Medical Billing and Outpatient Coding Specialist (MCOD-CC)

This 2024-25 Curriculum Guide is intended as a reference for Fall 2024 registration. The complete 2024-25 Academic Catalog will be finalized on July 1, 2024.

The Medical Billing and Outpatient Coding Specialist Certificate program prepares students for entry level positions in medical billing, outpatient medical coding, and health information in physician’s offices, hospitals, ambulatory care centers, telehealth, health insurance companies, and other allied health venues. Process claims submissions for compliant and equitable reimbursement. The healthcare industry is facing significant changes in how providers and insurers generate, maintain, and communicate documentation related to medical records, insurance, coding, and financial reimbursement.

Learning Outcomes:

• Identify and compare reimbursement methodologies.
• Summarize principles related to healthcare privacy, confidentiality, legal and ethical issues.
• Use current Electronic Medical Record (EMR) software to manage provider reimbursement and patient health information.
• Prepare revenue cycle documents by utilizing International Classification of Disease - Clinical Modification (ICD-10-CM), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) II reference material.
• Review and abstract information needed to support accurate outpatient coding and health record documentation for completeness and accuracy.
• Interpret healthcare data to determine claim status, resolve claim denials, submit appeals, post payments and adjustments, and manage collections.
• Apply Health Insurance Portability and Accountability Act of 1996 (HIPAA), Health Information Technology for Economic and Clinical Health Act (HITECH), and Protected Health Information (PHI) regulations as they apply in the outpatient setting.

Eligible for Workforce Innovation and Opportunity Act (WIOA) and Supplemental Nutrition Assistance Program (SNAP) specialized funding that affects program length or structure. It prepares students for a national industry certification. A coding credential provides proof of competency in the field and is often a requirement for clinical coding-related and healthcare revenue management positions.

National Health Care Association (NHA)

• CBCS - Certified Billing and Coding Specialist
• CMAA - Certified Medical Administrative Assistant

American Association of Professional Coders (AAPC)

• CPB - Certified Professional Biller
• COC - Certified Outpatient Coder
• CPC - Certified Professional Coder