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Medical Billing and Insurance Coding (AASMBICM)

The average length of time for a student taking a full course load is 4.5 semesters. A minimum of 65 semester credit hours is required for graduation.

Medical Billing & Insurance Coding Specialists are the experts who secure, analyze, integrate, and manage information that drives the health care industry. Their work directly contributes to the quality of patient care. In a coding career, medical coders work on the health care team with physicians, nurses, and other professionals as a respected authority on medical data. Coders assign codes to each diagnosis and procedure found in a patient’s record. The codes are then used by insurance and government agencies to pay for the patient’s medical expenses. Medical coders’ skills will be in demand in various health care related sectors ranging from hospitals and clinics, to insurance companies and law firms.

Courses Required for all MBIC Programs

Minimum requirements for graduation:
  • Diploma in Medical Billing and Insurance Coding: 45 Credits
  • Associate of Science in Medical Billing and Insurance Coding: 65 Credits
  • Bachelor of Science in Health Information Management: 124 Credits

Medical Sciences

MS 113 Medical Business Operations

This course introduces the student to the administrative portion of the health care environment as well as important legal and ethical guidelines. Students will become familiar with health information systems including interpersonal communication and customer service techniques, and appointment scheduling. 3.0 credit hours. Prerequisite: None.

MS 129 Medical Office Procedures

This course provides an overview of administrative tasks performed in a medical office. Students will learn about office financial management including accounting concepts, about the types of medical record keeping, accepting and entering payments, and human resource management. 3.0 credit hours. Prerequisite: None.

MS 144 Medical Terminology

This course introduces the foundations of the language of medicine and develops medical vocabulary through the study of the structures, functions, diagnostic procedures, pathology, and treatment procedures of the body systems. 1 credit hour. Prerequisite: None.

MS 146 Pathophysiology and Pharmacology

This course provides instruction in the study of human diseases with focus on the symptoms, signs, causes, and diagnosis of disease. Additionally, students will learn about pharmacology, drug categories, and pharmacological treatment related to human diseases. 2.0 credit hours. Prerequisite: None.

MS 161 Medical Billing and Insurance Procedures

This course is designed to provide students with an understanding of the basic types of medical insurance programs available in today’s health care system. It also acquaints students with billing formats using the universal claim form and provides the skills necessary to master the basic aspects of medical insurance billing. Current reimbursement methodologies (i.e., RBRVS, APC’s) and compliance will also be covered. 3.0 credit hours. Prerequisite: None.

Medical Coding

MC 171 Basic Diagnosis Coding

Basic Diagnosis Coding is an introduction to the ICD-9-CM data set used for reporting diagnoses. This course will also include instruction on how to classify and index diagnosis in the health care setting. The various uses for diagnosis codes will be discussed, as well. 3.0 credit hours. Prerequisite: SC 245 Anatomy and Physiology II, MS 144 Medical Terminology, and MS 146 Pathophysiology and Pharmacology.

MC 172 Basic Procedure Coding

Basic Procedure Coding helps students describe all types of health care services, treatments, and procedures provided to patients in both inpatient and outpatient facilities, as well as ancillary departments such as imaging centers and pathology/laboratories. 3.0 credit hours. Prerequisite: SC 245 Anatomy and Physiology II, MS 144 Medical Terminology, and MS 146 Pathophysiology and Pharmacology.

MC 173 Intermediate Diagnosis Coding

Intermediate Diagnosis Coding is a continuation of Basic Diagnosis Coding with advanced instruction on ICD-9-CM chapter-specific guidelines (specialty coding). Abstracting skills will continue to be reinforced. An overview of ICD-10-CM will be included to provide an introduction to this new code set. 3.0 credit hours. Prerequisite: MC 171 Basic Diagnosis Coding.

MC 174 Intermediate Procedure Coding

Intermediate Procedure Coding continues to teach students how to identify all types of health care services, treatments, and procedures provided to patients in both inpatient and outpatient facilities, as well as ancillary departments such as imaging centers and pathology/laboratories. In addition, how to properly apply HCPCS level II codes, as well as ICD-9-CM volume 3 procedure codes will be covered. An introduction to ICD-10-PCS will be provided. 3.0 credit hours. Prerequisite: MC 172 Basic Procedure Coding.

