Certified Professional in Health Insurance Billing and Coding

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The Certified Professional in Health Insurance Billing and Coding (CPHIB&C) certificate course is a vital step for healthcare professionals seeking to enhance their expertise in the revenue cycle management process. This course covers critical topics such as medical terminology, anatomy, physiology, diagnosis coding, procedure coding, and insurance billing.

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About this course

With the ever-evolving healthcare industry, the demand for certified professionals has significantly increased, making this course essential for career advancement. By equipping learners with in-depth knowledge and practical skills, the CPHIB&C course enables them to navigate the complex world of healthcare reimbursement accurately and efficiently. Moreover, this certification demonstrates a commitment to professional growth and a dedication to maintaining the highest standards of industry practices. As a result, CPHIB&C certified professionals are highly sought after by healthcare employers, offering improved job security, higher salaries, and better career growth opportunities.

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Course details

Health Insurance Billing and Coding Fundamentals: Understanding health insurance billing and coding basics, including the importance of accurate coding, medical billing process, and common terminology. • Anatomy, Physiology, and Medical Terminology: Learning human anatomy, physiology, and medical terminology relevant to health insurance billing and coding. • ICD-10-CM Coding System: Mastering the ICD-10-CM coding system, including code structure, diagnosis coding guidelines, and code selection criteria. • CPT Coding System: Familiarization with the CPT coding system, including procedure coding guidelines, modifiers, and code updates. • HIPAA Compliance and Privacy Rules: Understanding HIPAA regulations, especially privacy rules, and their impact on health insurance billing and coding. • Medicare and Medicaid Billing and Coding: Exploring Medicare and Medicaid-specific billing and coding requirements, including National Correct Coding Initiative (NCCI) edits and Risk Adjustment Factor (RAF) scoring. • Health Insurance Claims Processing: Learning about claim submission, processing, and appeal procedures, as well as claim rejections and denials. • Auditing and Compliance: Gaining knowledge of internal and external auditing processes, compliance programs, and risk management strategies for health insurance billing and coding.

Career path

The Certified Professional in Health Insurance Billing and Coding (CPHIBC) role is an essential part of the healthcare system in the UK. CPHIBC professionals are responsible for processing medical claims and ensuring accurate billing and coding. As healthcare facilities increasingly rely on data-driven decision-making and electronic health records, the demand for CPHIBC professionals continues to grow. This 3D pie chart showcases the significance of this role by presenting relevant statistics, such as job market trends, salary ranges, and skill demand. The CPHIBC job market is booming, with a 25% share in the healthcare industry. These professionals can expect a lucrative career, with an average salary range of £25,000 to £40,000, representing 30% of the chart. The primary reason for this high demand is the continuous growth in healthcare data, which results in a constant need for skilled coding and billing specialists, making up 45% of the industry. In summary, the CPHIBC role is crucial in maintaining a functional and efficient healthcare system. With a growing job market, attractive salary ranges, and high skill demand, pursuing a career as a Certified Professional in Health Insurance Billing and Coding can lead to a fulfilling and profitable career in the UK's healthcare sector.

Entry requirements

  • Basic understanding of the subject matter
  • Proficiency in English language
  • Computer and internet access
  • Basic computer skills
  • Dedication to complete the course

No prior formal qualifications required. Course designed for accessibility.

Course status

This course provides practical knowledge and skills for professional development. It is:

  • Not accredited by a recognized body
  • Not regulated by an authorized institution
  • Complementary to formal qualifications

You'll receive a certificate of completion upon successfully finishing the course.

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Sample Certificate Background
CERTIFIED PROFESSIONAL IN HEALTH INSURANCE BILLING AND CODING
is awarded to
Learner Name
who has completed a programme at
London School of Planning and Management (LSPM)
Awarded on
05 May 2025
Blockchain Id: s-1-a-2-m-3-p-4-l-5-e
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