Certified Medical Billing Representative

overhead shot of computer and stethoscope with blue box underneath with text “certified medical billing”

overhead shot of computer and stethoscope with blue box underneath with text “certified medical billing”

About the Program

The Certified Professional Biller (CPB™) AAPC credential prepares medical billers with skills to maintain all aspects of the revenue cycle. Through rigorous examination and experience, CPBs have proven knowledge of how to submit claims compliant with government regulations and private payer policies. They follow-up on claim statuses, resolve claim denials, submit appeals, post payments and adjustments, and manage collections. The CPB medical billing credential is vital to the financial success of the professional healthcare services claims process. 

This training provides the most up-to-date information relating to the health insurance industry and different reimbursement methodologies for correct claim submission. Successful completion of training prepares you to sit for the certified professional biller (CPB) exam and work in a medical billing department at a physician’s office, clinic, facility, other healthcare entity, or as a claims examiner for insurance carriers. Becoming a medical biller is just one of many jobs within the medical administration field and is a great step into the medical administration career pathway. Many open positions are remote work, work from home with high flexibility as many hospitals operate 24/7. The Bureau of Labor Statistics estimates demand for medical billing and coding specialists to rise by 11% from 2018 to 2028. The average certified medical biller earns over $61,000 annually.  

Certified professional Billers will be able to demonstrate: 

• An understanding of various types of insurance plans 

• Expertise in applying payer policy, Local Coverage Determinations (LCDs), and National Coverage Determinations (NCDs) for successful claim submissions 

• Knowledge of CPT®, ICD-10-CM, and HCPCS Level II coding guidelines  

• Successful navigation of healthcare industry rules and regulations, including HIPAA, False Claims Act, Fair Debt Collections Act, and Stark Law. 

• An understanding of the life cycle of a medical billing claim and how to improve the revenue cycle 

• Expertise in effective claim follow-up, patient follow-up, and denial resolution. 

Potential Careers for Graduates

  • Medical Biller

  • Medical Coder

  • Claims Analyst Biller – Patient Financial Services

  • Medical Biller/Collector 

PREREQUISITES  

Individuals enrolling in this course must have functional vision and if users of magnification software use no larger than 4x magnification.

• 75% comprehension when reading technical materials at 120 wpm  

• Fill out forms with a keyboarding speed of at least 30 wpm  

• Excellent skill using a web browser  

• Excellent skill with Microsoft Word, Excel and Outlook  

• Ability to read and write at or above a 10th-grade level  

• Ability to compose a professional email  

Workforce Development Services

Workforce Development Services are offered at WSB to provide individuals with visual impairments with the tools needed to enhance and sustain their employability. Through our prevocational and vocational training programs, we provide the education and skills training to jobseekers that employers are looking to hire long term. By producing qualified workers, it helps the individual become more marketable and benefits the employer by reducing their cost of on-the-job training and improving turnover rates for their company. WSB’s focus is to provide services of employment assistance for jobseekers with visual impairments which will assist them in getting competitive integrated employment. Through job preparation and job coaching, certain tools and resources will be provided for the client to be successful in their job search, such as assistance in locating local job fairs, employment workshops, and/or participation in online or virtual job fairs.

In the first 30 days, an extensive assessment is completed in order for WSB to meet the client’s needs where they are. An extensive Interpretive Career Report will be provided to the client and their Vocational Rehabilitation Counselor on the assessment of their career interests, career training potentials, job satisfaction indicators, career exploration and career recommendations completed with the assistance of our qualified workforce staff and a Certified Vision Rehabilitation Therapist. Each client’s program will be individualized based on their needs and level of employability. During the skills evaluation period, students will work on a career readiness program tailored to their personal needs in areas such as, their academic skills in areas they may need improvement, assistive technology and computer literacy, daily living skills, and orientation and mobility skills training. Each individual will learn how to complete a resume or update their current resume, interviewing skills, “dress for success” skills, participate in mock interviews, learn soft skills, independent living skills and essential workplace skills. This will assist in the client’s preparation and future choices of a Pre-Vocational or Vocational program, or their area of interest for employment.