Top 11 Billing Representative Certifications

Certifications for billing representatives demonstrate a commitment to professional excellence and a level of expertise that employers value. They provide tangible evidence that a candidate is knowledgeable in the field and has the skills necessary to perform their job effectively. Certifications can also give employers confidence that they are hiring a qualified individual who will be able to handle the responsibilities of the position. Additionally, having certifications can help distinguish a candidate from others in the job market and can offer them an edge when competing for positions.

This article reviews some of the top certifications for Billing Representatives and explains how they can help to advance a billing representative's career.

What are Billing Representative Certifications?

Billing representative certification is a type of professional certification that validates the knowledge, skills, and abilities of individuals who work in the billing field. This certification demonstrates that an individual has the necessary skills to provide accurate and efficient billing services, ensuring that customers receive timely and accurate bills for their products or services.

The certification process typically includes a written exam, as well as hands-on experience with billing software. Once certified, billing representatives are able to demonstrate their expertise in billing practices, which can lead to increased job opportunities. Additionally, certified professionals are better equipped to handle customer inquiries related to billing issues and can help reduce the number of customer complaints related to inaccurate or delayed bills. In addition, having a certified professional on staff can help businesses build trust with customers by providing assurance that their bills are accurate and up-to-date.

Pro Tip: To become a certified billing representative, you should be knowledgeable about the billing systems, processes, and procedures in your organization. Furthermore, it is important to stay up-to-date on any industry changes or new regulations that may affect your billing process. Additionally, take advantage of available training and certification programs to ensure that you are meeting all requirements and standards.

Related: What does a Billing Representative do?

Top 11 Billing Representative Certifications

Here’s our list of the best certifications available to Billing Representatives today.

1. Certified Medical Billing and Coding Specialist (CMBCS)

A Certified Medical Billing and Coding Specialist (CMBCS) is a professional who specializes in the accurate coding and billing of medical services. This includes assigning codes to medical procedures, diagnoses, and treatments for insurance companies and other third-party payers. CMBCSs are responsible for ensuring that the correct amount is billed to the patient or insurer, as well as making sure that all records are kept up-to-date.

The certification process typically takes anywhere from 6 months to 1 year depending on the individual’s experience level and commitment. To become certified, individuals must complete an accredited program in medical billing and coding, pass a national certification exam, and maintain their certification through continuing education courses.

The cost of becoming certified varies depending on the program chosen; however, most programs range from $2,000-$4,000 including tuition fees, textbooks, and testing fees.

2. Certified Professional Coder (CPC)

Certified Professional Coder (CPC) is a certification offered by the American Academy of Professional Coders (AAPC). This certification is designed to provide professional coders with the knowledge and skills necessary to accurately assign medical codes for diagnosis and procedures.

It typically takes between 6-12 months to become a CPC, depending on the individual's experience and level of commitment. To become certified, individuals must pass an exam administered by the AAPC. The exam consists of 150 multiple choice questions covering topics such as anatomy and physiology, medical terminology, coding guidelines, reimbursement processes, and more.

The cost of becoming a CPC varies depending on the type of membership you select with the AAPC. Membership fees range from $50-$150 per year plus the cost for taking the exam ($399 for non-members).

3. Certified Electronic Health Records Specialist (CEHRS)

Certified Electronic Health Records Specialist (CEHRS) is a certification program that recognizes individuals who have demonstrated the knowledge and skills necessary to effectively use electronic health records (EHRs) in healthcare settings. The CEHRS certification is offered by the National Healthcareer Association (NHA).

The CEHRS program consists of two parts: an online exam and a hands-on practicum. The online exam tests the candidate’s knowledge of EHRs, including topics such as patient privacy and security, data management, and system integration. The practicum provides practical experience with EHRs in a healthcare setting.

To be eligible for the CEHRS certification, candidates must have at least one year of experience working with EHRs in a healthcare setting. Candidates must also complete an approved training program or course related to EHRs prior to taking the exam.

The CEHRS certification process typically takes between four and six weeks to complete. To get certified, candidates must register for the exam through NHA's website and pay an application fee of $200 USD. After registering, candidates will receive instructions on how to access the online exam and practicum materials. Once they have completed both parts of the program, they will receive their official CEHRS certification from NHA.

The cost of becoming a Certified Electronic Health Records Specialist (CEHRS) includes the registration fee ($200 USD), any applicable training costs, and any additional fees associated with taking the online exam or practicum.

4. Certified Revenue Cycle Professional (CRCP)

Certified Revenue Cycle Professional (CRCP) is a professional certification program designed to recognize individuals who have demonstrated knowledge and proficiency in the revenue cycle. The CRCP credential is awarded by the Healthcare Financial Management Association (HFMA), a non-profit organization dedicated to helping healthcare organizations succeed financially.

