Top 10 Insurance Billing Specialist Certifications

Certifications for an insurance billing specialist are important in the job market because they demonstrate that a candidate has the necessary knowledge and skills to perform the job. They provide employers with assurance that the individual is qualified and experienced in the field. Additionally, certifications can open up new opportunities for advancement and higher pay. Certification also serves as proof of competency to clients, which can help build trust and confidence in their services.

This article reviews some of the top certifications for Insurance Billing Specialists and explains how they can help to advance an insurance billing specialist's career.

What are Insurance Billing Specialist Certifications?

Insurance billing specialist certification is a specialized form of training and certification that focuses on the specific skills and knowledge needed to work as an insurance billing specialist. This type of certification is typically obtained through a professional organization, such as the American Association of Professional Coders (AAPC). The certification process requires candidates to demonstrate their expertise in insurance billing processes, including medical coding, reimbursement systems, and claim processing.

The primary benefit of obtaining insurance billing specialist certification is that it helps to ensure that individuals are qualified to perform their job duties effectively and efficiently. By having this specialized knowledge, professionals can ensure that claims are processed accurately and quickly, leading to better customer service for patients and healthcare providers alike. Additionally, having insurance billing specialist certification can help professionals increase their marketability in the industry by demonstrating their commitment to quality assurance standards. Finally, having this type of certification can also provide access to additional career opportunities within the field due to its recognition as a sign of expertise.

Pro Tip: Make sure to take advantage of any continuing education opportunities available for insurance billing specialists. This will help ensure that you stay up-to-date on the latest trends and best practices in the field, as well as provide a way to demonstrate your commitment to professional development and certification renewal.

Related: What does an Insurance Billing Specialist do?

Top 10 Insurance Billing Specialist Certifications

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

1. Certified Professional Coder (CPC)

Certified Professional Coder (CPC) is a professional certification in medical coding. It is offered by the American Academy of Professional Coders (AAPC). This certification is designed to recognize individuals who have demonstrated their knowledge and proficiency in the field of medical coding.

It typically takes 6-12 months to prepare for the CPC exam, depending on experience and study time. To get certified, applicants must pass an exam that covers topics such as anatomy and physiology, medical terminology, ICD-10-CM/PCS coding systems, HCPCS Level II coding system, CPT coding system, and reimbursement methodologies.

The cost of the CPC exam varies depending on the location of the testing center but generally ranges from $300-$400. Additionally, there are other costs associated with taking the exam such as purchasing study materials or attending review courses.

2. Certified Medical Reimbursement Specialist (CMRS)

A Certified Medical Reimbursement Specialist (CMRS) is a professional who specializes in the medical reimbursement process. The CMRS credential is awarded by the American Medical Billing Association (AMBA) and is designed to recognize individuals who have demonstrated a high level of knowledge and experience in medical reimbursement processes.

To become certified, applicants must pass an exam that covers topics such as insurance coding, billing, and reimbursement practices. The exam also includes questions on healthcare regulations, HIPAA compliance, and patient privacy. It typically takes about four to six months to prepare for the exam, depending on the individual’s prior experience with medical reimbursement processes.

The cost of taking the CMRS exam varies based on the applicant’s country of residence. In the United States, it costs $225 for members of AMBA and $325 for non-members. After passing the exam, applicants must pay an additional fee of $50 to receive their certification from AMBA.

Once certified, CMRS professionals can work in a variety of settings including hospitals, clinics, physician offices, insurance companies and other healthcare organizations. They are responsible for ensuring that all claims are processed accurately and efficiently while adhering to applicable laws and regulations.

3. Certified Electronic Health Records Specialist (CEHRS)

Certified Electronic Health Records Specialists (CEHRS) are professionals who have been certified by the National Healthcareer Association (NHA) to demonstrate their knowledge and expertise in the use of electronic health records (EHRs). This certification is designed for individuals who work in a variety of healthcare settings, including hospitals, physician offices, long-term care facilities, and home health agencies. The CEHRS certification demonstrates that an individual has a comprehensive understanding of EHR systems and how to effectively use them to improve patient care.

It takes approximately 6-8 weeks to complete the CEHRS program. The program consists of six modules that cover topics such as EHR system implementation, data management, security and privacy considerations, coding and documentation requirements, regulatory compliance issues, and more. After completing all six modules, applicants must pass an exam administered by the NHA in order to become certified.

The cost of obtaining the CEHRS certification varies depending on the provider offering it. Generally speaking, it will cost between $500-$1000 USD for tuition fees plus any additional fees associated with taking the exam.

