Course Description
Mastering Medical Billing: Your Pathway to a Rewarding Healthcare Career
The healthcare industry is a vast, dynamic, and essential sector, with myriad specialties and vocations. Among these, medical billing stands out as a critical cog in the medical machinery. As the healthcare sector continues to expand, the role of a proficient medical biller becomes increasingly indispensable.
Why Medical Billing?
In our interconnected world, where patient care seamlessly merges with technological advancements, the medical biller emerges as a bridge between healthcare providers and insurance companies. They play a quintessential role in ensuring the financial health of medical establishments. From processing insurance claims to adhering to ever-evolving healthcare policies, a medical biller's responsibilities are both diverse and integral. The demand for skilled medical billers has surged in recent years. Hospitals, clinics, and private practices rely heavily on adept billers to streamline their operations and maintain fiscal health.
What Will You Learn?
This comprehensive, self-paced course is meticulously crafted to arm you with the essential skills required to excel in medical billing. It's structured to suit both novices and those looking to brush up on their skills. Designed in accessible language, this course promises a deep dive into the intricate world of medical billing.
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Overview of the Healthcare System & Career Opportunities in Medical Billing (Lesson 1): Gain insights into the healthcare system's landscape and the exciting career paths open to medical billers.
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Medical Biller Job Description (Lesson 2): Delve into the specifics of what a medical biller does, understanding the nuances and intricacies of the role.
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Analyzing Provider and Patient Information (Lesson 3): Learn the art of dissecting critical data, ensuring accurate billing and top-notch patient care.
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ICD-10-CM - What is it? (Lesson 4): Get acquainted with the International Classification of Diseases, Tenth Edition, Clinical Modification - an essential tool for medical billing.
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Analyzing the Hospital Billing Process (Lesson 5): A deep dive into the billing process of hospitals, understanding the differences and nuances from other medical establishments.
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Analyzing the Physician Billing Process (Lesson 6): Gain a comprehensive view of how billing works specifically for physicians, unraveling the unique challenges and solutions.
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Exploring Different Types of Health Insurance (Lesson 7): Understand the diverse insurance types, ensuring effective communication with insurance providers.
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Medicare Overview (Lesson 8): Discover the workings of Medicare, one of the most significant health insurance programs.
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Reimbursement & Legal Issues (Lesson 9): Navigate the legal framework surrounding medical billing and understand the pivotal role of reimbursements.
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Medical Billing & Coding Certifications Information (Lesson 10): Explore the various certifications available, understanding their relevance and the advantages they bring to your career.
Why Choose This Course?
For those aspiring to make a mark in the healthcare administration domain, this course serves as a beacon. You will not only learn the technical aspects of medical billing but also cultivate a holistic understanding of its role in the broader healthcare spectrum. By the course's end, you'll be poised to seamlessly integrate into any medical establishment, wielding the dual weapons of knowledge and confidence.
In conclusion, if you're seeking a career that blends the gratification of being part of the healthcare industry with the satisfaction of a meticulous administrative role, medical billing is your answer. And this course, with its extensive curriculum and practical insights, is the perfect springboard to launch you into this rewarding profession.
- Completely Online
- Self-Paced
- 6 Months to Complete
- 24/7 Availability
- Start Anytime
- PC & Mac Compatible
- Android & iOS Friendly
- Accredited CEUs

Learning Outcomes
- Describe the primary roles and responsibilities of medical billers when managing healthcare claims and revenue cycles within medical practices.
- Identify the projected percentage employment growth in healthcare occupations between 2021 and 2031 based on data from the U.S. Bureau of Labor Statistics.
- Define the key responsibilities of a medical biller, including account management, compliance with billing standards, and coordination with insurance providers within a healthcare facility.
- Demonstrate the ability to utilize billing software systems by accurately processing transactions and adjusting claims in hypothetical scenarios, ensuring compliance with current industry standards.
- Define the key responsibilities of a medical biller and demonstrate their impact on healthcare processes.
- Identify and apply the necessary CPT codes for various medical procedures to ensure accurate billing and reimbursement.
- Demonstrate the ability to accurately link ICD-10-CM and CPT codes to justify medical services and ensure successful insurance claims processing.
- Describe the difference between ICD-10-CM and CPT codes by explaining the specific use and purpose of each in medical coding.
- Explain the role of a hospital's ChargeMaster in billing transparency and demonstrate the ability to recognize how it impacts patient billing and fair pricing advocacy.
- Identify and describe the three major categories of hospital charges, demonstrating the ability to differentiate between room and board, ancillary items, and routine items.
- Demonstrate the ability to accurately translate patient medical information into billing codes using standardized forms, such as the CMS 1500 form, to minimize errors and optimize payment processes.
- Define the key steps in the physician billing process and explain the importance of each step in ensuring timely reimbursements.
- Identify and differentiate between various commercial health insurance plan types, such as PPO, HMO, POS, and EPO, based on coverage, copayment, and deductible characteristics.
- Demonstrate mastery of lesson content at levels of 70% or higher.
Assessment Guide
Assessment | Points |
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Lesson 1 Activity | 1 points |
Exam 1: Healthcare System Overview | 4 points |
Lesson 1 Review Exam | 20 points |
Exam 2: Medical Biller Duties | 5 points |
Lesson 2 Review Exam | 20 points |
Exam 3: Analyzing Provider and Patient Information | 5 points |
Lesson 3 Review Exam | 19 points |
Exam 4: ICD-10-CM - What is it? | 10 points |
Lesson 4 Review Exam | 10 points |
Exam 5: Hospital Billing | 5 points |
Lesson 5 Review Exam | 20 points |
WEB-BASED TRAINING- Medicare Billing: Form CMS-1500 and the 837 Professional | 5 points |
CMS.GOV - Learn about CLIA | 5 points |
Exam 6: Physician Billing | 6 points |
Claims Filing Tips & Guidelines | 9 points |
CMS video: Proper Documentation in Claims | 5 points |
Exam 7: Types of Health Insurance | 4 points |
Lesson 7 Review Exam | 20 points |
WEB-BASED TRAINING- World of Medicare | 5 points |
Exam 8: Medicare | 7 points |
Items & Services not Covered under Medicare | 12 points |
Lesson 8 Review Exam | 20 points |
WEB-BASED TRAINING- Combating Medicare Parts C and D Fraud, Waste, & Abuse | 5 points |
WEB-BASED TRAINING- Medicare Fraud & Abuse: Prevent, Detect, Report | 5 points |
Exam 9: Legal Issues | 5 points |
HIPAA | 30 points |
Lesson 9 Review Exam | 20 points |
Lesson 10 Review Exam | 20 points |