Certified Professional Coder + Certified Professional Biller

Last Update January 9, 2025

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About This Course

Certified Professional Coder (CPC) and Certified Professional Biller (CPB) Training

Start your journey into the world of healthcare with our industry-leading CPC and CPB training programs, designed by experts at Xpert HealthCare Group. These comprehensive courses prepare you for a rewarding career in medical coding and billing by providing the skills and knowledge needed to excel in today’s healthcare industry.

With the CPC training, you’ll master the art of coding using ICD-10, CPT, and HCPCS systems, enabling you to translate medical records into accurate codes essential for healthcare documentation and billing. Dive into real-world coding scenarios across multiple specialties, ensuring you’re well-prepared to handle the demands of professional medical coding.

Our CPB training equips you with the expertise to manage the billing cycle, process insurance claims, handle denials, and ensure compliance with payer policies. Learn the critical role of billing in the revenue cycle and how to effectively coordinate it with coding for seamless operations.

These programs offer a practical, hands-on approach to learning, combined with extensive resources and expert guidance to help you succeed. Whether you’re starting fresh or looking to enhance your healthcare career, Xpert HealthCare Group provides the tools and support you need to achieve your certification and thrive in the industry.

Learning Objectives

Certified Professional Coder (CPC):

Gain expertise in ICD-10, CPT, and HCPCS Level II coding systems.

Master coding guidelines and regulations for accurate documentation.

Learn to code for various medical specialties, including radiology, surgery, and more.

Understand compliance, ethics, and legal standards in medical coding.

Certified Professional Biller (CPB):

Develop proficiency in medical billing processes and insurance claims.

Learn to navigate payer policies and reimbursement methodologies.

Manage denied claims, appeals, and revenue cycle processes effectively.

Understand the integration of billing with coding for streamlined operations.

Material Includes

Access to detailed course modules for CPC and CPB training.
Downloadable guides and reference materials.
Practice exams tailored to CPC and CPB certification formats.
Real-world coding and billing exercises for hands-on learning.
Certification of Completion upon course conclusion.

Requirements

Prerequisites: Open to all; no prior experience required. A basic understanding of healthcare or finance is beneficial.
A computer or tablet with a stable internet connection.
Essential Manuals: ICD-10, CPT, and HCPCS coding manuals (available in print or digital formats).
Commitment to completing assigned coursework and assessments.

Target Audience

This training is designed for:
Individuals aspiring to build a career in medical coding and billing.
Current healthcare professionals looking to obtain CPC or CPB certification.
Students interested in healthcare documentation, billing, and coding.
Organizations seeking to upskill their workforce in coding and billing practices.

Curriculum

60h

Module 1: Introduction to Medical Coding and Billing

Overview of the Healthcare Revenue Cycle Role of Medical Coders and Billers in the Healthcare Industry Importance of Accuracy in Coding and Billing Understanding ICD-10, CPT, and HCPCS Coding Systems

Module 2: Medical Terminology and Anatomy

Essential Medical Terminology for Coding and Billing Anatomy and Physiology: Understanding Body Systems Common Medical Procedures and Diagnoses

Module 3: ICD-10-CM Coding

Structure and Organization of ICD-10-CM Codes Diagnosis Coding Guidelines and Conventions Applying ICD-10-CM in Outpatient and Inpatient Scenarios

Module 4: CPT and HCPCS Level II Coding

Basics of CPT Code Categories: Evaluation, Management, and Procedures Use of Modifiers in CPT Codes HCPCS Level II Codes for Equipment, Supplies, and Services

Module 5: Insurance Policies and Claims Management

Understanding Different Insurance Plans: Medicare, Medicaid, and Private Payers Claims Submission Process and Common Challenges Managing Denials, Appeals, and Reimbursements

Module 6: Compliance, Legal, and Ethical Practices

HIPAA Regulations and Their Impact on Coding and Billing Preventing Fraud and Abuse in the Revenue Cycle Ethical Standards for Medical Coders and Billers

Module 7: Reimbursement Methodologies

Fee-for-Service vs. Value-Based Reimbursement Models Diagnosis-Related Groups (DRGs) and Prospective Payment Systems Importance of Proper Coding for Accurate Reimbursement

Module 8: Practical Applications and Case Studies

Coding and Billing Scenarios Across Specialties (e.g., Radiology, Surgery, Cardiology) Abstracting Information from Medical Records Hands-on Exercises with Real-World Claims

Module 9: Exam Preparation for CPC and CPB Certifications

CPC and CPB Exam Structures and Guidelines Practice Exams and Mock Scenarios Time Management and Exam-Taking Strategies

Module 10: Career Development and Next Steps

Building a Career in Medical Coding and Billing Resume Writing and Job Interview Tips for CPCs and CPBs Opportunities for Continuing Education and Specializations