Unit 1: Career Roles and Responsibilities 1. Role of an Insurance Billing Specialist 2. Compliance, Privacy, Fraud, and Abuse in Insurance Billing Unit 2: The Claims Process 3. Basics of Health Insurance 4. Medical Documentation and the Electronic Health Record 5. Diagnostic Coding 6. Procedural Coding 7. The Paper Claim CMS-1500 (02-12) 8. The Electronic Claim 9. Receiving Payments and Insurance Problem-Solving 10. Office and Insurance Collection Strategies Unit 3: Health Care Payers 11. The Blue Plans, Private Insurance, and Managed Care Plans 12. Medicare 13. Medicaid and Other State Programs 14. TRICARE and Veterans' Health Care 15. Workers' Compensation 16. Disability Income Insurance and Disability Benefit Programs Unit 4: Inpatient and Outpatient Billing 17. Hospital Billing Unit 5: Employment 18. Seeking a Job and Attaining Professional Advancement Tests Appendix A: College Clinic Office Policies and Mock Fee Schedule Appendix B: Medicare Level II HCPCS Codes Appendix C: ICD-10-PCS Section 0 Medical and Surgical, Character 3, Operation Definitions Appendix D: ICD-10-PCS Section 0 Medical and Surgical, Character 5, Approach Definitions
