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Medical Billing and Coding

Learn to manage patient records, process insurance claims, and understand medical coding standards with hands-on training. This beginner-friendly course equips you with skills that are in high demand in healthcare offices and remote jobs. Start your journey to a professional healthcare career today!
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Course Duration
3 Months
Modules
6 Modules
Course Type
Short Course with Certification

Course Outline

Eligibility Verification in RCM

To train staff on advanced eligibility verification methods that help prevent claim denials and ensure upfront accuracy in insurance validation.

Verifying insurance eligibility before the date of service (DOS) involves confirming plan type, coverage, co-pays, deductibles, and out-of-pocket expenses. This ensures benefits are active and the correct payer is selected. Document verification details with reference numbers and communicate discrepancies to the registration or billing teams.

 

Session Topic Key Highlights
1
Introduction to Eligibility in RCM Importance of eligibility, impact on claim success, role in patient care, and revenue cycle.
Verification Tools & Portals Using portals and direct calls to the insurance companies.
Plan Type, Coverage & Benefit Checks Confirming active status, coverage for services, co-pays, deductibles, out-of- pocket limitations
2
Documentation & Reference Numbers Logging verification, capturing screenshots or ref. #s of representatives, storing in PM system
Handling COB & Policy Terminations Coordination of Benefits updates, resolving primary/secondary conflicts, handling terminations
3
Eligibility Escalations To ensure services are billed to valid coverage and prevent denials due to eligibility issues.
Reporting & Error Analysis Tracking eligibility errors, denial trends, reporting delays, root cause analysis

Production (Data Entry)

In medical billing, Production (Data Entry) refers to the process of accurately entering and processing patient information, medical codes, and billing details into a healthcare provider’s billing system or practice management software. The primary purpose of this step is to ensure that claims are correctly prepared for submission to insurance companies or government payers (like Medicare/Medicaid) for reimbursement.

Session Topic Key Highlights
4
Medical Billing Lifecycle Overview Understanding the full revenue cycle, production’s place in it, compliance, and key interdepartmental workflows.
Scheduling & Patient Data Entry Capturing accurate demographics and insurance data to prevent front-end billing errors.
Provider Visit & Charge Entry Translating provider documentation into accurate CPT/ICD/HCPCS codes, applying modifiers, and preventing coding errors.
5
Charge Review, Edits & Quality Control Manual/automated work queues, resolving payer edits, using scrubbers, and ensuring claims meet payer-specific billing standards.
Claims Creation & Submission Clean claim creation, clearinghouse process, correcting rejections, and tracking claim acceptance across multiple payers.

Accounts Receivable (AR) Training Module

Accounts Receivable (AR) in medical billing refers to the outstanding payments owed to a healthcare provider for services rendered but not yet collected from insurance companies, patients, or other payers. The primary purpose of AR management is to track, follow up, and collect reimbursements efficiently to maintain a healthy cash flow.

Session Topic Key Highlights
6 Introduction to AR in RCM Overview of AR role, impact on revenue cycle, payer types, key definitions
7 Aging Buckets & Claim Prioritization Understanding 0–30 to 120+ day buckets, how to prioritize claims based on TFL and payer behavior
8 Denial Management Types of denials, using reason/remark codes, denial trends, corrective actions
9 Appeals & Reprocessing Filing appeals, resubmission guidelines, supporting documents, and timelines
10 Insurance Communication Calling payers, documenting call notes, and using call reference numbers effectively
11
Recoupments & Reversals Identifying and posting recoupments/reversals,
impact on AR
AR Reporting & Metrics How to generate and read AR reports, aging
summaries, and denial dashboards

Payment Posting and Adjustments

Payment Posting and Adjustments are crucial steps in the medical billing revenue cycle that ensure accurate financial records, proper reimbursement tracking, and compliance with payer contracts.

