Medical Billing and Coding Professional

Medical billing and coding professionals are responsible for the collection of physician charges and patient data to ensure that claims are submitted to insurance carriers accurately and in the most efficient and expeditious manner.

Medical coders determine codes for physician procedures and diagnosis - using ICD-10 and CPT-4 coding protocols - for third party billing purposes. Physician practices, hospitals, pharmacies, longterm care facilities, chiropractic practices, physical therapy practices and other health care providers all depend on medical billing and coding for insurance carrier reimbursement.

Who Should Attend

This program is for individuals who are interested in understanding how to code health care services and procedures for third party insurance reimbursement.

Certificate Completion

Upon successful completion of the program, you will be eligible to sit for the National Healthcareer Association Certification Exam. The cost of this exam is $115 and is not included in your tuition.

CPR certification is not required, but is beneficial when working in a healthcare environment. The College of Extended Learning offers CPR certification courses. The cost of this course is $65 and is not included in your tuition.

Delivery Format

Face-to-face (lecture and labs)

Medical Billing Photo
Course Information
Course No. HSCI 1027
Units NC
Fee* $2,499**
Training Time 80 hours, classroom
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* Fees are subject to change

** Textbooks included

Skill Sets

  • Basics of health insurance and procedural coding
  • Introduction to CPT manual including CPT modifiers, E and V codes and late effects
  • Diagnosis coding
  • Introduction to international classification of diseases, clinical modifications, coding guidelines
  • The health insurance claim form (CMS 1500)
  • HIPAA and Electronic Data Interchange (EDI)
  • Tracing delinquent claims and insurance problem solving
  • Managed care systems and special plans & third party reimbursement, medicare, Blue Cross-and Blue Shield Plans, Medicaid and Other State Programs, CHAMPUS and CHAMPVA, worker’s compensation, disability income insurance and disability benefit programs

Requirements

People interested in becoming medical coders or pursuing national certification should have a high school diploma or GED equivalent. Also, certain National Medical Coding Certification exams are very complex and may require 6 months to 2 years of suggested practical coding experience prior to taking the exam or being recognized as a certified medical coding professional.

This program requires 80 classroom hours in order to earn a certificate of completion.

Outline

Training Time

80 hours, classroom


This 80-hour, face-to-face course offers the skills needed to solve insurance billing problems, how to manually file claims (using the CPT and ICD-10 manual), complete common insurance forms, trace delinquent claims (EOB’s) and use generic forms (CMS 1500) to streamline billing procedures. This course covers the following areas: CPT (introduction, guidelines, evaluation and management), specialty fields (such as surgery, radiology and laboratory), ICD-10 (introduction and guidelines) and basic claims process for medical insurance and third party reimbursement. Students will learn how to find the service codes using coding manuals, (CPT & ICD-10).

After obtaining the suggested practical work experience, students who complete this course could be qualified to sit for the American Academy of Professional Coders (AAPC) - Certified Professional Coder Exam (CPC or CPC-H - Apprentice); the American Health Information Management Association (AHIMA) Certified Coding Associate (CCA) exam; and/or other National Certification Exams.

This comprehensive Medical Billing and Coding Program provides training in the following areas:

  • A career as an insurance coding specialist
  • Documentation guidelines and legal issues affecting insurance claims and medical records
  • Basics of health insurance and procedural coding
  • Introduction to CPT Manual
  • Evaluation and management services
  • Anesthesia/Surgery, Radiology and Pathology/Laboratory Medicine
  • Diagnosis Coding
  • CPT Modifiers, E and V Codes and Late Effects
  • Introduction to International Classification of Diseases, Clinical Modifications, Coding Guidelines
  • The Health Insurance Claim Form (CMS 1500)
  • HIPAA and Electronic Data Interchange (EDI)
  • Tracing Delinquent Claims and Insurance Problem Solving
  • Managed Care Systems and Special Plans & Third Party Reimbursement, Medicare, Blue Cross-and Blue Shield Plans, Medicaid and Other State Programs, CHAMPUS and CHAMPVA, Worker’s Compensation, Disability Income Insurance and Disability Benefit Programs

This entry level course does not require the use of a computer as the focus of a coding professional is the proper use of coding and the related coding manuals

Summer 2017 Schedule (Monday-Wednesday & Saturday)

Day Date Time Location
Monday & Wednesday 6/12/17 - 8/21/17 6:00-9:30pm YC 105
Saturday 7/1 & 7/29 9:00am-3pm YC 105

Fall 2017 Schedule (Monday-Wednesday & Saturday)

Day Date Time Location
Monday & Wednesday 9/25/17 - 12/4/17 (NO CLASS 11/18) 6:00-9:30pm YC 105
Saturday 10/21 & 11/18 9:00am-3pm YC 105

Register

  • Summer 2017 - Cancelled
  • Fall 2017 - Information coming soon