Healthcare Administration Career Guide | American National University

Overview of Healthcare Administration+

Healthcare administration is the management and organization of healthcare systems, facilities, and providers. It encompasses a wide range of responsibilities aimed at ensuring that healthcare organizations operate efficiently, deliver quality patient care, and comply with evolving regulations and standards. Healthcare administrators play a vital role in overseeing the daily operations of healthcare facilities, such as hospitals, clinics, nursing homes, and outpatient centers. They also manage budgets, staffing, healthcare policies, and strategic planning to help their organizations meet the needs of patients and communities.

At its core, healthcare administration focuses on balancing the operational, financial, and human resources elements of healthcare systems while maintaining a patient-centered approach. Administrators must coordinate between various departments—medical staff, billing, human resources, and regulatory compliance teams—ensuring that everything functions smoothly. They are responsible for creating an environment where healthcare professionals can deliver high-quality care while ensuring that patients’ needs are met in a safe, effective, and efficient manner.

Additionally, healthcare administration requires a strong understanding of healthcare laws and regulations, including patient privacy laws (such as HIPAA), billing procedures, and insurance practices. With the increasing complexity of healthcare systems, administrators are also expected to stay ahead of trends in healthcare technology and policy reform, ensuring that their facilities can adapt to new changes while continuing to serve patients effectively. The ultimate goal of healthcare administration is to align the operations of a healthcare organization with its mission to provide accessible and high-quality healthcare to the population it serves.

Healthcare administrators are not only concerned with the business aspects of running a healthcare facility but also play a critical role in shaping policies and making strategic decisions that impact the quality and accessibility of healthcare services. Their leadership ensures that healthcare organizations are financially sustainable, comply with regulations, and are prepared to adapt to challenges in the evolving landscape of healthcare.

Medical Billing & Coding+

Medical billing and coding is a specialized profession within the healthcare industry that focuses on translating medical diagnoses, procedures, and treatments into standardized codes. These codes are essential for processing healthcare claims with insurance companies, government programs, and patients. Medical billers and coders ensure that healthcare providers are reimbursed accurately and promptly for their services, while also maintaining compliance with regulatory standards.

The process begins with medical coders who review patient records and assign codes using classification systems such as the International Classification of Diseases (ICD) and Current Procedural Terminology (CPT). These codes categorize patient diagnoses, procedures, and medical services. Coders must have a deep understanding of medical terminology, anatomy, and healthcare regulations to accurately code patient records.

Once the coding is complete, medical billers take the coded information and submit claims to insurance companies or billing entities. They ensure that the claim complies with payer requirements and follow up on any discrepancies or denials. Billers may also interact with patients to explain charges or collect payments. Both coders and billers play a crucial role in the financial health of healthcare organizations by ensuring proper reimbursement for services rendered.

A career in medical billing and coding typically begins with formal education and certification. Many employers prefer candidates who have completed a certification program, such as those offered by the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA). With experience, professionals can advance to roles such as coding supervisor, billing manager, or even transition into health information management, auditing, or compliance.

The profession offers flexibility, with many opportunities for remote work, and is expected to grow as the healthcare industry continues to expand and adapt to evolving regulations and technology. It’s a detail-oriented role that requires precision, organization, and a strong understanding of healthcare systems.

Day-to-Day Responsibilities

Medical Coders

Reviewing Patient Medical Records
Assigning Standardized Codes
Ensuring Coding Accuracy and Compliance
Working with Healthcare Providers
Staying Up-to-Date on Coding Guidelines

Medical Billers

Submitting Claims to Insurance Companies
Verifying Patient Insurance
Following Up on Denied or Rejected Claims
Tracking and Processing Payments
Interacting with Patients
Managing the Revenue Cycle

BLS.gov projects the job outlook for medical billers and coders to grow 9% from 2023-2033*

*Cited job outlook projections may not reflect local economic fluctuations and do not guarantee job placement. BLS.gov data retrieved on September 24, 2024 and subject to change.

Health Information Management+

Health Information Management (HIM) is a profession that combines the disciplines of healthcare, information technology, and data management to ensure the accurate, secure, and efficient handling of patient information. HIM professionals play a critical role in the healthcare system by managing health records, overseeing the use of health information technology, ensuring regulatory compliance, and analyzing health data to support decision-making and improve patient care.

At its core, HIM involves the maintenance of electronic health records and the management of all processes related to the collection, storage, and access of patient health information. HIM professionals are responsible for ensuring that medical data is accurate, up-to-date, and properly protected in accordance with healthcare laws such as the Health Insurance Portability and Accountability Act (HIPAA). This profession requires a deep understanding of both medical terminology and the legal framework governing healthcare information.

The field of health information management is rapidly evolving with advancements in technology, particularly with the widespread adoption of electronic health records and health information exchanges. HIM professionals often work closely with IT teams to implement and maintain systems that ensure the integrity and accessibility of patient data. They also play a key role in data governance, ensuring that information is handled in a manner that complies with federal and state regulations, as well as organizational policies.

