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| MEDICAL BILLING SPECIALIST Medical practices and hospitals rely on medical billing specialist to receive revenues. From processing patient information, posting charges to accounts, billing patients and insurance companies, filing claims, to posting EOBs, collections, and computer account transactions, the billing specialist is in high demand. It is essential a billing specialist has knowledge in all these fields. Because of this SE School for Career Development is offering a program that will cover the many procedures needed to be a confident, knowledgeable professional billing specialist. From beginners to expert. Medical Billing Specialist need to keep on top all monies due from insurance companies and patients, to ensure the success of both small and large healthcare providers. The medical field is rapidly expanding as hospitals, medical offices, and private practices add staff to handle the increasing number of patients that they see daily. If you have been thinking about a career in medical billing, you could not have chosen a better time. Everything you need, all in one course. |
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| Every time a patient receives health care, a bill for the patient’s services is produced. The billing specialist collects all the information concerning the bill. Superbills, encounter forms, or routing slips contain the patient’s diagnosis, codes, and procedures of the patients. All Superbills or encounter forms must be properly identified and signed. Medical billing professionals organizes and evaluates the information for completeness and accuracy. The insurance information must be verified and correct. All this nformation and charges for the patient is posted into patients account electronically. This is usually done in batches and is called batch processing. Billing specialist communicate daily with physicians and other health care professionals to clarify diagnoses and to obtain correct medical information. Every bill that is generated in a medical office must be coded correctly so that insurance companies can determine how to pay the claim. If the patient has medical insurance, the billing specialist will need to produce a claim, which is sent to the insurance companies for reimbursements. Billing personnel must have a good understanding of ICD-9-CM, CPT, and HCPCS coding and compliance. Medical billing professionals' duties vary with the size of the facility where they work. In large to medium-sized facilities, jobs are departmentalized, where billing personnel might specialize in one area of billing, such as account receivables, or might supervise collections. In small facilities, a medical billing personnel might be responsible the entire billing procedures. Home Billing is a very popular service to consider. Stay home, work from home, work the hours you want, stay home with the children. Physicians outsource, and hire billing companies or individuals to do there billing for them. Go to the section in our web site that states, Home Business. You can see the many jobs people can do at home. With a Medical Billing Specialist certificate from SE School for Career Development, one can pursue any of the following careers: Account Receivable’s Clerk Medical Account Representative Medical Reimbursement Specialist Medical Billing Clerk Medical Billing Manager Medical Billing Processor Medical Billing Specialist Medical Coding Specialist Medical Collector Medical Claims Processor Medical Insurance Processor Merchandising Manager and Pharmacy Biller and other billing related jobs. Start at beginners and advance to a professional expert level in training. Salaries can range from $19,000 to $34,000 annually, depending on title, experience, and knowledge. What You Can Learn: Medical Insurance Billing Specialist responsibilities and qualifications. Employment opportunities and certification. HIPAA Learn the legal issues and terms. Understanding HIPAA, the Privacy Rule, and Security Rule. Learn about fraud and abuse laws and guidelines to follow. Introduction and Understanding Health Government Sponsored Health Care Programs. Understanding Managed Care, HMO, PPO, EPO, IDS, and organizations. Understanding provider reimbursement methods. Understanding insurance policy, company terms, coverage terms, and terms related to payments. Understanding Coordination of Benefits. Primary and Secondary payers. Preauthorization, Precertification, and Predetermination. Learn the Fees for Service, Copayments, Capitation, and Payments. ICD-9-CM Coding Understanding the ICD-9-CM and coding, components, and symbols. Understanding V Codes Understanding E Codes and Modifiers. How to assign ICD-9-CM codes. Selecting the correct code. Guidelines and procedures for physician office coding. Guidelines for inpatient, short term, acute care, and long term care hospital coding. Supplementary classifications and coding categories. Miscellaneous coding guidelines. Hands-on coding applications and practice for expertise and proficiency. Learn how to code Symptoms, Signs, and Ill Defined Conditions, Infectious and Parasitic Diseases, Endocrine, Nutritional and Metabolic Diseases, Nervous System, Circulatory System, Respiratory System, Digestive, and Genitourinary System coding. ICD-10-CM Coding Hands-on coding applications and practice is provided for