The odds are good that anyone reading this article knows at least one medical coder, and probably even knows a coder who has more than one coding credential. What might be less well-known is the path they took to earn their certification, why medical coding has become a popular career choice, and how the profession is evolving in response to technological advancement and other industry trends
According to the annual salary survey of the American Academy of Professional Coders (AAPC), the nation's largest health care training organization, the advertised wage for those with the Certified Professional Coder (CPC) credential has risen in the last three years by 36.8 percent. The demand for these professionals is high and will continue to rise due to the historic shift in U.S. age demographics and an increase in chronic disease prevalence. The American Health Information Management Association (AHIMA) reported that the Bureau of Labor Statistics projected that employment for coders will grow 13 percent by 2026, which outpaces the average of 7 percent for all occupations. These roles are in demand across multiple market sectors, including payers, providers, and business support operations as well as within the government at the Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General (OIG).
Many medical coding programs can be completed online in less than a year. Depending on the student’s availability and background, training to earn a coding credential can take as little as four months. Beware of ads promising full preparation for a coding career in just weeks. A four-year bachelor's degree or even a two-year associate degree is not needed to become a certified coder. Receiving training through a reputable coding certificate program has advantages and can usually be achieved for around $4,000. Depending on where training is received and the need, financial aid may be available. A coder's education includes courses in medical terminology, anatomy, pathophysiology, and pharmacology, as well as navigating three code sets and their coding guidelines. Also included is education in applicable health care regulations at the federal and state level. The most important question to ask when evaluating programs is if it has a high pass rate, meaning that most who complete the training successfully earn their credential.
There are several soft skills that contribute to the success of a medical coder, and a successful medical coding career demands a multifaceted skillset, according to the AAPC. Precision is paramount, as subtle differences in terminology and documentation can significantly impact treatment and payment. Strong organizational skills are essential for maintaining productivity and meeting performance targets, especially in the context of a growing remote workforce. Furthermore, ethical conduct is crucial, given the legal and ethical obligations related to fraud prevention and data security. While independent work is often required, the ability to collaborate with colleagues is vital for effective knowledge sharing and problem-solving. Analytical and critical thinking skills are indispensable for accurately translating medical documentation into appropriate codes. Finally, a continuous learning mindset is essential to adapt to the evolving technological landscape and the ever-changing complexities of the health care industry.
Whoa! I think I might want to become this kind of a health care hero! But will we go through all of this training and education just for AI to take our jobs?
AI has the ability to significantly improve revenue cycle efficiency, including improved coding accuracy and fraud detection, and skilled professionals will be needed to provide oversight to technology evolution, such as that which is occurring with AI. This requires the development of auditing skills, and over time the industry is likely to see a blend of coding and auditing skills that are required to support the evolution of AI.
In risk adjustment and quality, AI has the potential to predict coding gaps that can then be communicated to providers, which can positively impact care quality and reimbursement. Providers particularly face numerous challenges related to coding, where it has been estimated that 42 percent of denials result from coding issues (Bindal, 2024). The integration of AI-enabled technologies can help significantly reduce coding errors and improve accuracy as well as streamline coding workflows. AI has yet to develop many of the aforementioned soft skills, and AHIMA (2024) noted that according to a 2023 PWC survey, adaptability is the top skill that AI does not possess since the health care regulatory and competitive landscape is constantly changing how work is done. For example, ambiguous acronyms and other specialized jargon add to the complexity of medical documentation in addition to frequent updates to code sets, coding guidelines and documentation requirements.
Experienced medical coders and billers will be needed to ensure compliance with regulations and to manage appeals when claim issues are identified. It is also useful for revenue cycle, risk adjustment, and quality leaders to earn coding credentials, because it helps them to understand and address the unique operational challenges related to coding that affect revenue cycle success and the people who are doing this important work.
You've convinced me of the value of earning a credential and joining the ranks of these health care heroes. To infinity, and beyond! Now what?