MC 207 Program Review

The directed practice seminar is a class in which the student will participate in seminars to prepare for certification examinations. The certified coding specialist certification is a nationally recognized credential that enables employers to have confidence in a potential employee’s ability. Students will also attend meetings to discuss their experience in the seminar. Students will be required to complete cover letters, resumes, and reference lists to use in job placement. This course aids the student in combining their didactic training with the seminar experience. Prerequisites for this class include successful completion of all didactic training. 2.0 credit hours. Prerequisite: All didactic course work with a GPA of 2.0

MC 294 Internship

During the internship phase of training, the student will experience various aspects of working in the coding field. The internship will provide the student with the opportunity to experience and participate in the duties of a medical coder in a working environment. Areas such as abstracting from medical records, CPT-4, and ICD-9-CM coding schemes will also be used. Other aspects of medical coding and billing will be experienced. Experienced coding personnel provide the instruction. 4.0 credit hours. Prerequisite: All didactic course work with a GPA of 2.0.

Natural Sciences

SC 145 Anatomy and Physiology I

This course will provide students with information about Anatomy and Physiology relating to each of the following body systems: Integumentary, Skeletal, Muscular/joints, Nervous, and Blood and Lymphatic systems. 3.0 credit hours. Co-requisite: SC 145L Anatomy and Physiology I Lab.

SC 145L Anatomy and Physiology I Lab

This is the lab portion of SC 145. 1.0 credit hour. Co-requisite: SC 145 Anatomy and Physiology I.

SC 245 Anatomy and Physiology II

This course will provide students with information about Anatomy and Physiology relating to each of the following body systems: Cardiovascular, Respiratory, Digestive, Endocrine, Special Senses, Urinary, and the Male and Female Reproductive systems. 3.0 credit hours. Prerequisite: SC 145 Anatomy and Physiology I.  Co-requisite: SC 245L Anatomy and Physiology II Lab.

SC 245L Anatomy and Physiology II Lab

This is the lab portion of SC 245. 1.0 credit hour. Co-requisite: SC 245 Anatomy and Physiology II.

Personal and Professional Development

IS 102 Computers and Application Software

This course provides an introduction to operating systems, browsers, and email as well as word processing, presentation, spreadsheets, and database applications. 4.0 credit hours. Prerequisite: None.

MO 110 Keyboarding

This course includes the development of keyboarding skills through touch, mastery of the keyboard, speed building, and preparation of office documents. 1.0 credit hour. Prerequisite: None.

PD 100 Student Success Skills

This course provides instruction in the both theory and practice of personal growth that lead to successful life experience. Topics include research in critical self-analysis of student habits and attitudes; and psychological impediments to successfully setting and achieving personal goals. 1.0 credit hour. Prerequisite: None.

PD 200 Career Development Seminar

This seminar provides an opportunity for the student to apply critical self-examination techniques and processes for developing a career path and an awareness of the need to embed life-long learning into career management. Topics include career planning research, job searching, developing career search documents, and refining interview and communication skills within an awareness of psychological boundaries implicit in this process. Successful completion of this course requires the creation of a professional resume suitable for email. 1.0 credit hour. Prerequisite: None.

Additional Course Required for the Associate and Bachelor of Science Degrees:

Elective Courses

A minimum of three semester credit hours of open electives is required

General Education Requirements

Students enrolled in Associate degrees must complete a minimum of 21 semester credit hours in general education distributed among the following disciplines. Refer to the General Education section of the course catalog for Herzing University courses that would satisfy these requirements.

  • 3 Semester Credit Hours in English Composition
  • 1 Semester Credit Hour in Information Literacy and Research Writing
  • 3 Semester Credit Hours in Speech
  • 4 Semester Credit Hours in Computer Applications
  • 4 Semester Credit Hours in Mathematics (College Algebra or Above)
  • 3 Semester Credit Hours in Social or Behavioral Science
  • 3 Semester Credit Hours in Science or Humanities with a Critical Thinking Focus

Additional Course Required for the Bachelor of Science in Health Information Management Degree

Business

AC 103 Accounting I

This introductory accounting course provides the practical application of the concepts and principles of the accounting cycle for service businesses. Topics include an overview of accounting concepts and procedures; analyzing and recording transactions; beginning the accounting cycle by journalizing, posting, and working with the trial balance; using worksheets, financial statements, and adjusting entries; completing the accounting cycle with adjusting, closing, and post-closing trial balance; working with cash and its control; working with accounting systems, journals, internal controls and an introduction to cash flow management. 4.0 credit hours. Prerequisite: IS 102 Computers and Application Software.

