Certified Medical Reimbursement SpecialistWIA Approved

Learn to increase revenue and apply compliance by guidelines. Certified Medical Reimbursement Specialists (CMRS) are skilled in facilitating the claims paying process from the time a service is rendered by a health care provider until the balance is paid. CMRS billers play a critical role in a health care provider's daily business operations. Students will learn the responsibilities of departments within the insurance company, claims processing, how to interpret insurance contracts, how to calculate UCR and create fee schedules utilizing RBRVS, and how to process health claim forms. The student will learn to differentiate between basic comprehensive and major benefits, understanding benefits, eligibility, coverage, COBRA, contract provisions, investigate third party liability. The student will learn reasonable fees, to understand, create, and evaluate physician fee schedules, compliance, electronic data exchange, HIPAA, OIG, and billing guidelines. Major health insurance programs and government sponsored programs will be discussed with an emphasis on Federal and State plans: Medicare, Medicaid, and commercial carriers. Students will become familiar with insurance terminology. This course prepares students to take the CMRS certification exam, which is awarded by the Certifying Board of the American Medical Billing Association (AMBA).

Session(s) Currently Offered