To become certified, an individual must pass a comprehensive exam that covers topics such as billing, coding, collections, reimbursement, compliance, and patient accounting. The exam consists of 150 multiple-choice questions and takes approximately four hours to complete. Candidates must also demonstrate at least two years of full-time experience in the revenue cycle field within the past five years.

The cost of the CRCP exam varies depending on whether or not you are an HFMA member. For members, it costs $500 for non-members it costs $750. After passing the exam, there is an annual fee of $50 to maintain your certification status.

Overall, obtaining a Certified Revenue Cycle Professional certification typically takes about six months from start to finish including studying for the exam and submitting your application materials.

5. Certified Medical Reimbursement Specialist (CMRS)

A Certified Medical Reimbursement Specialist (CMRS) is a professional who specializes in medical billing and coding. The CMRS certification is administered by the American Academy of Professional Coders (AAPC).

The CMRS certification requires passing an exam that covers topics such as medical terminology, anatomy, physiology, healthcare delivery systems, reimbursement methodologies, and coding principles. The exam consists of 150 multiple-choice questions and takes approximately three hours to complete.

In order to take the exam, applicants must have either two years of full-time experience in medical billing and coding or one year of full-time experience plus completion of a formal training program from an accredited institution. Applicants must also pay a fee for the exam. The cost varies depending on the type of membership you have with the AAPC; for non-members, the fee is currently $399 USD.

Once you have passed the exam, you will receive your CMRS certification and be able to use it to demonstrate your expertise in medical reimbursement processes.

6. Certified Healthcare Financial Professional (CHFP)

The Certified Healthcare Financial Professional (CHFP) is a professional certification offered by the Healthcare Financial Management Association (HFMA). It is designed to recognize healthcare financial professionals who demonstrate excellence in the field. The CHFP credential signifies that the individual has achieved a high level of knowledge and expertise in healthcare finance, as well as an understanding of the complexities of the industry.

To become certified, individuals must meet certain eligibility requirements and pass an examination. Eligibility requirements include having at least five years of experience in healthcare finance or related fields, such as accounting or business administration. Applicants must also have a bachelor’s degree from an accredited college or university.

The exam consists of 150 multiple-choice questions covering topics such as financial management, reimbursement systems, managed care, budgeting and forecasting, capital financing, information systems and more. To prepare for the exam, applicants can take HFMA’s online self-study course or attend one of their review courses.

The cost to take the exam is $595 for HFMA members and $795 for non-members. The fee includes access to study materials and practice exams. The exam is offered four times a year at various locations throughout the United States. Once certified, individuals must complete 40 hours of continuing education every two years to maintain their certification status.

7. American Academy of Professional Coders Certification (AAPC)

The American Academy of Professional Coders (AAPC) is a professional organization that provides certification and education for medical coders. The AAPC offers the Certified Professional Coder (CPC) credential, which is the most widely recognized medical coding certification in the United States.

The CPC credential requires applicants to pass a comprehensive exam that covers all aspects of medical coding. To become certified, applicants must have a minimum of two years of professional experience in medical coding or equivalent post-secondary training. The exam typically takes 4-5 hours to complete and consists of 150 multiple choice questions.

The cost for the CPC exam is $399 for AAPC members and $499 for non-members. In addition to the exam fee, applicants may also need to purchase study materials such as textbooks or online courses.

To get started, applicants should visit the AAPC website to register for the CPC exam and review the eligibility requirements. Once registered, they can access study materials and practice exams to help prepare for the test. After successfully passing the exam, they will receive their official CPC certificate from AAPC and be eligible to use their credentials when applying for jobs or contracts in medical coding.

8. National Association of Healthcare Revenue Integrity Certification (NAHRI)

The National Association of Healthcare Revenue Integrity (NAHRI) is a professional organization dedicated to providing education, resources, and certification in the field of healthcare revenue integrity. NAHRI is committed to helping healthcare organizations improve their financial performance by promoting best practices in revenue cycle management.

NAHRI offers the Certified Professional in Healthcare Revenue Integrity (CPHRI) certification, which is designed to recognize individuals who have demonstrated expertise in healthcare revenue cycle management. To be eligible for the CPHRI exam, applicants must have a minimum of two years of experience in the healthcare revenue cycle or a related field.

The CPHRI exam consists of 200 multiple-choice questions and takes approximately four hours to complete. The exam covers topics such as coding and reimbursement, compliance and fraud prevention, managed care contracting, patient accounting and billing, accounts receivable management, collections processes, and more.

To register for the CPHRI exam, applicants must submit an application form along with payment of the $395 fee. Once approved for the exam, applicants will receive a confirmation email with instructions on how to schedule their testing appointment. The CPHRI exam can be taken at any Pearson VUE testing center located throughout the United States.