In addition to managing health records, HIM professionals analyze healthcare data to identify trends, improve operational efficiency, and support clinical and administrative decision-making. They may work in various healthcare settings such as hospitals, physician offices, insurance companies, and public health organizations.

With the increasing importance of data-driven decision-making in healthcare, HIM professionals are often involved in developing and managing health information systems that support quality improvement initiatives, risk management, and patient privacy. Their expertise in both data management and healthcare regulations makes them key players in shaping the future of healthcare through the responsible use of health information.

Day-to-Day Responsibilities

Health Information Managers

Managing Health Records
Ensuring Regulatory Compliance
Overseeing the Use of Health Information Technology
Managing Data Privacy and Security
Analyzing and Utilizing Health Data
Managing Clinical Coding and Billing Information
Educating Staff on Health Information Practices
Facilitating Information Exchange
Supporting Clinical and Administrative Decision-Making
Participating in Strategic Planning

BLS.gov projects the job outlook for health information managers to grow 16% from 2023-2033*

*Cited job outlook projections may not reflect local economic fluctuations and do not guarantee job placement. BLS.gov data retrieved on September 24, 2024 and subject to change.

Medical & Health Services Management+

Medical and health services management, also known as healthcare administration or healthcare management, is a profession focused on the strategic planning, organization, and oversight of healthcare facilities, departments, or systems. Professionals in this field manage the daily operations of hospitals, clinics, long-term care facilities, physician practices, and other healthcare organizations, ensuring they deliver high-quality care efficiently while complying with regulations and financial constraints.

At its core, the profession involves coordinating a broad array of functions, including financial management, staffing, regulatory compliance, patient care services, and technology implementation. Medical and health services managers work closely with medical professionals, administrators, and support staff to create an environment where healthcare providers can focus on delivering effective patient care. Their work requires balancing the needs of patients, healthcare workers, and the organization’s financial and operational health.

In addition to operational management, these professionals are responsible for developing and implementing policies and procedures that align with the organization’s goals and with legal and ethical standards. This can include handling budgeting, overseeing billing systems, managing staff schedules, and ensuring that the organization meets state and federal healthcare regulations, including those related to patient privacy, safety, and quality of care.

Medical and health services managers must also stay current with evolving trends and technologies in healthcare, such as electronic health records, telemedicine, and advancements in healthcare delivery models. These advancements require them to make decisions on the adoption of new technologies or processes that can improve patient care and operational efficiency. Additionally, they often play a key role in addressing emerging challenges, such as adapting to changes in healthcare laws, managing the impacts of public health issues, or responding to shifts in patient demographics.

Medical and health services management offers diverse career paths, with opportunities to specialize in specific areas such as hospital administration, nursing home management, or clinical department management (e.g., surgery, cardiology).

Day-to-Day Responsibilities

Medical and Health Services Managers

Overseeing Daily Operations
Budgeting and Financial Management
Ensuring Regulatory Compliance
Managing Human Resources
Ensuring Quality of Patient Care
Strategic Planning and Policy Development
Managing Healthcare Technology
Collaborating with Medical and Administrative Teams
Handling Risk Management and Crisis Response

BLS.gov projects the job outlook for health information managers to grow 29% from 2023-2033*

*Cited job outlook projections may not reflect local economic fluctuations and do not guarantee job placement. BLS.gov data retrieved on September 24, 2024 and subject to change.

Education & Training+

Skills & Competencies+

Advancement & Specialization+

Industry Challenges & Trends+

Healthcare administration faces a dynamic environment, with both ongoing challenges and emerging trends that affect the way healthcare organizations operate and deliver services. Here are some of the key industry challenges and trends that healthcare administrators must navigate.

Industry Challenges

Controlling rising healthcare costs is a significant issue for healthcare organizations. Costs associated with medical services, prescription drugs, medical technology, and administrative overhead continue to rise, putting pressure on hospitals and healthcare systems to find ways to deliver high-quality care while managing expenses.

Healthcare is one of the most heavily regulated industries, and keeping up with constantly changing regulations—such as those related to patient privacy (HIPAA), value-based care, the Affordable Care Act (ACA), and Medicare/Medicaid billing—can be overwhelming.

There is a growing shortage of healthcare professionals, including physicians, nurses, and allied health workers, due to factors like an aging workforce, burnout, and increasing demand for healthcare services.

Health disparities—differences in health outcomes based on socioeconomic status, race, geography, or other factors—continue to be a major issue. Additionally, access to care remains a challenge in rural or underserved areas.

Patients today expect a higher level of service from healthcare providers, including shorter wait times, better communication, and more personalized care. Patient satisfaction is increasingly tied to reimbursement models, making it a critical area of focus.

The digitization of healthcare records and the widespread use of electronic health records (EHRs) have made healthcare organizations a prime target for cyberattacks and data breaches.

The shift from fee-for-service to value-based care, which ties reimbursement to patient outcomes rather than the volume of services provided, has created challenges for healthcare organizations in terms of adapting business models and workflows.