proficiency. Coding CPT and HCPCS Understanding CPT Procedure Coding, Coding Terminology. The Formats, Categories, Subsections, Subcategories, Conventions, Symbols, Instructional Notes. Understanding Evaluation and Management coding, sections and categories Understanding the levels of coding, needed for documentation. Understanding medical decision making documentation requirements. Learn how to select the correct codes. Learn how to code Anesthesia, Surgery Coding, and Modifiers. Learn how to code Radiology, Pathology, Laboratory, and the Medicine Sections. Learn the HCPCS Coding and Modifiers. Insurance Claims Steps and Procedures Steps on patient registration. Learn the new patient and established patient procedures. Understanding primary and secondary insurance policies. Understanding the superbills or encounter forms for new and established patients. Learn clinical assessment and treatment. Learn the Check-In and Check-Out Procedures. Learn how to post charges and payments to accounts CMS-1500 Claim Procedures and Samples Learn how to complete the CMS-1500 claim form, and how to fill out each section on the claim. Insurance Carrier Procedures Learn about insurance claim follow up procedures and how to handle problem claims. Understanding delinquent and pending claims. Understanding and completing CMS-1500 claim form. Learn the Place of Service Codes Learn Type of Service Codes Hospital Billing Introduction to the CMS-1450 Form and the UB-92 Form and completion. Learn the Uniform Hospital Discharge Data Sets. Understanding hospital reimbursements and the APC with procedures. Learn how to develop the hospital insurance claim. Understanding Hospital Patient Registration. Capturing Charges for Services Rendered. Computer Databases. Assigning Diagnosis and Procedure Codes. The Hospital UB-92 completion guidelines. Learn how to complete each section of the UB-92 for hospital coding. Learn the Condition FL codes and how to use. Learn the Value Codes, Revenue Codes, and descriptions of each. Understand the Services Provider and related charge codes. Understanding the Accommodation and Ancillary Service Revenue Codes. Understanding the Charges, Non-covered charges, the Payer, and the Provider. Samples of UB-92 coding is provided for proficiency. Electronic Data Interchange Introduction and Terms. Claims Understanding Electronic Claims Submissions. Understanding Carrier Direct Claims Submissions. Clearing House Claim Submissions Electronic completion of the CMS-1500 insurance claim. Confidentiality and Electronic Claims Processing. Insurance and Billing Understanding Blue Cross Blue Shield. Understanding BCBS and BSBC Health Insurance Plans. Understanding Blue Card Program. Federal Employee Program, Coverage, and Enrollment. Understanding Participating and Non-Participating Providers. Learn the BCBS Fees, Adjustments, Co-payments, and type of payment methods. Understanding the Usual, Customary, and Reasonable fees. The Relative Value Scale Fees. CMS-1500 claim completion for BCBS. Medicare Procedures Understanding Medicare Understanding the sections of the card. Understanding Medicare Part A covered services. Understanding Medicare Part B services. Understanding Deductibles and co-payments for Medicare. Understanding Participating and Non Participating Providers. Advance Beneficiary Notice, and Documents. Understanding Medicare Part D Medicare Fee schedules and calculating the fees. Completing the Medicare CMS-1500 Claim Form. Understanding Medicare as a secondary payer. Medicaid Understanding Medicaid and Medicaid procedures and terminology. The Medicaid Organizations. Understanding Medicaid billing procedures and guidelines to follow. Processing Medicaid payments. Medicaid claims processing. Tricare and Champva Understanding Tricare and type of plans. Understanding Prime, Plus, Extra, Standard, and Life Benefit Programs. Eligibility and Authorizations. Understanding Participating and Non Participating. Tircare Verification. Understanding the allowed charges and deductibles. Understanding the Covered and Non Covered Services. Learn the Preauthorization Procedures. Understanding DME. Tricare Billing. Learn how to calculate and Estimate Fees. Learn the Tricare CMS-1500 Claim Form and Completing. Champva Learn Champva Procedures, verifications, authorizations, and claim preparation. Workers’ Compensation Understanding Workers’ Compensation. Federal Workers’ Compensation Programs. Eligibility and Disability. Workers’ Compensation documentation, requirements, and completing. Learn Workers' Compensation Reimbursements Learn the CMS-1500 claim form and completion for Workers' Compensation. Office simulations of a medical facility has been set up for real world computer applications and practice, with computer applications completing the CMS-1500 claims for realistic insurance billing situations. Students are exposed to a variety of insurance billing situations. Sample forms, case study simulations, procedures, step by step activities, and reinforcement activities are intended to provide students with many practical real world applications. Training for many job opportunities and skills needed for a home billing services. Opportunities are there. _____________________________________________________________________________________ Start now. Fill out the Contact form below for more information or to talk to a counselor. |