinforce your knowledge.

By combining formal instruction, self-guided study, and practical familiarity with coding resources, you can confidently prepare for these medical coding certifications and advance your career.

Where Do They Work?

Medical coders are employed in various healthcare settings, such as physician offices, surgical centers, hospitals, and larger healthcare organizations. Many coders work from home either as employees or independent contractors.

Examples of Medical Billing / Coding Jobs in Pennsylvania

To give you an idea of the kinds of jobs available in this profession, below are a sample job descriptions from real openings on Indeed and ZipRecruiter.

Medical Coding Team Lead – Iron Mountain

Location: Royersford, PA

Iron Mountain seeks a Medical Coding Team Lead with a nursing background to oversee coding operations, ensuring compliance with CPT-4 and ICD-10 standards. The role includes supervising workflows, training coding personnel, and maintaining adherence to governmental and third-party billing guidelines. The position offers competitive benefits, including health insurance, 401(k) matching, and paid time off, with a schedule of Monday to Friday, 6:30 AM to 3 PM. Pay is $43/hour.


DME Medical Supply Biller – Seventh Street Medical Supply

Location: Feasterville-Trevose, PA

Seventh Street Medical Supply is hiring a DME Medical Biller to process billing for durable medical equipment and manage patient interactions. This full-time role prioritizes a positive work-life balance, with no nights or weekends, and offers a supportive team environment. Pay ranges from $17-$20/hour, with benefits like health insurance, 401(k) matching, and paid holidays. Experience with DME billing and Brightree software is a plus.


Medical Billing Specialist – APM

Location: Coraopolis, PA

APM is looking for an experienced Medical Billing Specialist to manage claims, denials, and account balances for a specialty practice. The role requires proficiency in medical billing software, ICD-10, and prior billing experience. Pay ranges from $20-$24/hour, with benefits including health insurance, 401(k) matching, and paid time off. This is a full-time, on-site position with an 8-hour workday.


Medical Billing Specialist – RKL

Location: Pennsylvania (Remote)

RKL is hiring a Medical Billing Specialist for its post-acute healthcare client base. This remote role includes billing, denial resolution, and claim submission. Applicants should have experience with Medicare, Medicaid, and coding practices. Pay ranges from $20-$28/hour, with benefits such as health insurance, 401(k) matching, and flexible scheduling. Training and mentorship opportunities are provided to support career growth.


Medical Biller – WHS Central Billing Office

Location: Washington, PA (Partially Remote)

Washington Physician Services Org. seeks a Medical Biller to handle billing tasks like posting charges, claims follow-ups, and addressing patient inquiries. Flexible schedules include an optional remote day after 90 days. Benefits include health insurance, tuition reimbursement, and paid time off. The role supports a collaborative team environment in a dynamic billing office.


Medical Biller – Medaqual, Inc.

Location: Jamison, PA

Medaqual, Inc., a 20-year medical billing company, seeks a Medical Biller with at least one year of experience. This full-time, in-person role involves using software like eClinicalWorks or Medent. Pay ranges from $18-$22/hour, with benefits like health insurance and dental coverage. This is a great opportunity for experienced professionals seeking stability.


Medical Billing/Coding Specialist – Indiana Ambulatory Surgical Associates, Inc.

Location: Indiana, PA

Indiana Ambulatory Surgical Associates is hiring a Billing/Coding Specialist to manage coding, claims submissions, and payment collections. Candidates should have experience with insurance billing and medical coding. Pay ranges from $20.41-$24.77/hour, with benefits like vision, medical, and dental coverage. Certification in outpatient surgery coding is a plus.


Medical Billing Office Assistant – MDRX Billing LLC

Location: King of Prussia, PA

MDRX Billing LLC is hiring an entry-level Medical Billing Office Assistant to support billing operations. Responsibilities include processing correspondence, resolving denials, and administrative tasks. The role offers a collaborative team environment and perks like provided lunches and potential bonuses. Knowledge of medical billing and workers’ compensation is a plus. Pay is $15/hour.