Medical Billing and Coding Specialist

Coding and billing are the invisible engines of the healthcare system. Without either field, the healthcare industry would be unable to efficiently transmit important data, and healthcare providers would have an incredibly hard time getting paid for their services. In a nutshell, it is the medical coder’s job to translate the healthcare provider’s report of a patient’s visit into numeric or alphanumeric code, which in turn is used by the medical biller to make a bill, or “claim,” for the insurance company and determine the appropriate charge for the patient. In this section, we’ll introduce you to the basic concepts of coding and billing, and we’ll give you an idea of what it’s like to work in these fields. You’ll learn about the leading professional organizations in coding and billing, and we’ll show you the certifications available for each position.

Medical billing is the preparation of invoices for procedures rendered, and these are given to patients and insurance companies. Medical billers act as the financial waypoint between patients, providers, and payers. Without billers, healthcare providers couldn’t be reimbursed for the procedures they perform. The training videos in this section cover the key concepts and guidelines that underpin the billing process. You’ll learn how the insurance process works, and what types of payers affect the reimbursement process. Finally, we’ll discuss Medicare, Medicaid, and the regulations enforced under the Health Insurance Portability and Accountability Act (HIPAA).

Upon graduation from the program the student will be able to:

• Evaluate medical documentation to determine codable diagnoses and procedures in accordance with established coding guidelines.
• Apply appropriate codes from ICD-10-CM, ICD-10-PCS, ICD-9-CM, and CPT-4 coding schemes to various health encounter scenarios in medical documents using coding manuals and encoder software.
• Evaluate reimbursement methodologies for correctness of assignment.
• Perform analysis of reimbursement methodologies through case-mix analysis.
• Audit coded data to determine accuracy and correct deficiencie

Medical coding is the translation of medical reports into a shortcode used within the healthcare industry. This helps summarize otherwise cumbersome medical reports into efficient, data-friendly codes. While complex and detail-driven, medical coding really comes down to knowing how to navigate the three main code sets: CPT, ICD, and HCPCS. These code sets help coders document the condition of a patient and describe the medical procedure performed on that patient in response to their condition. We’ll train you to recognize how code set is organized and how each should be used.

Medical billing and coding are two of the fastest-growing fields in the healthcare industry today. In this section, we’ll show you what it’s like to work as a medical biller and as a coder in the field. You’ll see some of the common problems coders face day-to-day, and we’ll guide you through each step of the billing and coding process. From the doctor’s visit to the completed claim, you’ll see this industry from every angle.

Contact our Admission Desk for more information, you may be qualified for some scholarship offers

When it comes to getting a coding certification, the American Association of Professional Coder (AAPC)’s Certified Professional Coder (CPC) exam is one of the most well known. You’ll need to be highly prepared for a test as intense and extensive as the CPC exam, which takes almost six hours to complete. In this section, we’ll teach you the basics of the exam and provide you with valuable study techniques and test-taking strategies. We’ll also go over each of the 24 sections that the CPC exam focuses on, meaning you’ll know what to expect when it comes time to get certified.Students learn to classify medical data from inpatient, outpatient, and physician office records. The ability to effectively and efficiently code data is critical to medical research, medical and health education, and planning and monitoring public health.Students will study disease pathology and the format and content of health records. Graduates gain an in-depth knowledge of the ICD-10-CM, ICD-10-PCS, and CPT coding systems as well as reimbursement systems used in the United States.Our program faculty have extensive experience in both inpatient and outpatient coding. This provides valuable practical knowledge for the classroom setting. Added: Students who complete the coding certificate courses can continue on and achieve a Bachelor of Science in Health Information Management