BU 105 Business Principles and Management

This course introduces the environment of American business with an overview of various topics that serve as a foundation for further study of business. Topics include the environments that businesses operate in; the organizational structures of businesses; management functions in enterprises; and the challenges of managing marketing, operations, information technology, finance, and human resources. 3.0 credit hours. Prerequisite: None.

BU 155 Team Development and Group Management

This course provides guidelines for building and managing teams. Topics include teamwork development, group organization, assessing team requirements, support role development, and how to work together in a diverse environment. The opportunity to experience teamwork concepts is provided through running meetings and presenting reports. 3.0 credit hours. Prerequisite: PS 101 Psychology.

BU 426 Organizational Behavior

This course examines the nature of organizational behavior through the study of group and inter-group relations, organizational design, and the structure and factors affecting organizational design. Topics include the external environment; the impact of technology, power, and politics; and organizational change and development. 3.0 credit hours. Prerequisite: BU 105 Business Principles and Management.

BU 435 Project Management

This course provides instruction in the principles and concepts of project management. Topics include project management concepts; needs identification techniques; proposed solutions preparation; the project life cycle; the project manager’s responsibilities and skills; the effective project team; types of project organizations; project communications and documentation; project planning, scheduling, and control; resource considerations; and cost planning and performance evaluation. 3.0 credit hours. Prerequisite: Senior year.

Health Information Management

HC 315 Medical Personnel Management

This course uses a practical approach to emphasize knowledge of employee benefits, salary administration, psycho-psychological needs, and written communications systems. Labor management relations and relationships in a medical office will be reviewed. 3.0 credit hours. Prerequisite: BU 105 Business Principles and Management.

HI 305 Healthcare Finance

This course introduces the unique aspects of healthcare finance, including payment sources and reimbursement methodologies, emerging industry trends, resource management, cost/benefit analysis, case mix management, compliance and reimbursement audit processes, and charge-master management. 3.0 credit hours. Prerequisite: AC 103 Accounting I.

HI 310 Principles of Health Information Management

This course provides an overview of health information practice and practitioners from a manager’s perspective, HIM professional associations, the content and standards of health records, the planning for the development of manual and computerized health record systems, storage and retrieval of manual and computerized records, and the management and design of medical word processing systems. This course introduces healthcare information standards (ANSI, ASTM, LOINC, UMLS, MESH, etc.); an overview of healthcare taxonomies. Clinical vocabularies, terminologies and nomenclatures (ICD-9-CM, ICD-10, CPT, SNOMED-CT, DSM-IV, etc.) and discussion of severity of illness systems. 3.0 credit hours. Prerequisites: MC 173 Intermediate Diagnosis Coding and MC 174 Intermediate Procedure Coding.

HI 320 Health Care Data

This course provides students with an advanced understanding of the management of data in healthcare organizations including uniform data sets and healthcare informatics standards for health data collection, evaluation of coded and statistical data and quality assurance of data, Diagnosis-Related Groups (DRG) and case mix systems, data collection for enterprise, reportable and specialized databases, data mining of healthcare data, research methods and healthcare research support.In addition, this course will include all aspects of data content and collection including structure and use of health information, clinical and health care data sets, epidemiology, vital statistics, data quality assessment and integrity, National Healthcare Information Infrastructure (NHII), and secondary data sources. 3.0 credit hours. Prerequisites: MC 173 Intermediate Diagnosis Coding and MC 174 Intermediate Procedure Coding.

