Dec 07, 2023  
College Catalog 2022-2023 
College Catalog 2022-2023 [ARCHIVED CATALOG]

Revenue Management Specialist Certificate

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Certificate of Completion: 61 credits

Enrollment Point: Fall or Winter Quarter

This program explores the payment systems and the types of reimbursement methodologies used by the U.S. government and other key healthcare organizations. Develop skills and knowledge to transform descriptions of diseases, injuries, conditions, and procedures into numerical designations in clinics, insurance companies, and other medical settings. Apply coding guidelines for CPT®, ICD-9-CM, and HCPCS Level II. Develop an understand of the various types of insurance plans and the application of payer policy, Local Coverage Determinations (LCD), and National Coverage Determinations (NCD) for successful claim submissions. Successful navigation of the varying rules and regulations applying to the healthcare industry, including HIPAA, False Claims Act, Fair Debt Collections Act, and Stark. Graduates will understand of the life cycle of a medical billing claim and how to improve the revenue cycle and proficient in effective claim follow-up, patient follow-up, and denial resolution.

A Certificate of Completion is awarded upon successful completion of core course requirements.

Transfer credit from other institutions is considered upon validation of transcript and course work.

Program Learning Outcomes:

  • Perform business functions in a medical office.
  • Model ethical behavior.
  • Communicate effectively with patients, co-workers and industry professionals.
  • Promote a positive workplace environment.
  • Evaluate medical documentation to identify and assign procedure and diagnostic codes.
  • Analyze clinic coding performance by extracting or auditing revenue performance.
  • Disseminate information on coding standards and requirements to optimize reimbursement.

Program Requirements

Below is the course sequence for students who enter in Fall Quarter. The course sequence for other entry points may vary. 

GPA Requirements

  • Minimum cumulative GPA: 2.0
  • Minimum grade for each course: 2.0

*Note: Clinical & Field-Based Experience courses require a Satisfactory (S) grade.

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