Health Insurance Reimbursement & Billing
Issued by
Community College of Vermont
Earners of this badge are able to analyze complicated medical claims to ensure proper reimbursement, identify the procedure for two or more party billing, apply medical insurance vocabulary, demonstrate proper use of coding manuals, identify methods for addressing common issues (medical necessity, claim denial and appeal, bundling, and charge capture), and demonstrate the ability to accurately follow procedures, fill out common forms, and address common issues to maximize reimbursement.
- Type Validation
- Level Foundational
- Time Weeks
- Cost Paid
Skills
Earning Criteria
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Complete readings and assignments in 7 modules. Topics include introduction to health insurance, private insurance and government plans (BCBS, Medicare, Medicaid, Tricare), insurance laws and regulations, claim development, revenue life cycle, medical coding, reimbursement methodologies, and claim form submersion.
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Apply knowledge of health insurance reimbursement and billing concepts through a series of quizzes.
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Complete assignments that provide practical experience in the field including working with the encounter form/superbill, calculating reimbursements and write-offs, processing different types of complex claims (commercial, Medicare, Medicaid, Tricare, Workers Compensation), appealing a denied medical claim, and identifying codes.