Professional Certificate in Medical Claim Processing Mastery
-- ViewingNowThe Professional Certificate in Medical Claim Processing Mastery is a comprehensive course designed to equip learners with the essential skills needed to excel in the healthcare industry. This program focuses on the critical aspects of medical claim processing, an area of high demand with increasing complexities due to regulatory requirements and technological advancements.
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โข Medical Billing Basics: Understanding coding systems (ICD, CPT, HCPCS), medical terminology, and insurance policies.
โข Medical Claim Processing: Learning the steps involved in claim processing, including claim preparation, submission, and follow-up.
โข Claims Management: Managing denied, rejected, and pended claims, and understanding the appeal process.
โข Electronic Data Interchange (EDI): Learning about EDI standards, including X12 and NCPDP, and how to use them for claim submission and remittance.
โข Compliance and Regulations: Understanding HIPAA, False Claims Act, and other regulations related to medical billing and coding.
โข Billing Software: Learning how to use medical billing software for claim processing, payment posting, and reporting.
โข Patient Financial Services: Managing patient accounts, including payment posting, balance billing, and collections.
โข Revenue Cycle Management (RCM): Understanding the RCM process, including charge entry, claim submission, payment posting, and reporting.
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