4. Certified Professional Biller (CPB)

Certified Professional Biller (CPB) is a certification program for medical billing professionals that demonstrates their knowledge and skills in the field. It is offered by the American Academy of Professional Coders (AAPC). The CPB certification requires a minimum of two years of professional medical billing experience, as well as passing an exam. The exam covers topics such as coding, reimbursement methodology, compliance regulations, and other aspects of medical billing.

It takes approximately four to six weeks to complete the CPB certification process. First, you must register with AAPC and pay the registration fee ($199). Then you will need to complete an online application and submit your resume and any other required documents. Once your application has been approved, you will be able to access the study materials and take practice exams. Finally, you will need to pass the CPB exam with a score of at least 70%.

The cost for the CPB certification varies depending on whether or not you are a member of AAPC. For members, the cost is $299; for non-members, it is $399. In addition to these fees, there may also be additional costs associated with taking practice exams or purchasing study materials.

5. Certified Medical Billing and Coding Specialist (CMBCS)

A Certified Medical Billing and Coding Specialist (CMBCS) is a professional who specializes in medical billing and coding. They are responsible for accurately coding patient information for insurance companies, government programs, and other healthcare organizations. This process involves assigning codes to diagnoses, treatments, procedures, medications, supplies, and equipment used in patient care.

It typically takes between one to two years of study to become a Certified Medical Billing and Coding Specialist. The program includes courses in medical terminology, anatomy and physiology, medical coding systems such as ICD-10-CM/PCS, HCPCS Level II codes, CPT codes, medical software applications such as Practice Management Software (PMS), Electronic Health Records (EHRs), third party payer regulations and guidelines, Medicare rules and regulations, HIPAA compliance laws etc.

In order to become certified as a CMBCS you must pass the American Academy of Professional Coders (AAPC) certification exam. The cost of the exam varies depending on the type of certification you are seeking. Generally speaking it costs around $300-$400 USD for the exam itself plus any additional fees associated with membership or study materials.

Once you have passed your exam you will be awarded your CMBCS credential which is valid for two years from the date of issue. You must renew your certification every two years by completing continuing education credits or taking another AAPC certification exam.

6. American Academy of Professional Coders (AAPC) Certification

The American Academy of Professional Coders (AAPC) is a professional organization for medical coders. It offers various certifications to help coders demonstrate their knowledge and skills in the field.

AAPC certification is a nationally recognized credential that validates an individual’s expertise in medical coding. It is designed to recognize those who have achieved a level of proficiency in the field, and it helps employers identify qualified candidates for job openings.

To become certified, one must pass an exam administered by AAPC. The exam covers topics such as anatomy and physiology, medical terminology, coding systems, reimbursement methodologies, and compliance regulations. The exam typically takes 3-4 hours to complete and consists of 150 multiple-choice questions.

To be eligible to take the exam, applicants must have at least two years of on-the-job experience as a coder or completion of an accredited coding program within the past five years. They must also pay an exam fee of $399 USD and submit proof of education and experience requirements to AAPC prior to taking the test.

Once they pass the exam, individuals will officially become AAPC certified professionals with access to exclusive benefits such as discounts on continuing education courses, access to online resources and networking opportunities with other certified professionals.

7. National Healthcareer Association’s Certified Medical Administrative Assistant (CMAA)

The National Healthcareer Association's Certified Medical Administrative Assistant (CMAA) is a certification program designed to recognize excellence in medical administrative assistants. This certification demonstrates that the individual has the knowledge and skills necessary to perform administrative duties in a healthcare setting.

The CMAA requires applicants to have at least one year of experience working as a medical administrative assistant, or equivalent education and experience. It also requires applicants to pass an exam that covers topics such as medical terminology, insurance billing, coding and reimbursement, patient scheduling, and other related topics. The exam consists of 100 multiple-choice questions and must be completed within two hours.

To get the CMAA certification, individuals must first submit an application through the NHA website. Once approved, they will receive access to study materials and can schedule their exam date. The cost for the certification is $125 for NHA members or $175 for non-members. After passing the exam, individuals will receive their official certificate from NHA within 6-8 weeks.

8. National Association for Health Professionals’ Certified Medical Coder/Biller (CMCPB)

The National Association for Health Professionals’ Certified Medical Coder/Biller (CMCPB) is a certification program designed to recognize individuals who have demonstrated expertise in medical coding and billing. It is an industry-recognized credential that demonstrates mastery of the skills necessary to accurately code and bill for healthcare services.

To become a Certified Medical Coder/Biller, you must complete an approved training program and pass the CMCPB exam. The training program typically takes between two and four months to complete, depending on the individual's experience level. The exam consists of 150 multiple-choice questions covering topics such as anatomy, physiology, medical terminology, coding guidelines, insurance regulations, and reimbursement practices.

