Medical Coding, Billing, & Insurance Certificate, CTE

Program Code: C25310C1 | (CTE) C25310H1*

(2021*03)

Medical billers and coders play a critical role in the healthcare system by handling the administrative processes related to patient records and insurance claims. Medical coders take the descriptions of medical procedures, diagnoses, and treatments from healthcare providers and use common coding systems including ICD-10 (International Classification of Diseases), CPT (Current Procedural Terminology), and HCPCS (Healthcare Common Procedure Coding System) to translate the descriptions into standardized codes. These codes are used for healthcare billing, insurance claims, and statistical data. A medical biller uses the codes provided by the coder to create accurate bills or claims for services rendered; they submit claims to insurance companies or government programs (e.g., Medicare, Medicaid) for payment; they follow up on claims and if claims are denied or underpaid, the biller may need to resubmit or appeal the claim, ensuring that the healthcare provider receives payment. In addition to working with insurance companies, they may also generate bills directly for patients, track payments, and manage accounts. Medical coders and billers may work in hospitals, medical offices and clinics, insurance companies, nursing homes, government agencies, or remote work-from-home.