Top 10 Medical Biller Certifications

Certifications are an important part of the job market for medical billers. Certifications demonstrate a level of knowledge and proficiency in the field that can be attractive to employers. Having a certification also shows that a medical biller is committed to their profession and has taken the time to develop their skills. Additionally, certifications often come with continuing education requirements, meaning that certified medical billers are more likely to stay up-to-date on industry trends and changes than those without certifications. Ultimately, having a certification can give medical billers an edge in the job market by making them stand out from other applicants.

The purpose of this article is to review some of the top certifications for Medical Billers and explain how they can help to advance a medical biller's career.

What are Medical Biller Certifications?

Medical biller certification is a professional credential that demonstrates competence in the field of medical billing and coding. It provides proof to employers that an individual has the knowledge and skills necessary to perform the job correctly and efficiently. Certification also serves as a signal of quality to patients, insurers, and other stakeholders who rely on accurate and timely billing processes.

Having a medical biller certification helps individuals stand out from the competition when applying for jobs or seeking promotions. It can also make them more attractive candidates for advancement within their existing employer’s organization. Additionally, having certification may help medical billers access higher salaries, better benefits packages, or other perks associated with increased expertise in their field. Finally, it can provide individuals with a greater sense of professional satisfaction by validating their commitment to their profession.

Pro Tip: If you are considering becoming a medical biller, make sure to research the different certifications available. Different certifications may require different levels of education and experience, so be sure to find out which one best fits your goals. Additionally, look into any continuing education requirements that the certification requires in order to stay valid.

Related: What does a Medical Biller do?

Top 10 Medical Biller Certifications

Here’s our list of the best certifications available to Medical Billers today.

1. Certified Professional Medical Biller (CPMB)

Certified Professional Medical Biller (CPMB) is a professional certification program offered by the American Academy of Professional Coders (AAPC). The CPMB credential is designed to recognize individuals who have demonstrated the knowledge and skills necessary to effectively manage medical billing operations.

The CPMB certification requires applicants to pass an exam that covers topics such as medical coding, insurance reimbursement, and healthcare regulations. The exam consists of 150 multiple-choice questions and must be completed within three hours.

To be eligible for the CPMB certification, applicants must have at least two years of experience in medical billing or coding, or have passed an AAPC-approved course in medical billing or coding. Applicants also need to complete an online application and pay a fee of $299.

Once the application is approved, applicants will receive a link to register for the exam. After passing the exam, applicants will receive their CPMB certification from AAPC. The certification is valid for two years and can be renewed by completing continuing education credits or retaking the exam.

2. Certified Medical Reimbursement Specialist (CMRS)

A Certified Medical Reimbursement Specialist (CMRS) is a professional who specializes in medical billing and coding. They are responsible for ensuring that claims are accurately processed and paid by insurance companies, Medicare, Medicaid, and other third-party payers. CMRSs must be knowledgeable about the various rules, regulations, and procedures that govern medical reimbursement.

It typically takes between 6 months to 1 year to become a Certified Medical Reimbursement Specialist (CMRS). To qualify for certification, individuals must have at least one year of experience in medical billing or coding and pass an exam administered by the American Academy of Professional Coders (AAPC).

To get certified as a CMRS, you will need to complete an accredited medical billing or coding program. You can find these programs online or through local community colleges. Once you have completed your program, you will need to register with the AAPC and take their certification exam. The cost of the exam varies depending on the type of membership you select with AAPC but usually ranges from $100-$200 USD.

Once you have passed the exam, you will receive your CMRS certification which is valid for two years before needing to be renewed. Renewal fees vary depending on the type of membership but generally range from $50-$100 USD.

3. Certified Medical Billing and Coding Specialist (CMBCS)

A Certified Medical Billing and Coding Specialist (CMBCS) is an individual who has been trained to accurately process medical insurance claims, code medical procedures and diagnoses, and interpret medical terminology. They are responsible for ensuring that all claims submitted to insurance companies are accurate and complete.

It typically takes between 6-12 months to become a Certified Medical Billing and Coding Specialist (CMBCS). This includes completing a formal training program in medical billing and coding, passing the national certification exam, and obtaining the necessary certifications or licenses required by the state.

To become a Certified Medical Billing and Coding Specialist (CMBCS), you must first complete a formal training program in medical billing and coding. These programs can be found at community colleges, vocational schools, universities, or online. After completing your training program, you must take the national certification exam administered by either the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA). Once you have passed this exam, you will need to obtain any additional certifications or licenses required by your state.

The cost of becoming a Certified Medical Billing and Coding Specialist (CMBCS) varies depending on which type of program you choose to complete. Generally speaking, it can range from $2,000-$10,000 for tuition alone. Additional costs may include textbooks, software fees, certification exam fees, licensing fees, etc.

4. Certified Professional Coder (CPC)

Certified Professional Coder (CPC) is a professional certification for medical coding professionals who work in the healthcare industry. It is offered by the American Academy of Professional Coders (AAPC). The CPC certification demonstrates that an individual has achieved a certain level of competency in medical coding and billing.

It typically takes between four to six months to prepare for the CPC exam, depending on how much time an individual can dedicate to studying. To become certified, individuals must pass a comprehensive exam that covers topics such as anatomy, physiology, ICD-10-CM/PCS, CPT®, HCPCS Level II and reimbursement methodologies.

To get the CPC certification, individuals must first become a member of AAPC and pay the membership fee. Once they are members, they can register for the exam online or by mail. The cost of taking the exam ranges from $300-$400 USD depending on whether you are an AAPC member or not.

5. Certified Medical Office Manager (CMOM)

Certified Medical Office Manager (CMOM) is a professional certification program offered by the American Academy of Professional Coders (AAPC). It is designed to recognize and validate the knowledge, skills, and abilities of medical office managers in managing a successful healthcare practice.

