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Medical Billing & Processing Fundamentals

Build real-world medical billing and processing related job skills when you learn how to prepare medical claims, maximize medical expense reimbursement and troubleshoot denials. This course also teaches you how to verify insurance coverage, physician contract status and manage patient accounts related to referrals and authorizations.

Skills you'll learn:

  • Accurately identify reimbursable services and treatments

  • Identify payer policies and the party responsible for payment

  • Appeal medical claim denials

  • Prepare medical claim forms and process electronic transactions

Key topics:

  • Healthcare practice front-office duties

  • Establishing financial responsibility

  • Medical billing claim analysis


What's included:

  • Self-paced, 100% online
  • 4 job-ready skills
  • No books or materials needed
  • Finish in approx. 30 hrs
  • Access for 1 year
  • Certificate of completion
  • 7-day satisfaction guarantee
Buy now

California: Professional Development Skills Pathways are not available to California residents.

Reasons to buy for business:

  • Employees can get registered and start learning today
  • Track employee progress
  • Helps prepare for CBCS exam

Certified Billing and Coding Specialist exam prep

This course can be purchased individually or as part of the Medical Billing and Coding Track that can help you prepare for the Certified Billing and Coding Specialist exam.

Course outline

  • Course Overview
    • Getting Started
    • Welcome to Medical Billing and Processing
  • Module 1: Interpretation of Benefits Coverage
    • Introduction to Benefits Coverage
    • Exploring Benefits Coverage Interpretation
    • Common Insurance Plans, Government Sponsored Insurance, Private Payers, and Other Insurance Programs
    • Benefits Coverage Key Concepts
    • Benefits Coverage Comprehension Check
    • Foundational Medical Billing and Coding Terms
    • Interpretation of Medical Benefits Skills Assessment
    • Benefits Coverage Resources
  • Module 2: Understanding the Medical Language
    • Introduction to Medical Terminology
    • Basic Anatomy and Physiology Terms
    • Medical Terminology for the Respiratory, Cardiovascular, and Nervous Systems
    • Foundational Medical Billing and Coding Terms
    • Medical Terminology Comprehension Check
    • Real-World Medical Billing and Coding Practice
  • Module 3: Establishing Financial Responsibility
    • Introduction to the Medical Revenue Cycle
    • Assigning Medical Codes and ICD Basics
    • Insurance Cards, Patient Benefits, and Collecting and Posting Payments
    • Important Financial Responsibility Terms
    • Financial Responsibility Comprehension Check
    • Real-World Medical Billing and Coding Practice
    • Establishing Financial Responsibility Skills Assessment
    • Establishing Financial Responsibility Resources
  • Module 4: Medical Back Office
    • Introduction to Front-End Duties and Patient Account Management
    • Patient Cost Shares and HIPAA Basics
    • Patient Account Management, Registration, Check-In, and Check-Out Processes
    • Medical Back Office Terms and Concepts
    • Medical Back Office Comprehension Check
    • Medical Back Office Skills Assessment
  • Module 5: Claims and Collection Management
    • Introduction to Claims and Collection Management
    • Medical Claims and Appeals Processes
    • Outpatient/Inpatient Claims Processes, Claim Adjudication and Follow-Up, and the Patient Collection Process
    • Claims and Collection Management Terms
    • Claims and Collection Management Comprehension Check
    • Real-World Medical Billing and Coding Practice
    • Claims and Collection Management Skills Assessment
    • Claims and Collection Management Resources
  • Conclusion
    • Conclusion

Tools and resources you can access after purchasing:

  • Abbreviation/Acronym Cheat Sheet

    A PDF that includes a handy list of common abbreviations and acronyms used in medical billing and coding.

  • Dos and Don’ts of Medical Billing and Coding

    A PDF that includes some helpful tips about what to do and what not to do in relation to medical billing and coding.

  • Medical Billing and Coding Tip Sheet

    A PDF that includes quick steps for ICD-10 and CPT coding, as well as a list of some commonly used codes.

Showcase your achievement

Share your Certificate of Completion and Professional Development Badge by uploading them to your social media profiles, such as LinkedIn®¹ , when you’ve successfully completed your course with a score of 85% or higher.

¹ LinkedIn is a registered trademark of LinkedIn Corporation and its affiliates in the United States and/or other countries.

Sample certificate and badge for Medical Billing and Processing Fundamentals ourse

Frequently asked questions

The Medical Billing & Processing Fundamentals Skills Pathway could be the right Skills Pathway for you if you have an interest in learning how to interpret benefits coverage. This Skills Pathway could possibly help you grow your career in the non-clinical healthcare field.

Purchasing the Medical Billing & Processing Fundamentals Skills Pathway is a great first step in growing your medical coding and claims analysis skills. You should purchase this Skills Pathway if you're interested in learning how to appropriately assign medical codes.

Everyone is welcome to take our Medical Billing & Processing Fundamentals professional development Skills Pathway. No application is necessary.

All skills and levels are welcome to take our Medical Billing & Processing Fundamentals professional development non-credit Skills Pathway. There are no prerequisites for this Skills Pathway.

This Skills Pathway helps prepare you to test for Certified Billing & Coding Specialist, (CBCS). This Skills Pathway is not endorsed by the National Heathcareer Association.

Our Medical Billing & Processing Fundamentals Skills Pathway has five modules comprised of subjects like “EMR structure and function.” Each module has a knowledge check and brief assessment to validate your skills. You can expect the Skills Pathway to take about 30 hours, and all Skills Pathways are 100% online and self-paced.

A Skills Pathway is a series of skills that can be learned over a period of time.

Prebuilt Pathway: A series of two or more existing skill modules that’s ready to launch today.

  • Training Pathway: A series of two or more one-hour skill modules that does not prepare employees for a certification exam or help them earn recertification credits.
  • Certification Pathway: Completing this Prebuilt Pathway can help employees prepare for a third-party certification exam.
  • Recertification Pathway: Completing this Prebuilt Pathway can help employees earn recertification credits for a specific agency such as SHRM® and HRCI®.

Tailored Skills Pathway: Select multiple existing skill modules to create this Pathway. Skill modules and assessments can be modified slightly to accommodate the needs of your business.

Custom Skills Pathway: Our team will build completely new skill modules and assessments for your business and workforce.