Master the essentials of medical billing, ICD-10-CM, ICD-11, CPT, claims processing, and insurance plans & way more
What you will learn
Accurately assign diagnosis codes using ICD-10-CM and understand how to transition to ICD-11.
Use CPT and HCPCS codes to document and report medical procedures and services.
Understand the full medical billing cycle, from patient intake to claim submission and payment.
Navigate various health insurance plans, including Medicare, Medicaid, PPOs, and workers’ compensation.
Ensure compliance with HIPAA and reduce risk of audit through ethical and accurate documentation.
Use billing software and clearinghouse systems to manage real-world claim submissions and denials.
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- Course Overview
- Explore the critical administrative backbone of the healthcare system, linking patient care to financial reimbursement.
- Understand the integral role of medical billers and coders in ensuring accurate and timely payment for healthcare services.
- Gain a comprehensive understanding of the entire revenue cycle process from patient registration to claim finalization.
- Learn how precise documentation and coding directly impact a healthcare provider’s financial health and compliance.
- Delve into the regulatory landscape governing healthcare claims, emphasizing ethical practices and legal adherence.
- Prepare for a dynamic career where attention to detail meets vital healthcare administration.
- Requirements / Prerequisites
- A high school diploma or equivalent is generally recommended.
- Basic computer literacy and comfort with online learning platforms are essential.
- Reliable internet access and a personal computer are necessary for course engagement.
- Strong organizational skills and an aptitude for detail-oriented work are beneficial.
- A genuine interest in the healthcare industry and administrative processes is highly encouraged.
- No prior medical experience is required, making this an accessible entry point into the field.
- Skills Covered / Tools Used
- Develop advanced analytical skills for interpreting complex medical documentation and assigning appropriate codes.
- Master the principles of healthcare data integrity and its importance in billing and coding.
- Acquire proficiency in navigating various types of electronic health records (EHR) and billing software interfaces.
- Gain expertise in preparing and submitting clean claims to a multitude of insurance carriers, minimizing denials.
- Cultivate effective problem-solving skills to address claim rejections, appeals, and payment discrepancies.
- Learn to leverage industry-standard coding manuals and online resources for accurate code assignment.
- Understand the fundamental architecture and flow of information within medical practice management systems.
- Benefits / Outcomes
- Position yourself for a rewarding career in high-demand healthcare administrative roles across various settings.
- Attain the professional knowledge required to confidently pursue certification exams, enhancing employability.
- Contribute significantly to the financial viability and operational efficiency of medical practices, hospitals, and clinics.
- Open doors to flexible work arrangements, including potential remote or hybrid opportunities.
- Build a foundational understanding that can lead to specialization in areas like auditing, compliance, or specific medical specialties.
- Empower yourself with a skill set critical for maintaining the seamless flow of information and finances in healthcare.
- PROS
- High Job Demand: The healthcare industry consistently requires skilled billing and coding professionals.
- Career Versatility: Opportunities exist in diverse environments like hospitals, private practices, insurance companies, and government agencies.
- Potential for Remote Work: Many roles offer the flexibility to work from home, providing a better work-life balance.
- Impactful Contribution: Play a crucial role in ensuring patients receive the care they need by facilitating proper reimbursement.
- Stable Industry: Healthcare is a recession-resistant sector, offering long-term career stability.
- CONS
- Continuous Learning Required: The field constantly evolves with new regulations, codes, and technologies, demanding ongoing professional development.
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