Certified Medical Billing and Coding Specialist (CBCS)
Program Description:
The Certified Medical Billing and Coding Specialist (CBCS) Program is a 360-Clock-hour course offered in two formats: a 100% Self-Paced Online Course or an Online Hybrid Flex Course. The program is designed to prepare students to become Nationally Certified Medical Billing and Coding Specialists (CBCS). The Certified Medical Billing and Coding Specialist (CBCS) course is taught by an experienced Certified Medical Billing & Coding Specialist who provides both theoretical instruction and hands-on practical training required to be a Medical Billing and Coding Specialist. The curriculum equips students with the essential knowledge and practical skills required to succeed in the medical billing and coding field.
Upon completion of the Certified Medical Billing and Coding Specialist (CBCS) Program, students must take a national certification examination, which certifies them to work in all states across the USA. The program at MedNoc Training College prepares students to sit for and pass any of the national certification exams offered by the three major certification agencies in the USA:
- Certified Billing and Coding Specialist (CBCS): Offered by the National Healthcareer Association (NHA).
- Certified Professional Coder (CPC) and Certified Professional Biller (CPB) Dual Certifications: Offered by the American Academy of Professional Coders (AAPC).
- Certified Coding Associate (CCA): Offered by the American Health Information Management Association (AHIMA)
The Certified Medical Billing and Coding Specialist (CBCS) is a comprehensive program designed to provide students with the skills, knowledge, and certification preparation necessary for a successful career in healthcare as a Certified Medical Billing and Coding Specialist (CBCS). As a Certified Medical Billing and Coding Specialist (CBCS), you can work in various healthcare settings where medical billing, coding, and insurance claim processing are essential. With certification and experience, a Certified Medical Billing and Coding Specialist can also advance to roles such as medical coding auditor, health information manager, or revenue cycle specialist.
Certified Medical Billing and Coding Specialist (CBCS) Clock Hour Distribution:
| Course Breakdown | Total Clock Hours | |
| 1 | Classroom/didactic | 360 |
Certified Medical Billing and Coding Specialist (CBCS) Program Schedule Options:
| CBCS Program Schedule | Program Length | Class Days | Class Time |
| 100% Online Flex Course
(Self-paced) |
12 Weeks | Online | Online Flex |
| Online Hybrid Flex Course
(Self-paced) |
12 Weeks | Mondays:
6:00pm to 9:00pm Online |
Virtual Online Flex |
What are the Career Opportunities for a Certified Medical Billing and Coding Specialist (CBCS)?
- Medical Billing Specialist: Manage billing processes, submit claims, and ensure timely reimbursement.
- Medical Coding Specialist: Accurately code medical procedures and diagnoses for insurance claims and patient records.
- Billing and Coding Auditor: Review and audit billing and coding practices to ensure compliance and accuracy.
- Revenue Cycle Analyst: Analyze and optimize the financial aspects of healthcare operations.
- Insurance Claims Specialist: Handle insurance claims, denials, and appeals for healthcare providers.
What are the Common workplaces for a Certified Medical Billing and Coding Specialist (CBCS)?
- Hospitals & Healthcare Facilities
- Inpatient and outpatient departments
- Emergency rooms
- Specialty hospitals
- Long-Term Care & Nursing Facilities
- Skilled nursing facilities (SNFs)
- Assisted living centers.
- Hospice care services
- Home Care Agency
- Home health Agencies
- Hospice Agencies
- Physician Offices & Private Practices
- Family medicine clinics
- Specialty clinics (e.g., cardiology, dermatology, orthopedics)
- Outpatient Care Centers
- Ambulatory surgical centers
- Rehabilitation centers
- Urgent care clinics
- Insurance Companies & Third-Party Payers
- Health insurance providers (e.g., Blue Cross Blue Shield, Aetna, Cigna)
- Government insurance programs (Medicare, Medicaid)
- Third-party billing services
- Medical Billing & Coding Companies
- Independent billing firms
- Revenue cycle management companies
- Government & Public Health Agencies
- Veterans Affairs (VA) hospitals
- Public health clinics
- State and federal health agencies
- Educational Institutions
- Medical billing and coding training programs
- Community colleges and technical schools
- Telehealth & Remote Work Opportunities
- Work-from-home positions with healthcare organizations.