Session Topic Key Highlights
12
Introduction to RCM & Payment Posting Overview of Revenue Cycle, role of payment posting, payer types, key terms
EOB & ERA Fundamentals How to read EOBs/ERAs, CO/PR/CR codes, denial & adjustment codes
Manual Payment Posting Posting from paper EOBs, write-offs, patient responsibility, and small balance adjustments
13
ERA Auto Posting & Verification Importing ERA files, setting rules, and validating auto-posted data
Patient Payment Posting & Allocation Unapplied payments, over/under payments
Patient Statement Generation Identifying patient responsibility, statement formatting, billing cycles, and coordinating output through billing system/tools.
Denials, Zero-Pay, Reversals & Recoupments Posting $0 payments, common denials, insurance reversals, and recoupment scenarios
14
Reconciliation & Reporting Bank vs. system reconciliation, posting logs, unapplied reports, and audit readiness
Final Mock Exercise & Wrap-Up Real-world practice case, error spotting, recap of key steps, Q&A, certification prep

Credentialing & Enrollments Training Module

Credentialing (also called Provider Enrollment or Payor Enrollment) is the process of verifying and approving healthcare providers to participate in insurance networks. It ensures that physicians, facilities, and other healthcare professionals meet the required standards to bill insurers and receive reimbursements

Session Topic Key Highlights
15 Credentialing and Contracting Importance Describe contracting and credentialing and their significance for billing.
16 Type of insurance and providers Group type, insurance, facilities, and providers.
17 CAQH/PECOS & Credentialing documents Provide a summary of the CAQH/PECOS account and other credentials.
18 In-network/Out of network/plan Davison/Re-credentialing Describe the various provider statuses based on credentialing.
19 Insurance FU and reporting FU is crucial, TAT, credentialing, and reporting.
20
Renegotiation/reconsideration & Others demo request Describe the demographic applications, renegotiation, and reconsideration.
Enrollments (EDI/ERA/EFT) What is EDI, ERA, and EFT, and why are they necessary in today’s world?
What Our Students Say’s About Us
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"I was already freelancing, but IPS Uni’s web design course helped me polish my skills and work more professionally. The instructors were helpful, and the content was straight to the point."
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Graduate (Medical Student)
"I joined the Medical Billing & Coding course with zero knowledge. The step-by-step teaching style helped me feel confident. I’m now applying for jobs in healthcare administration!"

Frequently Asked Questions

Browser our faq’s below, if you can not find the answer.

You’ll learn SEO (basic & advanced), SEM, social media marketing strategies, content marketing, Google Analytics, Search Console, and Google Ads setup and optimization.

You’ll learn to install and set up WordPress, navigate the dashboard, choose and customize themes, create pages and menus, use essential plugins like Elementor, Rank Math, and WP Rocket, and optimize website performance.

Yes! You’ll implement on-page SEO, URL structure, meta tags, internal linking, image optimization, and sitemap submission, both in theory and directly on WordPress sites.

You’ll use Google Analytics, Google Search Console, SEMrush, Ahrefs, Elementor, SEO plugins, and other WordPress tools for real-world practice.

Absolutely! Your final project involves building a 5-page SEO-optimized WordPress website, adding a blog post, optimizing content, and submitting a sitemap to Google.

Yes! You’ll receive a professional certificate validating your skills in both digital marketing and WordPress website creation and optimization.

You will learn medical coding (ICD & CPT), insurance claims processing, patient billing, denial management, and healthcare documentation.

No prior medical experience is required. The course starts from the basics and is suitable for complete beginners.

Yes! Medical billing and coding is a highly sought-after skill for remote positions in clinics, hospitals, and medical billing companies.

Experienced healthcare professionals and certified billing specialists will guide you through practical exercises and real-world scenarios.

Yes, you’ll receive a professional certificate that can boost your resume and help secure job opportunities in the healthcare industry.

You’ll learn load booking, carrier setup, dispatch software, rate negotiation, broker communication, and daily dispatch operations.

Yes, no prior logistics experience is required. The course covers fundamentals and builds practical skills step by step.

Absolutely! Truck dispatching offers remote and freelance opportunities in the logistics industry.

Yes, the course emphasizes real-world scenarios and practical exercises using industry-standard tools.

Yes, you will get a professional certificate to validate your expertise in truck dispatching and logistics.

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