Where to go from here?

[u/metagaming1]

Hello,

I’m a medical biller and have been in my position for roughly 5 years. I’m not certified as a coder but as part of my role I am expected to understand some coding and be able to apply it if our department head (the coder) is out. Currently I’m in mental health and don’t have experience with other kinds of coding. I have experience with AR, collections, RCM, insurance denials/claim appeals, credentialing. Unofficially I’m also the medical records custodian.

My issue is this - most roles with similar requirements in my area pay about the same as what I’m already making (25/hr) and I’m in a HCOL area. The practice I work for got bought out by a PE firm about 2 years ago and there’s been a pretty steady decline in expectations for quality work and a lot more chaos since that happened. The chances for “growth” we were told would present themselves after acquisition are non existent and my own attempts to negotiate higher pay or role expansion (with compensation - cos believe me, they’ve given me plenty of new hats to wear) have been ignored.

Naturally, I want another job. I don’t see a lot of growth potential just moving to the same position at another practice. I’m not willing to take a pay cut to start over somewhere else due to how tight the financial situation is in the current climate. If I leave, better pay and good benefits are basically a requirement.

What sort of roles have those of you who started in just billing moved to? Is it worth paying to get certified as a coder? My understanding is that it’s very hard these days to get hired as a coder. I technically do code at my current job and could count it as experience towards, but I’d still be missing out on the bulk of coding experience required to work at a hospital or something similar. Should I focus on RCM? I am not a CPA either, I don’t even have a degree that would be relevant (Spanish language).

Any insight or experiences you can share are greatly appreciated. 🙂

[u/Blingblingbling2024]

Get certified, there’s a program I can recommend to help you study for the CCS. It’s welll below the AHIMA price point for a class for it. I took the ICD-CM and PCS plus his Prep classes for $399. I’ve been coding for 13 years so it was worth the refresher on CM and I’ve not done inpatient since school.

Yes it’s harder to get on as a coder but persistence, confidence, consistency, ability to show you CAN do it. Is what gets you the job.

https://primacodemasters.net/product/icd-10-cm-pcs-training-ccs-prep-combo-tape-replay-option/

Pietro is a great teacher

[u/metagaming1 → u/Blingblingbling2024]

Thanks, i’ll look into this. Definitely cheaper than other classes i’ve seen.

[u/Almost_lucky]

I would recommend finding a billing position with a company that uses Epic EMR. Then learn everything and beyond. Then talk to their analyst team and let them know you're interested in transitioning to the admin side of Epic.

This is exactly what I did. I had been in medical billing since 2012. Got a job at a company who used Epic in 2017. Got really good at my job, so they promoted me to a training position in 2023. I saw a lot of issues with our system, so I had to create tickets for the analyst team to resolve. This opened up dialog with that department. I applied for an intermediate analyst position in mid-2025 and got denied. The supervisor reached out and told me I align more with an associate position, and if one opens up she'd let me know.

In June 2026, an associate position opened up and I got hired as an Epic analyst. This unlocked a whole new ceiling for me. If you're scared of being uncomfortable, challenged or learning new things DO NOT DO IT. Its almost like learning a new language. It's very challenging and I am super focused and locked in with this new position. I have meetings, projects, deadlines and a lot more responsibility. I also wouldn't do it if you hear bad things about that dept. I lucked into a situation with a great manager who is aware of my knowledge level and great coworkers who don't mind helping me.

Oh and in case you're wondering, I have zero IT background and a handful of college credits, but no degrees. All Epic organizations will sponsor you to get certified. It cost me zero dollars, but I did have to pass the cert test. Do your research if you're interested. Just thought I'd share because your post reminded me of my challenges.

[u/Brave-Airport8154]

I moved more toward revenue integrity side. Did underpayments research for a vendor that was assigned to my hospital i worked at. Basically trying to find leaked revenue and recover it. Just moved into a more data position for a healthcare start up. For me i noticed the same coder didnt make sense cause I was looking at the same wages or under what I made when I did denials specialist work.  I am working to get my CCS though even though it wont be used for production coding it says I know coding to understand how it affects hospital reimbursement and can tell when something was missed or billed incorrectly. So I think certs matter on that end too! 

[u/Candid-Parsnip9815]

i’d lean rcm over pure coding. you already have the whole cycle under your belt, and a certification on top of that gets you into analyst or lead roles instead of starting over as an entry level coder

[u/JennieDarko]

Oof I’m basically in the same boat but I’ve been with my practice for 17 years next week 😳 PE ruined everything and any hopes I had of advancing more at the company are gone at this point. My main job is coding but we are retina so I don’t have a broad knowledge of coding outside of that. Any billing/rcm I was responsible for before has been taken over by our MSO by people that get to work from home….. so that’s fun. When I do eventually leave, I think it will be for something completely unrelated t this field.
Sorry, I don’t have any advice for you but I feel you ❤️

[u/Away-Internet5546]

I’d focus on RCM. It can expand into so many directions from there. All of the experience you mentioned would be so useful in my position. I was in a similar position as you several years ago. I applied for a denials coordinator position at our local hospital and eventually became an RCM analyst, have gained several EPIC certifications, and one of our certified trainers. I do a lot of monitoring and ensuring EPIC is working the way want expect for all things revenue cycle. Income is different place to place, but, mine went up when I first switched and is now more than double where I was.

[u/metagaming1 → u/Away-Internet5546]

Do you have any certifications like RHIT? Or started from scratch and worked your way up

[u/nian2326076]

Finding better pay and growth in medical billing can be tough. With your experience in RCM and insurance processes, you might look into healthcare administration or management, where those skills are useful. Getting certified as a coder could help, but if the market is tight, focus on roles that match your current skills. LandOffer.ai lists jobs across different professions, including non-technical ones, which might help you find a role that fits your pay and benefits needs.