- Freelance or contract medical billing and coding.
- Legal & Consulting Services
- Medical coding compliance audits
- Healthcare fraud investigation
- Medical documentation review
Does the MedNoc Certified Medical Billing and Coding Specialist (CBCS) Curriculum Fully Cover the NHA, AAPC and CCA National Certification Exams?
✅ Yes! The program includes all core topics required for the CBCS (NHA), CPC (AAPC), and CCA (AHIMA) certifications. However, students may need additional practice and preparation based on the specific exam format they choose.
- For CBCS (NHA) – The program aligns closely with billing and reimbursement, making it a strong preparation course.
- For CPC & CPB (AAPC) – Students may need additional practice with real-world medical coding scenarios and physician-based coding guidelines.
- For CCA (AHIMA) – Students should focus on inpatient coding (ICD-10-PCS) and health information management concepts to excel in this exam.
What are the key areas tested by CBCS (NHA), CPC (AAPC) and CCA (AHIMA):
- Certified Billing and Coding Specialist (CBCS) – Offered by the National Healthcareer Association (NHA): Best suited for individuals interested in medical billing and insurance claim processing in hospitals, clinics, and insurance companies.
- Domain 1 – The Revenue Cycle and Regulatory Compliance: Emphasizes HIPAA compliance, coding accuracy, and healthcare regulations.
- Domain 2 – Insurance Eligibility and Other Payer Requirements: Focuses on medical billing and reimbursement processes, including insurance claims, payment processing, and claim denials.
- Domain 3 – Coding and Coding Guidelines Covers ICD-10-CM, ICD-10-PCS, CPT, HCPCS coding relevant to claim submission.
- Domain 4 – Billing and Reimbursement: Covers claims submission processes.
- Certified Professional Coder (CPC) and Certified Professional Biller (CPB) Dual certifications – Offered by the American Academy of Professional Coders (AAPC). Primarily focused on outpatient (physician-based) coding.
- In-depth coverage of ICD-10-CM, CPT, and HCPCS Level II coding systems.
- Includes Evaluation & Management (E/M) coding, surgical procedures, and specialty coding (e.g., radiology, pathology, anesthesia).
- Prepares students for coding roles in physician offices, outpatient clinics, ambulatory surgical centers, and specialty practices.
- Certified Coding Associate (CCA) – Offered by the American Health Information Management Association (AHIMA): Prepares students for entry-level positions in hospitals, outpatient centers, and health information departments. Focuses on ICD-10-CM, ICD-10-PCS (inpatient procedure coding), CPT, and HCPCS Level II coding. Includes health information management (HIM) principles, compliance, and medical record documentation.
- Domain 1 – Clinical Classification Systems Covers both inpatient and outpatient medical coding, making it more comprehensive.
- Domain 2 – Reimbursement Methodologies
- Domain 3 – Health Records and Data Content
- Domain 4 – Compliance
- Focuses on ICD-10-CM, ICD-10-PCS (inpatient procedure coding), CPT, and HCPCS Level II coding.
- Includes health information management (HIM) principles, compliance, and medical record documentation.
Admission Requirements:
- Fill out an Application either online or in person.
- Complete the Enrollment Agreement in person or electronically.
- Minimum age: 18 Years.
- High School Diploma, GED, or another Equivalency, or higher.
- Current Government-issued Photo ID: e.g., driver’s license, passport, military card, green card, work authorization card, or tribal card.
- Social Security Card or replacement letter from the Social Security Administration’s office.
