Medical Billing Certification Programs

Medical billing certification programs are a real option for people such as single mothers who need to find a way to make money from home. Not only can you work from home, but you can also study from home in order to complete the required training. When it comes to these programs you will have two main choices:

  1. Longer programs that lead to certification
  2. Shorter programs that do not lead to certification (but which you could still use as a stepping stone to certification if you wanted to)

In many ways, medical billing certification programs are the better option.

General Overview

Medical billing programs prepare you for a career as a medical biller. Medical billing is a subset of medical coding. Essentially what a medical biller does is to ensure that insurance companies pay for the services that clients make use of. They do this by preparing and submitting reimbursement requests to the insurance companies using special codes and so on. This may seem simple, but it is not and it takes skills such as attention to detail and organization in order to make a career out of an essential occupation such as this one. You have to learn the codes. You need to know what to bill for and you cannot make mistakes as this will make things incredibly difficult for both the insurance company and the patient. In fact it can be a matter of life and death for a patient in certain circumstances.

If you bill with the wrong code, the insurance company may reject the claim because they do not cover it and your patient may die as a result of not receiving adequate treatment. It is something that you cannot afford to be mistaken about. At more basic and all-encompassing level, your mistake could mean a huge difference in price. If you bill an illness as something less severe than it is, the insurance company will not pay out enough to cover the full cost. If you bill it as something more severe than it is, the insurance company loses money. To keep the system running smoothly you have to be on your toes at all times. Medical billing will most likely not be the only thing that you do. Most medical billers also have to do a variety of other tasks, so you may want to supplement your medical billing program with programs in:

  • Administration, and
  • Medical documentation

These are the two most common task areas that medical billers function in after medical billing itself.

Steps to Becoming a Medical Biller

The first thing that you will have to do is to look into medical billing certification programs. There are quite a few on offer. The three main places where you can do a program like this are through a:

  • Vocational program
  • Community college
  • Professional certification program

The last will take the longest, usually about 2 years, but it does mean that you will be a certified medical biller at the end of the day. This is a good because more people will want to hire you if you have a decent qualification like this than if you are not certified. However not everyone is able to devote this level of time and effort to the program. You will also be able to prepare for certification if you take a shorter course, so you do have other options. The coursework that will be included in any good program is:

  • Medical terminology
  • Word processing
  • Insurance claim processing

To become a certified medical biller you will have toMedical Billing Certification decide what certification you want. There are two bodies that offer certification:

  • The Medical Association of Billers – the Certified Medical Billing Specialist (CMBS) exam with a training component: possess a high school diploma and complete the six online courses that the association offers; once complete, register for the exam OR demonstrate adequate billing experience that renders the exam unnecessary
  • The American Medical Billing Association – Certified Medical Reimbursement Specialist (CMRS) title without a training component: anyone can register for an take this exam

Once you have chosen the organization you would prefer, register with them. It is impossible to do the exam and become certified unless you are registered with one of these medical billing associations. Pay the membership fee and ensure that you are fully aware of the processes and requirements for certification through that organization.


Although becoming certified is not compulsory, it is certainly beneficial to do so. Here are the reasons why:

  • You will stand a higher chance of getting a good quality job if you take the time to become certified. This is because your qualification will, essentially, be taken more seriously.
  • You will receive recognition. This is closely ties to the previous point as the government will not allow medical coders who are not certified to work for organizations such as Medicaid. This is because it is a well known fact that a certified medical biller has proven his or her skills in the area whereas a biller without certification has not necessarily proven this at all.
  • You will most likely receive a higher rate of pay if you are certified than if you are not certified. Pay also increases depending on how much experience you have.

In short it is extremely worthwhile to look into medical billing certification programs rather than just medical billing programs that do not lead you to achieve certification.

Working from Home

If you intend to work from home as a medical biller, which is what many medical billers do, you will, after you have completed your training and received certification, have to get a business license. This is because you will be operating your own business from your home and you will therefore be an independent contractor.

It is also a good idea to get some marketing material together. For example you could consider printing a few business cards and flyers in order to spread the word about eh small medical coding business you plan to start in the comfort of your own home. Advertise online. Although there are free sites for this you will have more success in sites where you have to pay a subscription fee as you will be taken just that much more seriously.

People who need medical coders also advertise online so you can spend some time each day looking at these ads until you find a job that fits what you are offering. Last but not least you need to spend some time contacting the healthcare facilities in your area and offering your services. Even if you do not find work right away in this manner, you will certainly be kept in mind if they need a medical coder again in the future. You will need to keep your working environment in your home extremely organized and well structured in order to avoid making unnecessary errors. Simply because you are working from home does not mean that you can afford to get distracted easily. Set clear boundaries and create a strict schedule and follow it.

Things You Need To Be Aware Of

There are a number of very crucial things that you need to look out for when it comes to medical billing certification programs. If you are looking for a decent program that will help you achieve your primary goal of becoming a successful medical biller, you will need to keep the following in mind:

  • Make sure that the person who will be teaching you on the medical billing program is someone that is either a medical biller or coder themselves with a lot of experience, or someone that owns a successful medical billing business.
  • Try to avoid schools that teach everything. Find a program that specializes in only a few areas, including, of course, medical billing. In this way you will stand a higher chance of getting the in-depth education that you need.
  • Have a look at the time frame for the course. The only instances in which the program will take you 2 years or more to complete is if you do not have time to dedicate yourself to the course on a full-time basis, the course you choose includes a number of additional subjects, or the course you are taking is preparing you to take a certification exam. If none of these conditions are present you should not take 2 years to complete the course.
  • On the other hand the course cannot be too short. There are about 8 essential aspects to medical billing that you must learn. This cannot be done as a cram course if you are to be a successful medical biller.
  • Have a look at the price. A good course will only cost about $500 to $700. The only time a good course will charge substantially more is if you are also being trained to sit the certification examination. If you are not going to sit the exam with the help of the course, be very suspicious of any course above $700 – this may be an indication that the course conveners are trying to line their pockets with your money and that they don’t have your best interests at heart.
  • Be suspicious of a medical billing program that claims that it will certify you after the course. Certification is a long and complex process. In addition there are only three bodies that can certify you and they are not schools. A course can help you prepare to sit an exam but cannot guarantee you certification.
  • If the course you are involved in is an online course (which many of them are), but the conveners are pushing you to work at their pace, consider an alternative option. The point of this kind of studying is that you are able to work at your own pace.
  • The school should also provide you with a number of different payment options. This is so that any student from any financial background should be able to find a way to pay for the course. If this stipulation is not present you may want to look into attending an alternative course.
  • Last but not least be incredibly suspicious of any school that will not put you in contact with present or past students from the school as this is a good indication that they are either not a genuine medical billing school or that they do not have a very good reputation or success rate.

Medical Billing Certification Programs

There are a number of different places that you can go to in order to receive the medical billing training that you need to become a professional in the field. The schools mentioned below are just a few of your options. A good place to start would be to look into what options are offered specifically in your state so that you can be sure that, at the very least, the program will be located nearby. Many programs can be completed online as well, so do not forget that aspect of your choice.

  • Ultimate Medical Academy
  • Kaplan University
  • Gatlin Education
  • Drexel University Online
  • California State University

Medical billing is not an easy job. You cannot look at this profession from the point of view that it will be a simple way for you to make money and support yourself. Nearly anyone can become a medical biller if they put the right thought and effort into it, but if you do not have the attention to detail and the attitude required you will not make a success of your career in this regard. That being said, this is an excellent way to work if you have kids or other commitments and you have to work from home.