Administrative Medical Specialist with Medical Billing and Coding
Partnered with Gatlin Education
GES 102 -- 300 hours
The Administrative Medical Specialist with Medical Billing and Coding (AMS/MBC) online program will give you the skills you need to find the job YOU are looking for as an Administrative Medical Specialist (AMS), Medical Billing Specialist, and/or Medical Coder. In addition to the extensive medical insurance billing and coding modules, you will learn all the other administrative tasks performed in a typical medical office – including appointment scheduling, patient check-in, registration, and check-out, accounts receivable and payable management, bookkeeping, and office management – to name just a few.
Gatlin Education Services has also partnered with National Healthcareer Association (NHA) to register and prepare you for skills certification in two areas. Included in the tuition for AMS/MBC is a voucher for a study guide, preparation course, and the registration fee for the dual CMAA/CBCS (Certified Medical Administrative Assistant/Certified Billing Coding Specialist) certification credential.
Upon successful completion of the Administrative Medical Specialist with Medical Billing and Coding course, students will be prepared for an entry-level position doing medical billing or coding in a medical office setting and will be prepared to sit for the national certification exam.
The medical industry is experiencing a tremendous demand for individuals with knowledge of medical office operations, which includes billing and coding, processing insurance forms, and using medical software. According to the American Medical Association, there are more than 1.2 million Medical Specialists in the United States. This profession is listed as one of the fastest growing professions in allied health.
The career of an administrative medical specialist is a challenging one with new opportunities arising continuously. Job security is high for an individual who understands claims processing and billing regulations, possesses sharp coding skills, and is successful in appealing under-paid or denied insurance claims. Recent surveys of medical office personnel Help Wanted advertisements indicate the need for individuals with these skills. With this online AMS/MBC program, students will learn the job skills they need to be successful candidates in the workforce.
The Administrative Medical Specialist with Medical Billing and Coding program will give you the skills you need to be competitive in the healthcare market, as well as the credentials through certification to prove your qualifications.
In addition to the skills already mentioned, the AMS/MBC course includes legal, ethical, and regulatory concepts – including HIPAA compliance requirements, industry- specific techniques for filing, proper protocol for patient interaction and communication, medical records management, charting and documentation, telecommunication and telephone techniques, inventory management, banking, payroll and taxes, and other office management skills.
Some typical tasks for the AMS include:
• Receiving, making and documenting telephone calls.
• Scheduling appointments and registering of patient information.
• Performing insurance verification, pre-authorization and referral tasks.
• Preparing patient charts and maintaining medical records.
• Preparing and posting transactions on day sheets, charge tickets and patient accounts.
• Coding and billing insurance claims.
• Collecting patient payments and performing collection activities.
Special Features
Videos
Throughout the course, video interviews of medical assistants and healthcare providers working at a real-world medical office are presented as part of our Gatlin Education Video Education Series. As they talk about their day-to-day responsibilities, challenges, and rewards of working in the field – you can also watch them at work as they perform those tasks.
Simulations
Each module contains step-by-step simulations for almost all of the tasks you will learn in the AMS w/ MBC course, including Patient Registration, Charge and Payment data entry, Insurance Claims Preparation and Processing, Appointment Scheduling, Pre-Authorization, and Bookkeeping – both accounts receivable and payable - to name just a few.
Games & Practice Quizzes & Activities
At the end of almost every topic within each module, Just for Fun! games like hangman, concentration, and crossword puzzles, and practice quizzes and tasks are presented. There is no grade for the games and practice activities – but they will help reinforce the concepts and information in each Module.
Medical Office Simulation Software (MOSS©)
MOSS© is a unique, state-of-the-art software which simulates all the computerized administrative tasks performed in the medical office, including appointment scheduling, patient registration, charge entry and payment posting, insurance and patient billing, collections, and many others.
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Upon successful completion of the Administrative Medical Specialist with Medical Billing and Coding program, students will:
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• Be proficient in skills such as communication, telephone techniques, organization and time management.
• Have knowledge of Medical Practice Settings and Specialties, as well as the differences in Traditional and Managed Care. Students also learn about Commercial, HMO/PPO, Federal and State insurance plans, including eligibility and coverage, as well as reimbursement methodologies.
