Career comparison
Bookkeeper vs. Medical Billing and Coding Specialist
Side-by-side pay, training, growth and day-to-day duties to help you choose between two related careers.
Medical billing and coding specialists earn more at the median ($51,140 vs. $50,670), while bookkeepers usually get to work faster (3–12 months of training). Bookkeepers record transactions, reconcile accounts and keep a business’s books accurate. Medical billing and coding specialists translate medical records into codes and claims so providers get paid correctly.
Pay data: BLS OEWS, May 2025 · Outlook: BLS 2025–35 · Checked October 15, 2026
| Bookkeeper | Medical Billing and Coding Specialist | |
|---|---|---|
| Median pay | $50,670 ($24.36/hr) | $51,140 ($24.59/hr) |
| Pay range (10th–90th) | $36,000 – $74,550 | $37,000 – $81,150 |
| Job growth, 2025–35 | -5.6% (a projected decline) | +7.8% (much faster than average) |
| Openings per year | 144,100 | 14,000 |
| Typical entry education | Some college, no degree | Postsecondary nondegree award |
| Training time | 3–12 months | 4–12 months |
| Key credential | Certified Bookkeeper (AIPB) | CPC (AAPC) |
| Work setting | Bookkeepers work for small businesses, accounting firms, nonprofits and larger companies, or for themselves serving multiple clients. | Medical billers and coders work for hospitals, physician practices, billing companies, insurance companies and outsourcing firms. |
What each job does
Bookkeeper
- Record transactions in accounting software
- Process accounts payable and receivable
- Reconcile bank and credit card accounts
- Prepare payroll data and track payroll liabilities
- Maintain the general ledger and chart of accounts
Medical Billing and Coding Specialist
- Review physician notes, operative reports and other documentation
- Assign ICD-10-CM diagnosis codes and CPT/HCPCS procedure codes
- Apply modifiers and check codes against payer and NCCI edits
- Prepare and submit claims electronically through a clearinghouse
- Post payments and review explanations of benefits
How they’re similar
Both careers involve working with information, desk work, indoor work, and working independently. They sit in different fields, business & office and healthcare, but share transferable skills such as accuracy and attention to detail.
Which should you choose?
Choose bookkeeper if…
- I like numbers and keeping things accurate
- I’m comfortable with spreadsheets and software
- I prefer structured, detail-oriented work
Choose medical billing and coding specialist if…
- I enjoy detailed, accurate work at a computer
- I want a healthcare job without patient contact
- I can stay focused and productive on my own
Still torn? Take the Bookkeeper fit quiz and the Medical Billing and Coding Specialist fit quiz, or the full Career Match Quiz.
Quick comparisons
Which pays more, bookkeeper or medical billing and coding specialist?
Medical Billing and Coding Specialists earn more at the median: $51,140 versus $50,670 for bookkeepers, based on BLS May 2025 data.
Which takes less time to train for?
Bookkeepers typically train faster (3–12 months) than medical billing and coding specialists (4–12 months).
Which career has better job growth?
BLS projects medical billing and coding specialists to grow +7.8% from 2025–35, compared with -5.6% for bookkeepers.