Global /US medical billing and coding, prior authorization, credentialing, Bill Payments and Medicare best practices
β±οΈ Length: 7.8 total hours
β 4.56/5 rating
π₯ 5,773 students
π January 2025 update
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- Course Overview
- This highly rated and concise ‘Master in Healthcare Revenue Cycle Management (RCM)’ course (4.56/5 from 5,773 students) is expertly crafted to equip healthcare professionals and aspiring RCM specialists with the foundational knowledge and practical strategies essential for optimizing financial operations. Updated in January 2025, it ensures relevance to current industry standards.
- Spanning a practical 7.8 hours, the program efficiently distills complex RCM principles, covering both global and US-specific nuances in medical billing, coding, prior authorization, credentialing, and Medicare best practices.
- The curriculum emphasizes achieving ‘RCM Excellence’ by focusing on actionable insights and proven methodologies, empowering participants to significantly improve financial health and operational efficiency within their organizations.
- Designed for those seeking a competitive edge, this course provides a strategic blueprint for understanding the entire revenue cycleβfrom initial patient interaction to final payment resolutionβensuring sustainable growth and financial integrity in healthcare settings.
- Requirements / Prerequisites
- A basic understanding of healthcare operations or administrative roles is advantageous, though not strictly required for highly motivated individuals.
- Familiarity with standard computer usage and internet navigation is expected, as the course is delivered digitally.
- A genuine interest in healthcare finance, medical administration, or the intricate processes of medical billing and coding will greatly enhance the learning experience.
- No specific academic degree or extensive prior RCM experience is mandated, making it accessible to a wide array of learners, from front-office staff to seasoned administrators.
- Skills Covered / Tools Used
- Precision Medical Billing & Coding: Develop expertise in global and US medical billing codes (ICD-10, CPT) and submission protocols, crucial for minimizing rejections and accelerating reimbursements.
- Strategic Prior Authorization & Credentialing: Master the efficient management of prior authorizations and provider credentialing workflows, ensuring service coverage and compliance with payer requirements.
- Optimized Bill Payments & Collections: Learn best practices for managing patient and payer bill payments, including effective collection strategies, payment posting, and robust reconciliation.
- Medicare Compliance & Reimbursement: Specialize in navigating Medicare billing regulations and policies to ensure full compliance and maximize legitimate reimbursement for services.
- Revenue Leakage Mitigation: Cultivate analytical skills to identify and rectify inefficiencies or gaps in the RCM process that lead to revenue loss.
- RCM Technology Integration (Conceptual): Gain understanding of how RCM software, EMR/EHR systems, and automation tools are leveraged to streamline workflows and enhance financial performance.
- Payer Contract Interpretation: Develop the ability to analyze and understand complex payer contracts for optimal reimbursement terms.
- Data-Driven Performance Analysis: Learn to monitor Key Performance Indicators (KPIs) and utilize RCM data for continuous process improvement and strategic decision-making.
- Benefits / Outcomes
- Accelerated Career Growth: Position yourself for advanced roles and new opportunities in healthcare financial management and administration.
- Maximized Organizational Revenue: Implement effective strategies to significantly boost revenue capture, reduce denials, and improve cash flow for healthcare providers.
- Enhanced Operational Efficiency: Drive process improvements across the revenue cycle, leading to reduced administrative overhead and greater productivity.
- Mitigated Compliance Risks: Ensure adherence to complex billing regulations, including Medicare policies, safeguarding against audits and penalties.
- Improved Patient Financial Experience: Foster trust and satisfaction through transparent financial communications and streamlined payment processes.
- Become an RCM Expert: Gain a specialized ‘Master’ level understanding in a critical healthcare domain, making you an invaluable asset.
- Access to Cutting-Edge Knowledge: Stay abreast of the latest industry trends, technologies, and regulatory changes via regularly updated content.
- PROS
- Time-Efficient: Achieves a “Master” understanding in a concise 7.8 hours, ideal for busy professionals.
- Proven Quality: High rating (4.56/5) from a large student base (5,773+) attests to its effectiveness and value.
- Up-to-Date: January 2025 update ensures curriculum relevance and incorporates the latest industry practices.
- Broad Applicability: Covers both global and US-specific RCM aspects, enhancing its utility across different markets.
- Comprehensive Coverage: Addresses essential RCM components like billing, coding, authorization, credentialing, and Medicare.
- Action-Oriented: Focuses on implementing ‘RCM Excellence’ with practical, real-world strategies.
- CONS
- Its relatively condensed duration might necessitate further hands-on experience or supplemental learning for deep mastery of highly complex RCM software environments and niche, real-world case scenarios.
Learning Tracks: English,Business,Management
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