• Have knowledge of the legal and ethical responsibilities of an administrative medical specialist, including the HIPAA mandates, the rules for maintaining privacy of medical records and protected health information, and the types of consents and disclosures that are required in a medical office environment.
• Be able to perform tasks associated with the entire Accounts Receivable and Revenue cycle, including scheduling and registration of patients; posting of accounting transactions; completion of insurance claim forms, and collections.
• Be able to perform the day-to-day tasks associated with medical coding, medical billing and completing insurance forms.
• Be able to effectively input patient information, run office reports, and process insurance claims using Medical Office Simulation Software.
• Be prepared to take an Advanced Coding course to prepare for more advanced national certifications.
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Module 1 - Introduction to Healthcare
- Course Introduction and Overview
- Medical Assisting as a Profession
- Healthcare: Past, Present & Future
- Communication Skills
- Introduction to Medical Office Simulation Software (MOSS)
Module 2 – Law, Ethics & HIPAA
- Health Insurance Portability and Accountability Act (HIPAA)
- Law & Ethics
Module 3: The Patient Encounter
- Telephone Procedures
- Appointment Scheduling
- MOSS© Appointment Scheduling
- Filing Procedures
- Medical Records Management
- The Receptionist & Facility Environment
- MOSS© Patient Registration
- Drugs & Medications
- MOSS© Procedure and Payment Posting
Module 4: Billing & Reimbursement
- Medical Insurance Overview
- Billing & Reimbursement
- CMS-1500 Claim Form (Provider)
- MOSS© Insurance Processing
- Insurance Carriers
- Blue Cross/Blue Shield
- Medicare
- Medicaid
- TRICARE
- Worker’s Compensation
- Reimbursement & Follow-up
Module 5 - Diagnostic Coding
- Diagnosis Coding Overview
- Abstracting from the Medical Document
- ICD9 Conventions, Layout and Guidelines
- Steps for Diagnostic Coding
- ICD9 Guidelines by Body System
Module 6 - Procedural Coding
- CPT Overview
- Evaluation & Management Coding
- Anesthesia Coding
- Surgery Coding (by body and organ system)
- Laboratory & Pathology Coding
- Radiology Coding
- Medicine Coding
- HCPCS Level II Coding
Module 7: Business Office / Management
- Daily Financial Practices
- Accounting Practices
- Medical Office Simulation Software (MOSS©)
- Office Manager
- Human Resources Management
Module 8 – Completion & Certification Prep
- Instructions for marking course complete
- Employment Strategies
- Certification
- Steps to access National Healthcareers Association
- Certification preparation module
- Certification handbook and study guide
- Certification exam
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A basic understanding of Medical Terminology is a prerequisite for this program.
Students should be proficient in keyboarding, have a basic understanding of a word-processing computer program (Microsoft Word recommended), and have a command of English grammar and punctuation. No healthcare work experience is required.
The target audience for this program is individuals interested in learning job skills for medical office opportunities, changing job skills to become medical office assistants, or changing job skills to become medical coders.
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The Administrative Medical Specialist with Medical Billing and Coding online course must have:
- IBM Compatible (PC) computer running Windows 98 or any later version up to Windows XP
- CD ROM drive (for installing the Medical Office Simulation Software (MOSS©).
- Students need to have access to a word-processing program, preferably Microsoft Word
- Students must have internet access. While the program will work from a dial-up connection, high-speed Internet access (like DSL or Cable) is recommended.
Important Note:
The Medical Office Software Simulation (MOSS) is not currently compatible with Windows Vista Operating System.
A Macintosh computer will not work for this course.
GES will provide the following materials:
- Administrative Medical Assisting- Text & Workbook (Fordney)
- Getting Started in the Computerized Medical Office: Fundamentals & Practice with Medical Office Simulation Software (MOSS©) (Correa)
- Understanding Health Insurance: A Guide to Insurance Billing (Green, Rowell, Williamson)
- Current Year CPT-4 Coding Manual
- Current Year ICD-9-CM Coding Manual
- Merriam-Webster’s Medical Desk Dictionary
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Carline Dalgleish:
Carline Dalgleish has been employed in the business office management profession since 1970. She began in the Medical Records department of the Army/Air Force Hospital in Nuremberg, Germany and has, over the years, performed accounts receivable and business office management services for physicians, clinics, and hospitals, as well as the Healthcare Financing Administration (now CMS). She has real-time experience in administrative and financial departments, as well as management experience in business office administration, regulatory compliance, information technology and services. In addition, she has created the curriculum for, and instructed, administrative medical billing, diagnostic and procedural coding, accounts receivable, accounts payable educational programs and other allied health, business and professional development courses.
