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Medical Billing certificate course curriculum

The Medical Billing certificate course curriculum is developed by knowledgeable instructors with years of experience in their field. You'll gain real-world, high-demand skills to succeed in a variety of healthcare settings including hospitals, clinics, and physician offices.

Orientation: Ashworth College Career Program

Learning at Ashworth  

The goals and values of Ashworth College; time management; creating a realistic weekly and monthly study schedule; the nature and purpose of assessments; how to study effectively to prepare for and take an online examination; developing the skill sets necessary for success in the twenty-first century.

Lesson Group 1: Understanding Managed Care

Introduction to Professional Billing and Coding Careers 

An introduction to the different types of facilities that employ allied health personnel; job descriptions pertaining to billing and coding careers; options available for certification.

Insurance Plans 

The history and impact of managed care; the organization of managed care and its effect on the provider, employee, and policyholder; patient financial responsibility; types of managed care plans and insurance coverage.

Medical Contracts, Ethics, and HIPAA 

Key elements of managed care contracts; covered services for patients, including preventive medical services and office visits; protected health information; patient information disclosure; HIPAA security standards and regulations compliance; HITECH and EHRs.

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Program Description

Students learn the fundamentals of the medical billing and coding field. Program topics include insurance plans; medical ethics; HIPAA; ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding; coding compliance and auditing; physician and hospital billing; Medicare, Medicaid, and TRICARE; EOBs, refunds, and appeals; and workers’ compensation.

Program Objectives

After completing the Medical Billing program, students will be able to:

  1. Outline the typical responsibilities of a medical biller/coder, describe the personal and professional ethics required for success in this profession, and describe the career opportunities available to appropriately trained personnel.
  2. Describe the purpose and impact of the Health Insurance Portability and Accountability Act (HIPAA) and explain how medical professionals can learn about changes to the laws and regulations that affect them.
  3. Compare and contrast the major types of government and commercial insurance health plans, including Medicare, Medicaid, Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Point-of-Service (POS) plans.
  4. Describe the typical billing guidelines for inpatient medical, inpatient/outpatient global surgery, medical/surgical, and minor surgical procedures.
  5. Summarize the life cycle of a typical insurance claim and explain the processing steps that must be completed before claims and other forms can be submitted to the insurance company.
  6. Explain the purpose of medical coding and accurately code diagnoses and procedures using industry-standard coding systems published by the World Health Organization (WHO) and the American Medical Association (AMA).

Insuring job path preparedness

You'll gain job skills from every lesson in the Medical Billing Career Certificate course and prep for your job search at the same time. The online tools available through the Ashworth EDGE are integrated into your studies so you'll be ready to deliver a polished presentation of your qualifications to potential employers as soon as you graduate. You'll also be able to revisit the Ashworth EDGE whenever you need to after you've earned your certificate. Learn more about it at the Ashworth College Career Services page.

Ready to get started?

Advance your career in our online API Program Name program. Call 1-800-957-5412