Medical Records Specialist Career Assessment
Medical coding and health records — ND in-demand occupation
Welcome
Medical records specialists (often called medical coders) turn doctor notes into codes used for billing, insurance, and health data.
This is a healthcare job with no patient contact, and many jobs are remote. You will explore whether it fits you.
This takes about 15 minutes.
What is a Medical Records Specialist?
A medical records specialist reviews patient records and assigns standard codes for each diagnosis and procedure. These codes tell insurance companies what was done so the hospital or clinic gets paid.
The Reality: This is detail work. One wrong code can mean a claim is denied or a hospital is paid the wrong amount. You will spend most of the day reading records and looking up codes on a computer.
Your Responsibilities:
- Read doctor and nurse notes in the medical record
- Assign diagnosis codes (ICD-10-CM)
- Assign procedure codes (CPT and ICD-10-PCS)
- Check records for missing or unclear information
- Ask doctors questions when notes are unclear
- Help fix denied insurance claims
- Protect patient privacy (HIPAA)
- Keep up with yearly code changes
You are a translator between medical care and the business of health care.
A Day in the Life
7:30 AM — Log in from home. 40 charts in your work queue today.
8:00 AM — Code emergency room visits. Read each note carefully and assign codes.
10:00 AM — A note is unclear about which arm was broken. Send a question to the doctor.
11:00 AM — Short team video call about new coding rules.
12:00 PM — Lunch.
1:00 PM — Code surgery records. These take longer and need more detail.
3:00 PM — Look into a denied insurance claim. Find the coding error and fix it.
4:00 PM — Finish your queue. Check your accuracy score.
Quiet, focused computer work, often from home.
Training in North Dakota
No state license is needed. Most employers want a coding certificate or associate degree plus a national certification.
Training Pathways:
- Coding certificate (about 1 year): Anatomy, medical terms, and coding systems. Fastest path.
- Associate degree in Health Information (2 years): Coding plus health records management. Leads to the RHIT credential.
- Online options: Many programs are fully online.
Where to Train in North Dakota:
- ND State College of Science (Wahpeton or fully online) — Health Information Technician AAS (65 credits); North Dakota's only CAHIIM-accredited HIT program
- ND State College of Science — Medical Coding certificate
- Online coding programs approved by AHIMA or AAPC
Before You Start: High school diploma or GED. Good reading skills, basic computer skills, and strong attention to detail. Anatomy and medical terminology classes come first.
Tip: Start with financial aid, scholarships, and any help an employer offers — that is where the money starts. After that, ask a career counselor or Job Service North Dakota whether WIOA or other programs can help with what is left over, like tuition, exam fees, or supplies. What can be paid for depends on the program and on your own situation, so ask before you sign up rather than after. Some ND employers also help pay for training if you agree to work for them afterward.
Certification & Licensing
No license. Certification is expected. Most job ads ask for at least one national coding certification.
Certifications Employers Look For:
- CCA (Certified Coding Associate, AHIMA) — entry level
- CPC (Certified Professional Coder, AAPC) — common for clinic and physician coding
- CCS (Certified Coding Specialist, AHIMA) — advanced, often hospital coding
- RHIT (Registered Health Information Technician) — after an accredited associate degree
The Exams: Coding exams are 2–4 hours and include real coding cases. Some let you use your code books.
Cost: About $300–$500 per exam. Prices change, so check before you buy.
Keeping It Current: All certifications require continuing education every 1–2 years. Codes change every year.
Salary & Job Outlook
North Dakota Medical Records Specialist Pay (May 2025):
- Starting out (bottom 10–25%): $19.03–$19.39/hour ($39,580–$40,330/year)
- Middle (median — half earn more, half earn less): $22.25/hour ($46,280/year)
- Experienced (top 25–10%): $29.26–$38.36/hour ($60,860–$79,800/year)
What that means: Starting pay is modest. Certified, experienced coders (especially hospital and surgery coders) earn much more. Many ND residents also work remotely for out-of-state employers.
Jobs in North Dakota: About 380 people do this work in ND today. By 2034, that should be about 410 (about 8% growth). Expect about 30 job openings every year in ND from growth and people retiring or changing jobs. Across the U.S., the change is about 7% growth — much faster than average.
Outlook: Good, with about 30 openings a year in ND. AI and computer-assisted coding are changing the work, so coders who can check and correct computer-suggested codes will be in demand.
Who Hires in ND: Hospitals and health systems, clinics, insurance companies, billing companies, and remote coding companies.
Work Setting: Offices or remote from home. Usually regular daytime hours. Very computer-based.
Physical Demands: Light. Sitting at a computer most of the day. Eye strain and wrist strain are common.
Sources: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, North Dakota, May 2025 (SOC 29-2072); North Dakota and U.S. long-term employment projections 2024–2034, via O*NET OnLine. Numbers are rounded.
Where This Leads
Path 1: Hospital or Surgery Coder — More complex coding, higher pay.
Path 2: Coding Auditor — Check other coders' work for accuracy.
Path 3: Clinical Documentation Specialist — Work with doctors to improve their notes.
Path 4: Health Information Technologist — Move into records management (RHIT).
Path 5: Coding Manager — Lead a coding team.
Path 6: Cancer Registrar — Specialize in cancer data.
The Real Talk
What's Great:
- Healthcare job with no patient contact
- Many remote jobs
- Short training (1–2 years)
- Regular hours
- Good fit for detail-focused people
- Clear ladder with certifications
What's Hard:
- Starting pay is modest
- Quiet, repetitive work
- Production and accuracy quotas
- Codes change every year
- AI is changing entry-level coding
- Many employers want 1–2 years of experience
- Long hours at a screen
- Isolated if working remotely
Be Honest: Do you enjoy detailed, quiet work? Can you focus on a screen for hours? Are you OK with little people contact? Will you keep learning as codes and technology change?