Once you have successfully passed the CPHRI exam with a score of 70% or higher, you will receive your official CPHRI certification from NAHRI. Your certification will remain valid for three years before needing to be renewed.

9. American Health Information Management Association Certification (AHIMA)

The American Health Information Management Association (AHIMA) is an international professional organization that offers a wide range of certifications to health information management professionals. AHIMA certification is designed to recognize the knowledge and skills of those working in the field, and it is highly regarded by employers.

AHIMA offers several different types of certifications, including Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Coding Associate (CCA), and Certified Documentation Improvement Practitioner (CDIP). Each certification requires a specific set of educational requirements and/or experience before taking the exam.

The amount of time it takes to obtain an AHIMA certification depends on the type of certification you are pursuing. Generally, it can take anywhere from 6 months to 2 years to complete all the necessary requirements for a specific certification.

To get AHIMA certified, individuals must first meet the educational requirements for their chosen certification. After meeting these requirements, they must then pass an exam that covers topics related to their chosen specialty. The exams are administered by Prometric Testing Centers around the world and typically consist of multiple-choice questions.

The cost of getting AHIMA certified varies depending on the type of certification being pursued. Generally, fees range from $200-$400 per exam plus additional fees for study materials and registration costs.

10. Healthcare Financial Management Association Certification (HFMA)

The Healthcare Financial Management Association (HFMA) is a professional organization that provides certification to individuals in the healthcare finance field. The HFMA certifies individuals who demonstrate a mastery of the knowledge and skills necessary to be successful in the healthcare finance industry.

To obtain certification, applicants must first pass an online examination that tests their knowledge of financial management principles and practices. The exam consists of 150 multiple-choice questions which must be completed within three hours. After passing the exam, applicants must also complete an additional 10-hour course in healthcare finance and submit a portfolio demonstrating their understanding of the material.

It typically takes four to six weeks from start to finish to complete all requirements for certification. Applicants should expect to spend approximately 40 hours studying for the exam and completing the coursework associated with it.

The cost for HFMA certification varies depending on whether or not you are already a member of HFMA. For non-members, the cost is $595, while members pay only $395. Additional fees may apply if you need to retake any part of the exam or if you need to resubmit your portfolio for review after initial submission.

11. American Academy of Professional Coders Credentialing Exam (AAPC-CEX).

The American Academy of Professional Coders Credentialing Exam (AAPC-CEX) is a comprehensive exam designed to assess the knowledge and skills of medical coding professionals. The exam consists of 150 multiple-choice questions that cover topics such as medical terminology, anatomy, physiology, disease processes, pharmacology, reimbursement methodologies, and coding guidelines. The exam is administered by the AAPC and can be taken at any one of their testing centers around the country.

The AAPC-CEX takes approximately four hours to complete and is offered in both English and Spanish. To take the exam, you must first register with the AAPC and pay a fee of $399 for members or $449 for non-members. After registering for the exam, you will receive an authorization letter from the AAPC with instructions on how to schedule your test date. Once you have completed the exam, you will receive your results within two weeks.

If you pass the AAPC-CEX, you will be awarded an AAPC Certified Professional Coder (CPC) credential that is valid for three years. This credential demonstrates your expertise in medical coding and allows employers to verify your qualifications for employment or advancement opportunities.

Do You Really Need a Billing Representative Certificate?

No, you do not need a billing representative certificate to work as a billing representative. Although having the certification may give you an edge over other job applicants, it is not strictly required for the role. Employers will likely look for people with experience in accounting or finance and good customer service skills. You can also demonstrate your knowledge and ability to handle billing tasks by providing references from previous employers or by taking classes related to bookkeeping and business operations. Ultimately, having a certification may help you stand out among other job applicants, but it is not necessary to be successful in this field.

Related: Billing Representative Resume Examples

FAQs About Billing Representative Certifications

1. What are the requirements to become a certified billing representative?

Answer: To become a certified billing representative, you must have at least two years of experience in medical office or hospital billing and coding, as well as pass an approved certification exam.

2. How long does a billing representative certification last?

Answer: Most certifications are valid for two years, after which you will need to renew your certification.

3. Is there a fee associated with becoming a certified billing representative?

Answer: Yes, there is typically a fee associated with taking the certification exam and/or any required continuing education courses.

4. What type of job opportunities can I expect with my certification?

Answer: With your certification, you may be able to find employment in hospitals, physician offices, insurance companies, and other healthcare facilities that require knowledge of medical coding and billing processes.

5. Are there any online resources available to help me prepare for the certification exam?

Answer: Yes, there are many online resources available such as practice tests and study guides that can help you prepare for the certification exam.