Table of Contents
Unit One: Career Roles and Responsibilities
1. Role of an Insurance Billing Specialist
2. Privacy, Security and HIPAA
3. Compliance, Fraud and Abuse
Unit Two: Introduction to Health Insurance
4. Basics of Health Insurance
5. The Blue Plans, Private Insurance and Managed Care Plans
6. Medicare
7. Medicaid and Other State Programs
8. TRICARE and Veteran’s Health Care
9. Workers Compensation
10. Disability Income Insurance and Disability Benefit Insurance
Unit Three: Documentation and Coding for Professional Services
11. Medical Documentation and the Electronic Health Record
12. Diagnostic Coding
13. Procedural Coding
Unit Four: Claims Submission in the Medical Office
14. The Paper Claim CMS-1500
15. The Electronic Claim
Unit Five: The Claim Follow-Up and Payment Process
16. Receiving Payments and Insurance Problem Solving
17. Collection Strategies
Unit Six: Healthcare Facility Billing
18. Ambulatory Surgery Center
19. Hospital Outpatient and Inpatient Billing
Unit Seven: Employment
20. Seeking a Job and Attaining Professional Advancement
