Medical Coding and Reimbursement Specialist Certificate

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75 Credits

This certificate provides students an opportunity to develop ICD, CPT and HCPCS Level II coding skills to prepare them to become entry-level coders and reimbursement specialists. A coder is a health information specialist who is equally at home with computerized and medical reference books and patient records. Students who complete this certificate may find employment in professional billing and coding facilities, including physician practices, emergency rooms, ambulatory facilities, hospitals and skilled nursing facilities, insurance companies and government agencies.

Course content includes studies in clinical coding and classification systems, life sciences, reimbursement methodologies, health information and delivery systems, legal and compliance rules with an emphasis on HIPAA. Students obtain either field-based or virtual professional practice experience. Students learn basic computer, math and communication skills.

Upon completion of the program, students will be eligible to sit for formal exams offered through national organizations in order to obtain medical coding certification.

These classes may be applied toward the two-year Associate in Applied Arts Degree. Students in this program must complete each class with a grade of 2.0 or higher.

Contacts: Shannon Sharpe, ext. 4378, ssharpe@greenriver.edu, Lea Ann Simpson, ext. 4393, lsimpson@greenriver.edu

Program Website:

Medical Office Administration | https://www.greenriver.edu/students/academics/degrees-programs/medical-office-administration/

Program Outcomes

Students who successfully complete this certificate program will be able to:

Identify the different types of healthcare providers, disciplines, common departments and general structure found within healthcare organizations.
Analyze and verify medical record and documentation accuracy and validity.
Identify and define medical disease, diagnosis, procedural terms and abbreviations.
Abstract diagnostic and procedural terminology to accurately assign ICD-10-CM, CPT-4 and HCPCS level II codes.
Utilize a computerized encoder to determine procedure values based on RBRVS (resource based relative value scale), coding guidelines based on LCD (local coverage determination), NCD (national coverage determination) and CCI (correct coding initiative) edits.
Define key legal concepts related to healthcare including the impact of ethics, morals, fraud and abuse in a healthcare setting.
Apply legal principles, policies, regulations, and standards for the control and use of health information.
Perform mathematical calculations needed to process a claim, determine allowed amounts, deductibles and co-payments, process cash, check and electronic payments, and balance monthly and yearly financial records.
Complete all general medical practice management software tasks such as registering and scheduling patients, searching and reviewing medical records online, entering codes, payment and other electronic health record (EHR) tasks.