Program: Medical Billing & Coding Specialist

Program Curriculam

Prefix     Number     Title  

MAA         101       Medical Office Administration 

MAA         102       Medical Coding  & Its Application

MAA         103       Medical Billing & Its Application

MAA         104       Electronic Health Records Basics

Program Description

Medical Billing and Coding Specialist Program provides students with the skills necessary to function as Physician-Based Coders, Hospital Coders, or Medical Claims Reviewers. Today, there is a demand for coding specialists for accurately coding data from the medical record in all types of health care institutions. Coded data is used on claims for reimbursement, patient care management, and healthcare evaluation and research. Upon successful completion of this course, students will receive a certificate of completion and may be eligible for National Certification through the American Education Certification Association (AECA)

National Certifications Exams Offered:

  1. AECA Certified Medical Billing And Coding Professional.
  2. AECA Certified Coding Professional (Physician – Hospital)
  3. AECA Certified Medical Software / Insurance / Pre-authorization Specialist

Program Goals

The goals of the Medical Billing and Coding Specialist program are to

  1. Understand medical terminology and anatomy/physiology and can apply it to coding physician-documented patients’ records in an inpatient or outpatient setting.
  2. Understand the coding assignment guidelines: ICD, CPT and HCPCS and have the skills to code diseases and procedures from patients’ records.
  3. Have an understanding of the relationship between coding and reimbursement; be knowledgeable about insurance terminology, various insurance carrier requirements and complete an insurance form.
  4. Understand the Health Insurance Portability and Accountability Act (HIPAA) and how it applies to coding and billing release of information.
  5. Can demonstrate proficiency in preparing an electronic medical record, billing services, posting payments, generating appointments, and medical/financial reports using medical software.
  6. Provide a base of theory and practice that is appropriate to develop entry level skills as a Medical Billing and Coding Specialist.
    • Demonstrate knowledge of health care delivery system
    • Provide a program with ongoing review so that approval guidelines are maintained.
  7. Graduates will possess cognitive skills needed to function as a Medical Billing and Coding Specialist.
    • The student will demonstrate competence of Medical Billing and Coding Specialist in a billing and coding setting.
    • The student will utilize and apply theoretical knowledge of anatomy and physiology, medical terminology, and other relevant Medical Billing and Coding techniques in preparing and submitting a healthcare claim.
  8. Graduates will possess psychomotor skills needed to function as a Medical Billing and Coding Specialist.
    • The student will apply the principles of billing and coding in a knowledgeable manner providing for processing a claim.
    • The student will apply the responsibility of maintaining a patient records as per HIPAA compliance.
    • The student will demonstrate the ability to perform the Medical Billing and Coding Specialist procedure in a timely and efficient manner.
  9. Graduates will exhibit behaviors consistent with the attitudes expected of a health are professional. Support the profession by preparing graduates who are competent in performing medical billing and coding duties, and as members of the health care team.
    • The student will demonstrate responsible behavior as a health care professional.
    • The student will demonstrate commitment to professional growth, continuous learning, and self development.
    • The student will demonstrate effective written, verbal, and nonverbal communication techniques.
    • The student will work in collaboration with the interdisciplinary team members as a Medical Billing and Coding Specialist.
  10. Prepare graduates to successfully complete a national certification exam.
    Communicate (verbally and nonverbally) effectively and appropriately in the workplace.
  11. Demonstrate support of the school mission and goals.

Program Mission Statement

The mission of the program is to provide a learning experiences that prepare students to demonstrate the skills and behaviors congruent with those of professional biller and coders. Upon graduation students will be considered competent for entry level positions as a Medical Biller, Medical Coder or Medical Biller and Coder.

Program Philosophy

The Faculty of Americation Career and Training School believes that: Healthcare is constantly changing, and the need for competent, proficient, and professional healthcare workers is growing. The medical billing and coding specialist has an important role in collecting information to code the condition and treatment followed by billing the insurance company for re-imbursement to the healthcare facility. A graduate of this program can get employed at the following: in doctor's offices, billing companies, insurance companies, outpatient centers and ambulatory clinics. The educational environment of the Medical Billing And Coding Specialist Program at ACTS considers individual differences which affect learning ability, and provides motivation to continue to learn and adapt to the changes in a healthcare setting. The ACTS faculty believes an individual’s ability to learn is based on past experiences and personal potential, which permits learning to occur at different rates and levels. Learning takes place most readily when material is covered in a logical sequence and progresses in difficulty from simple to complex. Under the guidance of the faculty, the student should assume responsibility for much of their own learning. The ACTS faculty believes that Medical Billing And Coding education should reflect the student’s development of skills and theoretical knowledge essential for coding and accurately billing the insurance company for re-imbursements. As part of the Medical Billing Coding team, the Medical Billing And Coding Specialist must be able to work independently, with great attention to detail, and professionalism. As a member of the Medical Billing And Coding team, the Medical Billing And Coding Specialist may perform technical and or clerical functions. The Medical Billing And Coding Specialist is a vital member of the Medical Billing & Coding team whose main function is to code and bill for insurance claims for re-imbursements to the appropriate healthcare facility and doctors.