Medical Billing & Coding Specialist Certification

PURPOSE
This credential documents the essential skills for a medical coder working in various health settings.

AUDIENCE
This credential is appropriate for anyone wanting to demonstrate proficiency in the billing and coding process.

JOB/CAREER REQUIREMENTS
The successful medical coder will demonstrate proficiency with coding manuals and have the ability to extract coding information from medical documentation. The medical coder also needs thorough knowledge of anatomy and physiology and medical terminology. Credentials in Medical Billing & Coding demonstrate competencies including reading medical charts, coding diagnoses using ICD-10-CM, coding medical procedures using CPT, and having familiarity with HCPCS Level II and ICD-10-PCS coding requirements. A general understanding of medical insurance and the medical billing process is also required. Basic knowledge of anatomy and physiology and medical terminology are important to this field.  

MEDICAL BILLING & CODING WORKPLACE TASKS

• Professional written and verbal communication with patients, medical personnel, 3rd party payers, and vendors and suppliers 
• Handling of medical records with attention to HIPAA privacy requirements  
• Identify, compile, abstract, and code patient data, using standard classification systems  
• Resolve or clarify codes or diagnoses with conflicting, missing, or unclear information by consulting with doctors or others or by participating in the coding team's regular meetings  
• Complete standard billing forms and resolve issues with 3rd party payers

EXAM STRUCTURE OVERVIEW
Number of Questions in Exam: 65
Total Time: 90 minutes
Overall Passing Score: 70%
(All sections require an individual passing score of 70%)