cranford

Medical Billing Course: Healthcare Billing, Coding & Revenue Cycle Management

Categories: Medical
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About Course

The Medical Billing Course is a practical, career-oriented program designed to provide learners with the knowledge and skills required to understand healthcare billing processes, medical terminology, insurance procedures, claims processing, and revenue cycle management.

The course introduces participants to the complete medical billing workflow, from patient registration and insurance verification to charge entry, claim submission, payment posting, denial management, and accounts receivable follow-up.

Through practical examples, case studies, sample claims, billing exercises, and simulated workflows, learners will develop the skills needed for entry-level opportunities in medical billing, healthcare administration, insurance processing, and revenue cycle management.

What Will You Learn?

  • Understand the complete medical billing cycle
  • Understand basic medical terminology and healthcare documentation
  • Perform basic patient registration and insurance verification
  • Understand ICD-10-CM, CPT and HCPCS coding concepts
  • Prepare and review basic medical claims
  • Understand electronic claim submission workflows
  • Read and interpret EOBs and ERAs
  • Perform basic payment posting and reconciliation
  • Identify common claim errors and denials
  • Understand denial management and appeals processes
  • Perform basic accounts receivable follow-up
  • Understand healthcare billing compliance and patient-data privacy
  • Work with basic EHR and medical billing workflow concepts
  • Develop practical skills for entry-level medical billing and revenue-cycle roles

Course Content

Introduction to Medical Billing
Fundamentals of medical billing Healthcare revenue cycle Role of a medical biller Medical billing workflow Healthcare provider and payer relationship Patient billing process

Medical Terminology
Basic medical terminology Anatomy and physiology fundamentals Common diseases and conditions Medical abbreviations Procedures and treatments Understanding clinical documentation

Patient Registration & Insurance
Patient demographic information Insurance verification Eligibility and benefits Primary and secondary insurance Insurance plans and payer types Authorization and referral concepts

Medical Coding Fundamentals
Introduction to medical coding ICD-10-CM concepts CPT concepts HCPCS Level II basics Diagnosis and procedure coding Coding guidelines and documentation requirements Understanding modifiers

Charge Entry & Claim Preparation
Charge capture Entering patient and service information Claim form basics Electronic claims Claim validation Common claim errors Claim submission workflow

Claims Processing
Understanding the claim lifecycle Clearinghouse concepts Payer adjudication Claim status Clean vs. rejected claims Correcting and resubmitting claims

Payment Posting
Explanation of Benefits (EOB) Electronic Remittance Advice (ERA) Payment posting Insurance adjustments Patient responsibility Copay, coinsurance and deductible concepts Refunds and payment reconciliation

Denial Management
Common claim denial reasons Denial identification and categorization Claim correction Appeal basics Resubmission procedures Preventing recurring denials Denial tracking and reporting

Accounts Receivable & Follow-Up
Accounts receivable management Aging reports Insurance follow-up Patient balance follow-up Outstanding claim management Collection workflow A/R performance monitoring

Compliance & Data Privacy
Healthcare billing compliance Patient confidentiality HIPAA fundamentals for U.S.-focused billing Data security and privacy Accurate documentation Fraud, waste and abuse awareness Ethical billing practices

Medical Billing Software & Technology
Introduction to billing systems Electronic health records (EHR) Practice management systems Electronic claim submission Billing workflow automation Basic reporting and dashboards

Practical Medical Billing Training
Patient registration exercises Insurance verification scenarios Coding and billing case studies Claim preparation exercises EOB and ERA analysis Payment posting practice Denial management exercises A/R follow-up scenarios Complete revenue-cycle simulation