Certified Coding Specialist (CCS)

Certified Coding Specialists are professionals skilled in classifying medical data from patient records, generally in the hospital setting. These coding practitioners review patients' records and assign numeric codes for each diagnosis and procedure. To perform this task, they must possess expertise in the ICD-9-CM coding system and the surgery section within the CPT coding system. In addition, the CCS is knowledgeable of medical terminology, disease processes, and pharmacology.

Hospitals or medical providers report coded data to insurance companies or the government, in the case of Medicare and Medicaid recipients, for reimbursement of their expenses. Researchers and public health officials also use coded medical data to monitor patterns and explore new interventions. Coding accuracy is thus highly important to healthcare organizations because of its impact on revenues and describing health outcomes. Accordingly, the CCS credential demonstrates tested data quality and integrity skills in a coding practitioner. The CCS certification exam assesses mastery or proficiency in coding rather than entry-level skills.

If you have experience in coding inpatient records or coding the hospital portion of ambulatory surgery and emergency room care, you should consider obtaining this certification. In fact, certification is becoming an implicit industry standard.

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Certified Coding Specialist—Physician-based (CCS-P)

The CCS-P is a coding practitioner with expertise in physician-based settings such as physician offices, group practices, multi-specialty clinics, or specialty centers. This coding practitioner reviews patients' records and assigns numeric codes for each diagnosis and procedure. To perform this task, the individual must possess in-depth knowledge of the CPT coding system and familiarity with the ICD-9-CM and HCPCS Level II coding systems. The CCS-P is also expert in health information documentation, data integrity, and quality. Because patients' coded data is submitted to insurance companies or the government for expense reimbursement, the CCS-P plays a critical role in the health provider's business operation. What's more, the employment outlook for this coding specialty looks highly favorable with the growth of managed care and the movement of health services delivery beyond the hospital.

The CCS-P certification exam assesses mastery or proficiency in coding rather than entry-level skills. If you perform coding in a doctor's office, clinic, or similar setting, you should consider obtaining the CCS-P certification to attest your ability.

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RHIAs are skilled in the collection, interpretation, and analysis of patient data. Additionally, they receive the training necessary to assume managerial positions related to these functions. RHIAs interact with all levels of an organization—clinical, financial, administrative—that employ patient data in decision making and every day operations.

In a recent membership survey, AHIMA found that more than half of the RHIA respondents were directors, managers, or consultants, with nearly 31 percent serving as health information management directors. Historically, most RHIAs have held the title of director of the health information management department of an acute care facility, but today other career opportunities abound. As patient records evolve toward computerization and as more entities such as third-party payers require health data, RHIAs benefit from a wide selection of roles in the industry. Information security and storage, data quality assurance, and advanced assistance to consumers with their health information are among the new domains. AHIMA's Vision 2006 identifies and describes emerging HIM roles that parallel changes in the healthcare industry.

RHIAs enjoy job placements in a broad range of settings that span the continuum of healthcare including office-based physician practices, nursing homes, home health agencies, mental health facilities, and public health agencies. The growth of managed care has created additional job opportunities in HMOs, PPOs, and insurance companies. Prospects are especially strong in these settings for RHIAs who possess advanced degrees in business or health administration.

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