Certified Medical Billing and Coding Specialist Course Objectives:
- Medical Terminology and Anatomy: Develop a strong foundation in medical terminology, human anatomy, and physiology to ensure accurate coding and billing practices.
- Medical Coding Systems: Master the use of ICD-10, CPT, and HCPCS coding systems for various medical procedures, diagnoses, and services.
- Medical Billing Processes: Learn the intricacies of the medical billing process, including claim submission, reimbursement procedures, and appeals.
- Healthcare Laws and Ethics: Understand the legal and ethical considerations in medical billing and coding, including HIPAA compliance and patient confidentiality.
- Electronic Health Records (EHR): Gain proficiency in managing electronic health records, HIPAA laws ensuring accurate and up-to-date patient information.
- Insurance Procedures: Explore different types of insurance plans, policies, and procedures for handling private, government, and third-party payer claims.
- Problem-Solving and Analysis: Develop critical thinking and analytical skills to efficiently identify and resolve billing and coding issues.
- Software Proficiency: Become proficient in using industry-standard medical billing and coding software. Practice using software tools for claim submission, payment posting, and reporting.
- Professional Development: Understand the role and responsibilities of a medical billing and coding specialist within the healthcare team. Learn effective communication skills for interacting with healthcare providers, insurance companies, and patients.
Certified Medical Billing and Coding Specialist Curriculum
The Certified Medical Billing and Coding Specialist (CBCS) Curriculum for MedNoc Training College covers a wide range of essential topics to ensure competency in medical billing, coding, and healthcare reimbursement. Below are the key areas typically included in our curriculum:
- Medical Billing and Healthcare Reimbursement
- Health Insurance Basics (Medicare, Medicaid, private insurance, TRICARE, etc.)
- Claim Submission and Processing
- Electronic Health Records (EHR) and Paper Billing
- Reimbursement Methods and Payment Models
- Denial Management and Appeals
- Coordination of Benefits (COB) and Third-Party Payers
- Medical Coding Systems
- International Classification of Diseases (ICD-10-CM– Diagnosis Coding
- Current Procedural Terminology (CPT) – Procedure and Service Coding
- Healthcare Common Procedure Coding System (HCPCS Level II) – Supplies, Services, and Equipment
- Modifiers in Medical Coding
- Medical Coding Guidelines and Updates
- Medical Terminology and Anatomy
- Fundamental Medical Terminology
- Body Systems and Functions
- Common Medical Conditions and Diagnoses
- Anatomy and Physiology for Coding Accuracy
- Health Information Management (HIM)
- Medical Record Documentation Requirements
- Compliance with Health Information Policies
- Use of Electronic Health Records (EHR) and Practice Management Software
- Healthcare Laws and Compliance
- Health Insurance Portability and Accountability Act (HIPAA)
- Fraud, Waste, and Abuse Prevention (False Claims Act, Anti-Kickback Statute, Stark Law)
- Office of Inspector General (OIG) Compliance
- Medical Necessity and Audit Compliance
- Ethical and Legal Considerations in Billing & Coding
- Revenue Cycle Management
- Patient Registration and Insurance Verification
- Charge Entry and Coding Compliance
- Claim Submission and Adjudication
- Accounts Receivable and Collections
- Explanation of Benefits (EOB) and Remittance Advice
- Procedural and Diagnostic Coding Accuracy
- Coding for Physician Services vs. Hospital Services
- Specialty Coding (Radiology, Surgery, Pathology, Anesthesia, etc.)
