Medical Billing and Outpatient Coding Specialist
Program code: MCOD-CC
Locations: Asnuntuck, Middlesex, Northwestern, Norwalk, Quinebaug Valley
Program Description
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 nationally recognized professional certification. A billing or coding credential provides proof of competency in the field and is often a requirement for medical billing, medical coding, or other healthcare revenue cycle positions. Students are encouraged to discuss certification options with their faculty advisor and consider sitting for one of the following credentialing exams on completion of the certificate:
National Health Care Association (NHA)
- CBCS - Certified Billing and Coding Specialist
- CMAA - Certified Medical Administrative Assistant
AAPC
- CPB - Certified Professional Biller
- CPC - Certified Professional Coder
Certificate Requirements
| Code | Title | Credits |
|---|---|---|
| Required Courses | ||
| MDAS 1011 | Administrative Medical Assisting | 3 |
| or HIMT 1410 | Healthcare Access Management | |
| HIMT 1110 | Introduction to Health Information Management | 3 |
| or HIMT 2110 | Health Information Management Principles | |
| Choose one of the following: | 3 | |
| Human Diseases and Pathophysiology | ||
| Pathophysiology | ||
| Biology of Disease | ||
| HIMT 2732 | Introduction to Diagnosis Coding | 2 |
| HIMT 2745 | Healthcare Coding for Services & Supplies | 2 |
| MDAS 1012 | Medical Insurance and Billing | 3 |
| or HIMT 2460 | Healthcare Reimbursement | |
| Choose one of the following: | 3 | |
| Medical Terminology for Clinical and Administrative Professions | ||
| Medical Terminology and Anatomy | ||
| Medical Terminology | ||
| MDAS 2016 | Electronic Medical Records | 3 |
| or HIMT 2350 | Healthcare Informatics | |
| HIMT 2410 | Professional Medical Billing | 2 |
| Total Credits | 24 | |