Medical billing and coding is the office-side work that turns health care into paid claims.
Coding reads a provider's documentation and assigns the standard codes that describe the care; billing takes those codes, submits the claim to the payer and follows it until it is paid.
A medical billing and coding specialist does both, in a role that may combine the two halves or split them across dedicated coding and billing staff.
What is medical billing and coding?
Medical billing and coding is one career field with two halves.
Coding asks what the provider documented; billing asks how that care gets paid for.
Medical coding is the work of reading clinical documentation and assigning the standard diagnosis and procedure codes that describe the care given.
BLS says medical coders assign those codes for patient care, population health statistics and billing purposes.
The BLS occupation group that contains coders, medical records specialists, compiles and maintains patient files and classifies and enters medical information into the healthcare coding system.
Medical billing starts where coding ends.
The biller turns coded services into claims, submits them to insurance payers, posts the payments that come back and works accounts under insurance guidelines — the processes AAPC says its CPB credential validates.
The two halves meet in the middle, which is why BLS describes coders as the liaison between healthcare providers and billing offices.
The federal occupation system has no combined code for a worker who does both.
BLS puts coders in medical records specialists (SOC 29-2072) and billers in billing and posting clerks (SOC 43-3021).
That is one reason this guide, and the salary data behind it, keeps the two halves in separate, labeled pieces.
The code sets are not informal shorthand, either.
Under HIPAA, HHS adopted specific code sets for diagnoses and procedures used in health care transactions, so learning those code sets is core to the job rather than an employer quirk.
What does a medical billing and coding specialist do all day?
The day is built around records, codes and claims rather than patients.
BLS counts this work among the few health-related occupations with no direct hands-on patient care.
On the coding side, the specialist reviews patient records for timeliness, completeness and accuracy, then uses classification systems to assign clinical codes for diagnoses, procedures and services.
When a record is unclear, O*NET lists resolving conflicting, missing or unclear codes or diagnoses by consulting doctors or coding-team meetings as a standard task, and BLS says specialists meet with healthcare workers such as registered nurses to clarify diagnoses.
On the billing side, the seat handles claim submission, payment posting, insurance guidelines and revenue-cycle workflows.
In a combined role, the specialist is the provider-to-billing-office liaison BLS describes.
It is precise, deadline-aware, people-facing work.
In O*NET survey data, 78% of medical records specialists rated being exact or accurate as extremely important in their job, 37% said the job requires meeting strict deadlines every day, and 79% reported having telephone conversations every day.
On the billing side, 58% of billing and posting clerks report telephone conversations every day too.
BLS sums up the personal qualities the work calls for: detail oriented, with the interpersonal skills to discuss patient information and discrepancies with physicians and finance personnel, and the discretion to act ethically with patient data and protect confidentiality as the law requires.
Where do billers and coders work?
Hospitals and physician offices anchor the field, but they are not the whole map.
In 2025, BLS reported the largest employers of medical records specialists as hospitals (28%), offices of physicians (18%), professional, scientific and technical services (10%), administrative and support services (8%) and management of companies (7%).
For billing work, BLS's OEWS industry data puts ambulatory health care services first: that industry employed 127,200 billing and posting clerks in May 2025 at a $47,870 median wage.
AAPC's career material extends the employer list well past those anchors.
It names ambulatory surgery centers, walk-in clinics, long-term care, home health agencies, hospice, telehealth companies, labs and imaging centers.
It also names non-patient-care employers: software and DME vendors, insurance companies, government agencies, educational institutions, billing companies, risk adjustment vendors, healthcare consulting firms and some law offices.
Pay follows the setting.
BLS May 2025 medians for medical records specialists across those top industries ran from $46,800 in professional, scientific and technical services to $60,980 in management of companies, with hospitals at $59,120 and physician offices at $47,120.
You can see which of these employers are hiring right now by browsing medical billing and coding jobs on the board.
Can you do medical billing and coding from home?
Remote work is a real part of this field, with one important caveat about what the numbers measure.
In AAPC's 2025 salary survey, 64.8% of respondents reported working fully remote, 19.8% fully on-site and 15.4% hybrid.
That is a share of survey respondents, not a share of job postings — treat it as a picture of AAPC's respondents rather than of the whole job market.
The shift is recent.
AAPC says that before 2020, only 30-33% of its salary-survey respondents worked remotely, and remote arrangements used to be reserved for the most experienced employees.
Remote work does not take HIPAA's workstation rules out of play.
The HIPAA Security Rule (45 CFR 164.310) requires policies for workstations that access electronic PHI, plus physical safeguards that restrict workstation access to authorized users — and the rule applies to any workstation that accesses ePHI regardless of location, home office included.
Discretion travels with the job.
BLS says medical records specialists must exercise discretion and act ethically with patient data to protect confidentiality as required by law.
One line separates employees from entrepreneurs.