HI 440 Health Care Database Design and Security

This is a course in the design and implementation of databases specifically designed to store and process health care data information and file structures, systems development, human factors and user/interface design, data warehousing, data storage and retrieval, and systems life cycle. Basic security principles of effective security policies including HIPAA’s security rule, risk assessment, user tracking, permissions, audit and control systems, and data recovery as also included. 3.0 credit hours. Prerequisites: MC 173 Intermediate Diagnosis Coding and MC 174 Intermediate Procedure Coding.

HI 480 Research Methodologies

This course will teach research design and methodologies, knowledge-based research techniques, evaluating resource credibility, and research protocol management. National guidelines regarding human subject’s research and other healthcare related regulations and leading development of health information resources and systems will also be covered. 3.0 credit hours. Prerequisite: None.

HI 490 HIM Capstone

This course is designed to review all knowledge competencies of the HIM program, provide the student with multiple methodologies for keeping these competencies up-to-date with continuing education, and researching current events and trends. Test-taking tips and studying strategies for taking the American Health Information Management’s Registered Health Information Administrator (RHIA) exam will be included. 2.0 credit hours. Prerequisite: All didactic training.

Electives

A total of 15 semester credits of open electives is required.

Additional General Education Requirements

Students enrolled in bachelor degrees must complete a minimum of 37 semester credit hours in general education distributed among the following disciplines. A minimum of 9 semester credit hours must be upper level (300-400 level courses). Refer to the General Education section of the course catalog for Herzing University courses that would satisfy these requirements.

  • 6 Semester Credit Hours in English Composition
  • 1 Semester Credit Hour in Information Literacy and Research Writing
  • 3 Semester Credit Hours in Speech
  • 4 Semester Credit Hours in Computer Applications
  • 7 Semester Credit Hours in Mathematics (College Algebra or above)
  • 4 Semester Credit Hours of Natural Science with a Lab Component
  • 3 Semester Credit Hours in Social or Behavioral Science
  • 3 Semester Credit Hours in Science or Humanities with a Critical Thinking Focus
  • 3 Semester Credit Hours in Cultural Diversity
  • 3 Semester Credit Hours of General Education Electives

Medical Billing and Insurance Coding — Career Paths

Properly trained Medical Billing and Insurance Coding professionals are in very high demand across the health care industry. Positions exists in all areas of health care including doctors’ offices, insurance companies, hospitals, clinics, assisted living facilities, or any other health care provider. Examples of career paths for Herzing University graduates include:

  • Medical Coder
  • Insurance Claims Analyst
  • Coding Specialist
  • Abstractor
  • Medical Office Assistant
  • Coding Technician
  • Medical Billing Specialist
  • Medical Clerk
  • Health Information Specialist
Graduates of the Herzing University Medical Billing and Insurance Coding programs will be positioned to work as either a Medical Biller or Medical Coder. They may also choose to incorporate both career paths as some employers seek one person who is capable of performing both functions.

Work environment for careers in Medical Billing and Insurance Coding

Medical Billing and Insurance Coding specialists typically work in an office environment in either a health care facility or agency setting. A typical work week for full-time employees is 40 hours, Monday–Friday with the possibility of paid overtime, depending on the employer. Medical Billing and Insurance Coders often receive a comprehensive benefit package that includes health insurance, paid vacation, and a retirement savings plan such as profit-sharing or 401(k). Some employers have part-time opportunities available as well.

While some Medical Billing and Insurance Coding specialists have special arrangements with an employer to work from home once they graduate, new professionals in this field should expect to work on-location for the first several years in order to gain enough experience before successfully finding an opportunity to work from home.

Medical Billing and Insurance Coding — Career Outlook

The US Bureau of Labor Statics states that Medical Records and Health Information employment will continue to grow at a rate of 18% through 2016, a rate that is much faster than the average for all occupations. The Bureau also stated that technicians with a strong background in medical coding will especially be in demand.

Further information can be found at US Department of Labor–Bureau of Labor Statistics

Salary surveys

Salaries for Medical Billing and Insurance Coding professionals depend on level of education, experience, credentials earned, and geographic location.

  • The American Academy of Professional Coders recently compiled a survey in which over 5,000 members responded. See the result at AAPC Salary Survey
  • The American Health Information Management posted the results of their member salary survey from 2006. Review their findings at AHIMA Salary Survey


Total Credits: 63


    

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