In the early 90's, Ms. Dalgleish moved full-time into curriculum development, teaching and management of business and allied health education programs, with special emphasis on business office administration and management.
Ms. Dalgleish is a Certified Medical Assistant-Administrative, a formerly licensed vocational/practical nurse LVN/LPN), and holds a Bachelor's degree in Business Information Systems, and a Master's Degree in Leadership and Healthcare Administration.
She is a member of AAHAM, AHIMA, PAHCOM, AAMA, AAPC, CCST, AAMT and AMTIE, as well as the National Dean's Scholars List. She currently owns and operates COUGAR-Ed.net, which specializes in curriculum development and delivery of continuing education products, seminars and services.
In addition to her work with Gatlin Education Services, Carline is adjunct faculty at University of Phoenix, and is a contributing author to several allied health textbooks.
April Raines:
April Raines currently teaches in the Administrative Medical Specialist and Medical Billing & Coding Programs. She resides in Albany, Georgia with her husband, Gabriel, and two sons, Justin and Jordan.
April attended Albany State University where she earned a BS in Allied Health Sciences and Healthcare Administration. She later received an MBA in Healthcare Management from American Intercontinental University.
During her role as Business Office Manager at the Phoebe Cancer Center, she received her Certification from the Healthcare Financial Management Association in Patient Accounting. Her professional experience includes management of Patient Access, Medical Records, and Patient Accounting/Business Office functions.
April is a member and Co-Chair of the Georgia Society of Clinical Oncology Administrators’ Association, National Association of Healthcare Executives, and Oncology Nursing Society.
In addition to her service at the Phoebe Cancer Center and Gatlin Education Services, April is also adjunct faculty at University of Phoenix and Anthem College. In her free time, April enjoys reading, shopping, traveling, and spending time with family and friends
LaTrisha Howard has over 10 years experience in the healthcare industry. Ms. Howard has expertise in coding Inpatient, Outpatient, and ER medical records. In addition to Ms. Howard’s experience in coding, she has experience in chart auditing and physician education.
She is currently working as an ER Coder/Auditor for a physician billing and consulting service, and currently holds the CCS and CPC certification, as well as being a member of AHIMA and AAPC.
Lydia S. Stewart, RN, BSN, received her Bachelor of Science Degree in Nursing from McNeese State University in Lake Charles, La. Lydia currently serves as the Revenue Cycle Manager at a large regional medical center in Northeast Louisiana. Lydia has been a Registered Nurse for 23 years, 15 of those years specializing in Critical Care Nursing and supervision.
Lydia has mentored hundreds of nurses throughout the course of her nursing career. She is responsible for Medical Audits, Charge Capture, and governmental compliance audits and reviews. She performs revenue cycle fundamental and charging education to department directors and hospital staff. Lydia collaborates with the business office to rectify billing edit issues. She performs managed care reviews for accurate payment. Lydia also serves as an independent chargemaster and reimbursement consultant to area outpatient service centers. Lydia is a member of the Louisiana Medical Auditor Association and HFMA.
Lydia enjoys reading, spending time with family, elderly parents and brilliant Boxers Venus and Pluto. She resides in Monroe, La. with her husband and son.
Marguerite Spence has served as a Health Information Specialist since 1997.
Ms. Spence is currently a corporate compliance auditor at a medical center in New York. Ms. Spence simultaneously operates a consulting company where she hires consultants for professional training of medical staff and offers a workshop regarding guidelines and regulations for documentation and coding. Ms. Spence also teaches CPC prep classes at the City University of New York.
Ms. Spence is a certified professional coder. She is a member of AAPC and AMBA.
Ms. Spence is admired by students, doctors, and administrators for her knowledge, skills, and training methods. She is also the proud mother of a Magna Cum Laude graduate of Morgan State University.
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