Medical Billing/Coding Certificate
Description and Outcomes
The objective of the Medical Billing/Coding Certificate program is to prepare you with the knowledge, technical skills, and work habits to pursue an entry-level position as a billing and insurance specialist in either a physician's office or institutional setting, or as a patient referral specialist, coder, or medical receptionist. The curriculum concentrates on helping you acquire the basic skills and knowledge necessary to submit medical claims for reimbursement, process bills, operate computerized billing systems, and gain a working knowledge of various insurance plans. Emphasis is placed on quality of coding for reimbursement and statistical reporting. You will gain additional hours of practical experience in medical billing, coding, and administrative functions in a virtual lab setting.
Upon graduation, workplace duties may include evaluating medical records in order to appropriately assign ICD-10 and CPT codes related to medical diagnoses and procedures, submitting insurance claims for reimbursement, and evaluating rejected claims for resubmission. You may use computerized billing programs and complete the HCFA claim form. In addition, you may develop a working knowledge of various insurance plans, including their associated regulations and guidelines, in order to efficiently and accurately refer patients to various health care providers.
Prior to graduation, you will be required to complete a 40 -hour practicum experience during HS292 Billing and Coding Practicum. You will select the facility where you will complete the experience. Detailed guidelines for selection of a facility will be provided during HS215 Medical Insurance and Billing.
The Medical Billing/Coding Certificate program consists of 44 quarter credit hours. Upon completion of the program, you will be awarded a certificate.
- Administration: Perform administrative functions of medical billing and coding.
- Technical: Apply computer literacy skills in managing electronic medical claims.
- Foundational Knowledge: Demonstrate knowledge of coding and billing guidelines and requirements in the process of medical claims management.
- Standards, Laws, Ethics, and Professionalism: Analyze ethical and legal standards in practical applications within the discipline of coding and medical claims processing.
- Critical Thinking: Apply problem-solving skills to real and simulated health care scenarios.
Certification, State Board, and National Board Exams
You are responsible for understanding the requirements of certification, state board, or national board licensing exams. Such requirements may change during the course of your program. You are not automatically certified in any way upon program completion. Although certain programs are designed to prepare you to take various certification and licensing exams, Kaplan University cannot guarantee you will be eligible to take these exams or become certified. Your eligibility may depend on your work experience, completion of education and/or degree requirements, not having a criminal record, meeting other licensure or certification requirements, or the program or the University itself having appropriate accreditation or licensure.
Upon completion of the program, you may be eligible to take the Certified Billing and Coding Specialist (CBCS) certification exam sponsored by the National Healthcareer Association (NHA), the Certified Coding Associate (CCA) certification exam sponsored by the American Health Information Management Association (AHIMA), the Certified Coding Specialist–Physician-based (CCS-P®) and Certified Coding Specialist (CCS®) exams offered by the American Health Information Management Association (AHIMA), and the Insurance and Coding Specialist (NCICS) certification exam sponsored by the National Center for Competency Testing (NCCT). You may be eligible for additional certifications once you attain professional experience.
|HI253||Medical Coding I||5|
|HI255||Medical Coding II||5|
|HS200||Diseases of the Human Body||5|
|HS215||Medical Insurance and Billing||3|
|SC121||Human Anatomy and Physiology I||5|
|SC131||Human Anatomy and Physiology II||5|
|HS292||Billing and Coding Practicum||3|
|Total Major Requirements||44|