- Evaluation and Management (E/M) Coding
- Medical Necessity and Coding to the Highest Specificity
- Medical Billing Software and Technologies
- Practice Management Software (PMS) and Electronic Health Records (EHR)
- Billing and Coding Software Applications
- Clearinghouses and Claim Processing Systems
- Ethical & Professional Standards
- Confidentiality and Patient Privacy in Billing & Coding
- Professional Conduct in the Healthcare Industry
- Effective Communication with Patients and Providers
- Exam Preparation & Certification Readiness
- Practice Exams and Test-Taking Strategies
- Case Study Reviews and Real-World Application
- Mock Billing & Coding Scenarios
- Understanding the NHA CBCS Exam Format
Certified Medical Billing and Coding Specialist Topics Outline
| CERTIFIED MEDICAL BILLING AND CODING SPECIALIST TOPICS OUTLINE | |
|
Medical Coding |
1. Reimbursement, HIPAA, and Compliance
2. An Overview of ICD-10-CM 3. ICD-10-CM Outpatient Coding and Reporting Guidelines 4. Using ICD-10-CM 5. Chapter-Specific Guidelines (ICD-10-CM Chapters 1-10) 6. Chapter-Specific Guidelines (ICD-10-CM Chapters 11-14) 7. Chapter-Specific Guidelines (ICD-10-CM Chapters 15-21) 8. Introduction to CPT 9. Introduction to the Level II National Codes (HCPCS) 10. Modifiers 11. Evaluation and Management (E/M) Services 12. Anesthesia 13. Surgery Guidelines and General Surgery 14. Integumentary System 15. Musculoskeletal System 16. Respiratory System 17. Cardiovascular System 18. Hemic, Lymphatic, Mediastinum, and Diaphragm 19. Digestive System 20. Urinary and Male Genital Systems 21. Reproductive, Intersex Surgery, Female Genital System, Maternity Care and Delivery 22. Endocrine and Nervous Systems 23. Eye, Ocular Adnexa, Auditory, and Operating Microscope 24. Radiology 25. Pathology/Laboratory 26. Medicine 27. Inpatient Coding |
| Medical Billing
|
|
| CERTIFICATION EXAMINATION PREPARATION | |
| Certification Exam Preparation | 1. The Revenue Cycle and Regulatory Compliance
2. Insurance Eligibility and Other Payer Requirements 3. Coding and Coding Guidelines 4. Billing and Reimbursement |
National Certification Examination for Billing and Coding Specialist
The Certified Medical Billing and Coding Specialist training program at MedNoc Training College prepares students to sit for various Billing and Coding certification examinations, including:
- Certified Billing and Coding Specialist (CBCS) – Offered by the National Healthcareer Association (NHA)
- Certified Professional Coder (CPC) and Certified Professional Biller (CPB) – Offered by the American Academy of Professional Coders (AAPC)
- Certified Coding Associate (CCA) – Offered by the American Health Information Management Association (AHIMA)
While students are prepared for all these certifications, MedNoc Training College prefers the NHA’s CBCS certification and has partnered with NHA to offer the Certified Medical Billing and Coding Specialist (CBCS) exam at the MedNoc Test Site.
NHA CBCS Exam Eligibility
- Must be 1 years of age.
- Possess a high school diploma or GED/high school equivalency.
- Completed a medical billing and coding training or education program within the last 5 years.
- Possess a high school diploma or GED/high school equivalency; or are scheduled to earn a high school diploma or GED/high school equivalency in the next 12 months.
- 1 year of supervised work experience in a medical billing and coding field within the last 3 years; or 2 years of supervised work experience in a medical billing and coding field within the last 5 years.
NHA Certified Medical Billing and Coding Specialist National Certification Exam Details:
- 100 Scored Questions, 25 Pretest Questions.
- Exam time: 3 hours.
- Pass: 390 out of 500 is a passing score in a scaled scoring system.
Certified Medical Billing & Coding Specialist (CBCS) Program Tuition and Fees:
| ITEM | Online Hybrid Flex Course | 100% Online Self-paced Course | |
| 1. | Tuition | $ 1,800.00 | $ 1,250.00 |
| 2. | National Certification Exam | $ 200.00 | $ 200.00 |
| 3. | Total Cost | $ 2,350.00 | $ 1,450.00 |
NOTE: Other additional costs may include but are not limited to the textbooks. Students can purchase textbooks from MedNoc or at the place of their choice. The cost of the new textbook may be around $350.00.