Many who have walked the path of credentialing, whether it be through AAPC or AHIMA, started their journey by talking to those who hold credentials. They are the best resources when it comes to how and why they decided on a particular preparatory path, exam tips, how and where to get a job, the list goes on and on. There are also many groups on social media and influencers that are useful resources. For example, Dawn Carter, one of the authors of this article who works as a senior director of health policy and regulatory affairs, decided to pursue a CPC, CRC, CPMA, CDEO, and CPCO to ensure that the operational perspective related to coding, auditing, and documentation is considered when developing products and services that support coders and their employers, who are usually health plans and providers, and because her job is associated with compliance. Rey Gross, the other author of this article who is a manager of coding services and has a CPC and CRC, gives an excellent piece of advice to those who are starting their journey and might be apprehensive about their ability to get a job while they still have the apprenticeship designation. She says that newly-credentialed coders shouldn't be afraid to start at the bottom and take a job that gets a foot in the door at an organization and leads to a coding job later, and this helps prevent becoming discouraged as well as adds other valuable knowledge, skills, and abilities to one's resume.
Take a moment to show appreciation to the superhero coders you might know and talk to them about their career. Let them share their enthusiasm about being a health care hero!
References
AAPC (n.d.). 10 things to know about a career in medical coding. https://www.aapc.com/resources/career-in-medical-coding
AAPC (2025). Annual salary report. https://www.aapc.com/resources/medical-coding-salary-survey
AAPC (n.d.) Transforming careers: AAPC certified professionals in the AI era. https://www.aapc.com/resources/transforming-careers-aapc-certified-professionals-in-the-ai-era
AHIMA (2024). Medical coding hub. https://www.ahima.org/education-events/medical-coding-hub/
Bindal, C. (2024). Reshaping the healthcare industry with AI-driven deep learning model in medical coding. HIMSS. https://www.himss.org/resources/reshaping-healthcare-industry-ai-driven-deep-learning-model-medical-coding
Muthukumaraswamy, V. (2023). Reinventing the Role of Medical Coders in the Artificial Intelligence Era. AHIMA. https://journal.ahima.org/page/reinventing-the-role-of-medical-coders-in-the-artificial-intelligence-era
About the authors
Dawn Carter
Dawn Carter, BSBA, CPC, CRC, CPMA, CDEO, CPCO, CSPO, is a senior director of health policy and regulatory affairs at Centauri Health Solutions. Her career in health care spans 25 years, which most recently includes extensive experience in developing revenue integrity and quality software solutions, with a focus on encounter management and risk adjustment solutions for Medicare Advantage, Medicaid, and commercial health plans.
She also provides strategic advisory solutions and consulting services for revenue cycle operations. Prior to that, her experience spans all domains of health care including health plan claims and provider systems administration, and health care applications development. Her experience also includes multiple teaching engagements in medical administration, billing, and coding. Carter holds a bachelor’s degree in business administration. She is a passionate and prolific industry speaker, author, blogger and subject matter expert in claims, EDI management, and risk adjustment.
Rey Gross
Rey Gross began her career in the medical field in 1999 in medical billing. In 2004, she became certified as a CPC with AAPC. Gross has had the opportunity to provide a wide range of valuable services to the health care industry with her primary focus being on providing auditing services, medical billing, and education to providers as well students. For more than 10 years, she owned and operated a medical billing company where she worked closely with providers to conduct prospective and retrospective audits to ensure they were compliant with CMS policies.
Additionally, she has spoken at both local and national organizations on various topics including proper CPT, ICD-10-CM and HCPCS coding with an emphasis on CPT modifiers and risk adjustment coding. While teaching at a local community college, she created the curriculum for the medical billing and coding programs. Additionally, she has served her local community as an officer with her local AAPC chapter, which included a two-year term as president of the San Antonio, Texas chapter.
HCC coding has been her passion since 2015. She has worked on the training team at two major companies, most recently at Centauri Health Solutions in her role as the coding education manager. Because of this passion, she took the leap to become an AAPC-approved instructor.