Industry Trends

Telemedicine has become a mainstream mode of delivering care, especially following the COVID-19 pandemic. Remote consultations, virtual follow-ups, and digital health tools have made healthcare more accessible.

AI and data analytics are transforming healthcare by enabling predictive modeling, personalized medicine, and improved operational efficiency. AI can assist in areas like diagnostics, resource allocation, and patient monitoring.

Population health management focuses on improving health outcomes for specific groups of people by coordinating care, identifying risk factors, and implementing preventive measures. This trend aligns with the shift to value-based care.

The integration of advanced health information technology systems, such as electronic health records (EHRs), health information exchanges (HIEs), and patient portals, continues to shape healthcare delivery.

Patients today are more empowered and informed, demanding greater transparency, convenience, and access to care. The consumerization of healthcare is driving innovations like retail clinics, home care, and direct-to-consumer health services.

There is growing recognition that social determinants of health, such as income, education, housing, and access to nutritious food, significantly impact health outcomes.

As healthcare becomes more diverse, organizations are increasingly focusing on workforce diversity and inclusion initiatives to ensure that the healthcare workforce reflects the populations they serve.

There is a growing emphasis on sustainability and eco-friendly practices within healthcare organizations, such as reducing waste, using renewable energy, and adopting environmentally friendly policies.

Resources+

FAQs+

How do I become a health information technician?	To become a health information technician, earn a relevant associate degree, gain knowledge in medical coding, and pursue certification such as RHIT (Registered Health Information Technician).
How do I get the RHIT certification?	To get RHIT certification, complete a CAHIIM-accredited health information program, then pass the RHIT exam administered by AHIMA. Maintain certification through continuing education every two years.
Is health information management a good career?	Health information management is a good career with strong job growth, competitive salaries, and opportunities to work in healthcare, data management, and technology, improving patient care and operational efficiency.
What can you do with a health information management degree?	With a health information management degree, you can work in medical coding, data analysis, health informatics, compliance, and manage electronic health records in hospitals, clinics, insurance companies, or government agencies.
What does a health information technician do?	A health information technician organizes, manages, and secures patient health records, ensuring accuracy, confidentiality, and compliance with regulations, while often coding diagnoses and procedures for billing and reporting.
What does health information manager do?	A health information manager oversees patient data systems, ensures compliance with privacy laws, manages records accuracy, and analyzes healthcare data to improve operations and patient care in medical facilities.
What is registered health information technician?	A Registered Health Information Technician (RHIT) manages and analyzes patient health records, ensures data accuracy, codes medical information, and supports healthcare operations, holding certification from AHIMA after passing the RHIT exam.
How long does it take to become a medical coder?	Becoming a medical coder typically takes 1-2 years, including completing a certificate or associate degree program, followed by certification through exams like CPC (AAPC) or CCA (AHIMA).
How much does it cost to become a medical coder?	Check out our tuition fees page for the latest on Medical Billing & Coding program.
How do I become a medical coder?	To become a medical coder, complete a certificate or associate program, learn medical terminology and coding systems, then pass a certification exam like CPC (AAPC) or CCA (AHIMA).
How to get a medical billing and coding certification?	To get medical billing and coding certification, complete a relevant training program, then pass a certification exam like CPC (AAPC) or CCA (AHIMA) to become certified in the field.
Is medical billing and coding in demand?	Medical billing and coding is in demand due to the growing healthcare industry, increased use of electronic health records, and the need for accurate medical data for billing and insurance purposes.
What do medical billing and coders do?	Medical billing and coders translate healthcare services into standardized codes, process insurance claims, and ensure accurate billing for medical providers, while maintaining patient data and compliance with regulations.
What does coding mean in a hospital?	In a hospital, coding refers to assigning standardized codes to diagnoses, treatments, and procedures for billing, insurance claims, and accurate patient records, ensuring compliance with healthcare regulations.
What is medical billing and coding?	Medical billing and coding involve translating healthcare services into standardized codes for insurance claims and billing, ensuring accurate patient records, and facilitating reimbursement for healthcare providers.
What is medical billing and coding salary?	The median salary for medical billing and coding professionals is around $48,000 annually, depending on experience, location, and certification, according to BLS.gov. (BLS.gov data accessed on October 10, 2024 and subject to change.)
How do I become a medical and health services manager?	To become a medical and health services manager, earn a bachelor’s or master’s degree in healthcare management, gain experience in healthcare settings, and pursue relevant certifications like CMM or ACMPE.
How do I get into healthcare management?	To get into healthcare management, earn a degree in healthcare administration or management, gain experience in healthcare settings, and pursue certifications like CMM or ACMPE to enhance career prospects.
What can I do with a healthcare management degree?	With a healthcare management degree, you can manage healthcare facilities, oversee departments, handle operations, improve efficiency, or work in healthcare consulting, policy, or insurance industries.
What does a medical and health services manager do?	A medical and health services manager oversees healthcare facility operations, manages staff, ensures regulatory compliance, improves efficiency, and coordinates services to enhance patient care and organizational performance.