Global Certificate in Medical Claim Industry Best Practices
-- viewing nowThe Global Certificate in Medical Claim Industry Best Practices course is a comprehensive program designed to provide learners with the essential skills needed to excel in the medical claim industry. This course focuses on industry best practices, ensuring that learners are equipped with the most up-to-date and effective methods for managing medical claims.
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Course Details
• Medical Coding Basics: Understanding ICD, CPT, and HCPCS codes, code sets, code selection, and sequencing.
• Medical Billing Foundations: Generating accurate claims, claim submission, remittance advice, and handling claim rejections.
• Regulatory Compliance: Adhering to HIPAA, False Claims Act, Stark Law, Anti-Kickback Statute, and other regulations.
• Medicare and Medicaid Best Practices: Understanding program-specific requirements, coverage rules, and documentation guidelines.
• Third-Party Payer Practices: Dealing with commercial insurance, worker's compensation, and auto insurance claims and requirements.
• Revenue Cycle Management: Managing claim denials, underpayments, and appeals, as well as improving cash flow and reducing days in A/R.
• Medical Auditing and Compliance: Identifying and addressing potential compliance risks, internal auditing, and external audits.
• Healthcare Data Analytics: Leveraging data analysis for improved decision-making, identifying trends, and enhancing financial performance.
• Patient Financial Responsibility: Managing patient estimates, patient collections, and financial assistance programs.
Career Path
Entry Requirements
- Basic understanding of the subject matter
- Proficiency in English language
- Computer and internet access
- Basic computer skills
- Dedication to complete the course
No prior formal qualifications required. Course designed for accessibility.
Course Status
This course provides practical knowledge and skills for professional development. It is:
- Not accredited by a recognized body
- Not regulated by an authorized institution
- Complementary to formal qualifications
You'll receive a certificate of completion upon successfully finishing the course.
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