To be eligible for the CMCPB exam, applicants must have either completed an accredited medical coding or billing program or have at least three years of full-time coding or billing experience within the last five years. Applicants must also submit proof of their education and/or work experience along with their application form.

The cost to take the CMCPB exam is $250 USD plus any applicable taxes or fees. This fee includes access to study materials as well as one attempt at taking the exam. Additional attempts may be purchased for $50 each if needed.

9. American Health Information Management Association’s Registered Health Information Technician (RHIT)

The Registered Health Information Technician (RHIT) is a professional credential offered by the American Health Information Management Association (AHIMA). It is designed to recognize individuals who have demonstrated the knowledge and skills necessary to manage and protect patient health information.

To become an RHIT, an individual must complete a two-year associate degree in health information technology from an accredited college or university. The program must include courses in medical terminology, anatomy and physiology, coding systems, computer systems, healthcare reimbursement methods, legal aspects of healthcare data management, and quality improvement techniques. After completing the degree program, individuals must pass the RHIT exam administered by AHIMA.

The cost of taking the RHIT exam varies depending on where you take it. Generally speaking, it costs around $250 plus any applicable taxes or fees. It can take up to six weeks to receive your results after taking the exam.

Once you have passed the RHIT exam, you will be eligible for certification as a Registered Health Information Technician. You will then be able to use the credentials “RHIT” after your name on resumes and other professional documents. This credential is valid for five years before needing to be renewed with continuing education credits or retaking of the examination.

10. American Academy of Professional Coders' Certified Outpatient Coder (COC).

The Certified Outpatient Coder (COC) credential is offered by the American Academy of Professional Coders (AAPC). The COC credential is a certification that validates an individual’s knowledge and proficiency in outpatient coding. It demonstrates that the individual has acquired the necessary skills to accurately code diagnoses and procedures for outpatient services.

To get the COC credential, applicants must first pass a certification exam, which consists of 150 multiple-choice questions. The exam covers topics such as ICD-10-CM diagnosis coding, HCPCS Level II procedure coding, and medical terminology. Applicants must also have at least two years of professional coding experience in an outpatient setting or complete a formal education program in medical coding.

The cost of the COC certification exam is $399 USD for AAPC members and $499 USD for non-members. The exam can be taken at any authorized testing center around the world or online via remote proctoring. After passing the exam, applicants will receive their COC certificate within four to six weeks.

The COC credential is valid for two years from the date it was awarded and can be renewed by completing continuing education credits or retaking the certification exam.

Do You Really Need a Insurance Billing Specialist Certificate?

The answer to this question depends on your goals and the type of job you are seeking. If you are looking for a job as an insurance billing specialist, then having a certificate in this area can certainly be beneficial. Having a certificate demonstrates that you have taken the time to learn about the insurance billing process and have acquired specialized knowledge that is important for this profession.

Having a certificate in insurance billing can also help you stand out among other candidates when applying for jobs. Employers may view your certification as an indication that you are serious about your career and have invested in developing additional skills related to the field. Additionally, having a certificate may help qualify you for higher positions or more competitive roles within the industry.

Ultimately, if you want to pursue a career in insurance billing, having an insurance billing specialist certificate can be very beneficial and may even give you an edge over other candidates. However, it is important to weigh the cost of obtaining such a certificate against any potential benefits it may provide before making your decision.

Related: Insurance Billing Specialist Resume Examples

FAQs About Insurance Billing Specialist Certifications

1. What is an Insurance Billing Specialist Certification?

Answer: An Insurance Billing Specialist Certification is a professional certification that validates the knowledge and skills of individuals who work in the insurance billing field. It demonstrates proficiency in processing claims, coding and billing procedures, and other related topics.

2. How do I become certified as an Insurance Billing Specialist?

Answer: To become certified as an Insurance Billing Specialist you must pass a certification exam administered by a recognized organization such as the American Academy of Professional Coders (AAPC) or the National Association of Certified Medical Coders (NACMC).

3. What are the benefits of being certified as an Insurance Billing Specialist?

Answer: The primary benefit of becoming certified as an Insurance Billing Specialist is that it can lead to increased job opportunities, higher salaries, and greater career advancement potential. Having this certification also sets you apart from others in your field, making you more attractive to potential employers.

4. How long does it take to become certified as an Insurance Billing Specialist?

Answer: The amount of time required to become certified will depend on individual preparation for the certification exam. Typically, it takes between six months and one year for most individuals to study for and pass the exam.

5. Are there continuing education requirements for maintaining my Insurance Billing Specialist Certification?

Answer: Yes, most certifying organizations require that you complete continuing education courses every two years in order to maintain your certification status. These courses help ensure that you stay up-to-date on industry knowledge and trends so that you can continue providing quality services to clients.