Medical Coding and Reimbursement Specialist Certificate

Prepare online for an entry-level career as an inpatient and outpatient coder, biller, patient account representative and other support positions in a variety of healthcare settings.Students who successfully complete this program, by achieving a grade of 2.0 or better for each individual course in the program and program prerequisites, should be able to:Apply knowledge of medical and clinical terminology, anatomy and physiology, human diseases and pharmacology.Read and interpret patient medical records, utilize an electronic health record, and query physicians when appropriate to obtain an accurate code.Accurately assign diagnostic and procedural codes in accordance with Uniform Hospital Discharge Data Set (UHDDS), National Correct Coding Initiative (NCCI), American Hospital Association (AHA), and American Medical Association (AMA) guidelines for inpatient and outpatient health record.Use computerized encoders to group to proper prospective payment systems in various healthcare settings including Medicare Severity Diagnosis-Related Group (MS-DRG) and Ambulatory Payment Classification (APC) case-mix systems.Accurately analyze clinical documentation and code patient health records as part of hierarchical condition categories (HCCs) and risk adjustment (RA) methodology and reimbursement.Complete commercial insurance, Medicare and Medicaid claim forms.Apply privacy and security regulations to protect confidential health care records and billing data.