The FTC has long warned about paid at-home medical billing business opportunities, saying few people who pay for them find clients or make any money.
It also notes that doctors who outsource billing often use established firms rather than individuals working from home — a remote billing job is employment, while a home-based billing business is a different venture entirely.
How do you get into medical billing and coding?
There is more than one door in.
BLS says medical records specialists typically need a postsecondary certificate to enter the occupation, although some qualify with a high school diploma and others need an associate's or bachelor's degree.
For some positions, BLS says a high school diploma plus health care experience is enough.
Certificate and associate programs at community colleges and technical schools typically cover medical terminology, health data requirements and standards, and classification and coding systems.
Those three subjects are the working vocabulary of the job.
Billers have a lower formal bar on paper: BLS's employment projections list a high school diploma plus moderate-term on-the-job training as the typical entry path for billing and posting clerks.
Entry also happens through adjacent seats — AAPC's career-changer material names patient account representative and preauthorization specialist as entry-level roles, along with denials follow-up specialist.
Certification is the other lever.
BLS says it may be required or preferred, employers may prefer certified applicants or expect certification shortly after hire, and AAPC — which sells the training — says most people complete its CPC coursework and pass the exam in 4 to 8 months.
Which certifications do employers ask for?
Certification is not one fixed requirement, but employers do ask.
BLS says certification may be required or preferred for medical records specialists, and that employers may prefer to hire certified specialists or expect certification shortly after being hired.
For coding, AAPC names the CPC, COC, CIC and CRC as its four main core coding certifications, with the CPB for billers.
AAPC says the CPC validates comprehensive knowledge of medical coding across outpatient and physician services, while the CPB validates expertise in claim submission, payment posting, insurance guidelines and revenue-cycle workflows.
The CPC exam runs 100 questions in four hours, and passing requires an overall score of 70%.
It cost $425 for one attempt or $499 for two attempts as of 2026-10-13, and AAPC offers it online at home with a live remote proctor or on a computer at a testing center.
Degrees are a separate question from certification.
AAPC says its certification does not require an associate or bachelor's degree — its own assessment of its own credential, so weigh it accordingly — and AHIMA states plainly that taking its certification exams is voluntary.
Exam rules change — confirm with the credentialing body
How much do medical billers and coders make?
BLS has no separate SOC code for a combined medical billing and coding specialist — the federal system puts coders under medical records specialists (29-2072) and billers under billing and posting clerks (43-3021) — so the closest available groups are used and labeled as such.
For coding work, the closest group is medical records specialists (SOC 29-2072), an occupation that also includes records staff who do not code.
Its median annual wage was $51,140 in May 2025, and BLS puts the lowest-paid 10% under $37,000 and the highest-paid 10% above $81,150.
For billing work, the closest group is billing and posting clerks (SOC 43-3021, all industries), with a $48,500 median wage in BLS's 2025-35 employment projections.
A combined billing and coding specialist sits across both groups, which is why this guide shows both figures, each labeled.
Certification shows up in survey averages, not federal wage data.
AAPC's 2026 salary report put certified respondents at a $67,260 average versus $55,721 for non-certified respondents — 20.7% more — from self-selected, mostly member respondents.
For the BLS benchmark on its own, the medical billing and coding salary page shows the national figure for medical records specialists, labeled as the closest available group.
Is medical billing and coding a good career?
The federal outlook is the strongest signal, and it is positive.
BLS projects medical records specialist employment to grow 8% from 2025 to 2035, much faster than the average for all occupations.
Its projections table shows the same occupation going from 200,700 to 216,300 jobs, with 14,000 openings a year — many from replacing workers who change occupations or retire.
BLS attributes the demand to the work itself: an aging population with more chronic conditions means more specialists are needed to translate patient information and services into standardized codes for insurance reimbursement and other purposes.
The billing side is flatter but still busy.
BLS projects billing and posting clerks roughly flat — a 0.1% decline from 418,000 to 417,700 jobs — with 37,000 openings a year.
The honest caveat is automation.
The same BLS outlook warns that increasing adoption of AI-powered solutions that make medical coding more efficient may affect demand for these workers — a watch item from the same federal projection, not a separate forecast.
As a fit, the field rewards precise, independent, records-driven work, and BLS counts it among the few health-related occupations with no direct hands-on patient care.
Most medical records specialists work full time, and in always-open facilities such as hospitals, shifts can include nights or weekends.
If you want the numbers in one place while you weigh the decision, our medical billing and coding industry statistics page collects the employment and wage data.
And if you are on the other side of the desk — a practice, hospital department or billing company trying to fill this seat — the hiring hub explains how to hire a billing and coding specialist.
Career information, not coding, billing-compliance, legal or tax advice. Confirm exam, certification and wage details with the bodies named here — AAPC for its certifications, BLS for wage data and projections.