The CMOM certification requires applicants to have at least two years of experience as a medical office manager or supervisor in a healthcare setting. Applicants must also pass an exam that covers topics such as patient relations, billing and coding, insurance claims processing, appointment scheduling, and medical record keeping.

The exam consists of 150 multiple-choice questions and takes about three hours to complete. The cost for the exam is $299 for AAPC members and $399 for non-members. Once you pass the exam, you will receive your CMOM certification which is valid for two years from the date of issuance. After two years, you will need to renew your certification by submitting proof of continuing education credits or taking an additional exam.

6. American Academy of Professional Coders (AAPC)

The American Academy of Professional Coders (AAPC) is a professional organization that provides certification and education to medical coding professionals. It is the largest medical coding certification organization in the United States, with over 150,000 members.

To become certified through the AAPC, you must first pass an exam. The exam consists of multiple-choice questions covering topics such as anatomy and physiology, medical terminology, diagnosis coding, procedure coding, reimbursement methodologies, and compliance regulations. The exam takes approximately four hours to complete and costs $399 for non-members or $299 for members.

Once you have passed the exam, you will receive your Certified Professional Coder (CPC) certification from the AAPC. This certification is valid for two years and can be renewed by taking continuing education courses or retaking the exam.

The cost of membership in the AAPC varies depending on which type of membership you choose. For example, a basic membership costs $99 per year while a premium membership costs $199 per year. Membership benefits include access to educational materials and discounts on products and services related to medical coding.

7. National Healthcareer Association’s Certified Electronic Health Records Specialist (CEHRS)

The Certified Electronic Health Records Specialist (CEHRS) is a certification offered by the National Healthcareer Association (NHA) that validates an individual’s knowledge and skills in the use of electronic health records. The CEHRS certification is designed to help healthcare professionals demonstrate their expertise in the area of electronic health record management.

To become certified, individuals must pass a comprehensive exam that covers topics such as: patient data management, privacy and security, system design and implementation, workflow optimization, and more. The exam consists of 125 multiple-choice questions and must be completed within two hours.

In order to take the exam, individuals must first register with NHA and pay a fee of $199. Once registered, individuals can take the exam at any Pearson VUE testing center or online from home. The entire process typically takes about 4-6 weeks from registration to receiving results.

Upon successful completion of the exam, individuals will receive their CEHRS certification which is valid for two years. To maintain certification status, individuals must complete 20 hours of continuing education every two years.

8. American Health Information Management Association's Registered Health Information Technician (RHIT)

The Registered Health Information Technician (RHIT) is a professional certification offered by the American Health Information Management Association (AHIMA). It is designed for individuals who have a working knowledge of health information management and technology, and who are responsible for managing patient health information.

To qualify for the RHIT certification, applicants must have an Associate’s degree in Health Information Technology from an accredited institution or equivalent coursework. They must also pass the AHIMA RHIT exam, which consists of 200 multiple-choice questions that cover topics such as medical terminology, coding systems, legal and ethical issues in health information management, data analysis and quality improvement techniques.

The exam can be taken at any Pearson VUE testing center located throughout the United States. The cost of the exam varies depending on location but typically ranges from $200 to $300 USD. The exam takes approximately three hours to complete.

Once certified, RHITs are required to maintain their credentials by completing continuing education requirements every two years. This includes attending conferences and workshops related to health information management or taking online courses. The cost of continuing education varies depending on the type of course chosen.

9. National Alliance of Medical Auditing Specialists' Certified Medical Auditor (CMA)

The National Alliance of Medical Auditing Specialists (NAMAS) Certified Medical Auditor (CMA) is a certification that demonstrates a professional’s knowledge and expertise in medical auditing. This certification is designed for professionals who are responsible for reviewing and analyzing medical records to ensure accuracy, compliance, and quality of care.

In order to become certified as a CMA, an individual must complete the NAMAS Certification Program. This program consists of two components: an online course and an online exam. The online course covers topics such as medical coding, reimbursement systems, audit techniques, and data analysis. The online exam tests the candidate’s knowledge of medical auditing principles and practices.

The cost of the NAMAS Certification Program is $595 USD. The program takes approximately 10 hours to complete, depending on the individual’s learning pace. Upon successful completion of both components, individuals will receive their CMA certification from NAMAS.

10. National Healthcareer Association's Certified Billing and Coding Specialist (CBCS).

The National Healthcareer Association's Certified Billing and Coding Specialist (CBCS) is an industry-recognized certification for individuals who work in the medical billing and coding field. The CBCS credential demonstrates that the individual has the necessary knowledge and skills to accurately code medical services, procedures, and diagnoses.

To become certified as a CBCS, individuals must pass a comprehensive exam that covers topics such as medical terminology, anatomy and physiology, coding systems, reimbursement methodologies, health insurance plans, and other related topics. The exam consists of 125 multiple-choice questions with a time limit of 2 hours. Candidates must answer at least 70% of the questions correctly in order to pass the exam.

In order to be eligible to take the CBCS exam, candidates must have at least one year of experience working in medical billing or coding or have completed an accredited program in medical billing or coding. Candidates may also be required to submit proof of their education or experience prior to taking the exam.

The cost for taking the CBCS exam is $199 USD for NHA members and $239 USD for non-members. The fee includes access to online study materials such as practice tests and flashcards. Once certified, individuals must renew their certification every two years by completing continuing education activities and paying an annual renewal fee of $99 USD for NHA members or $129 USD for non-members.

Do You Really Need a Medical Biller Certificate?

Whether or not you need a medical biller certificate depends on your individual situation. If you are already working in the field of medical billing, then having a certificate may be beneficial to you. It could help demonstrate to employers that you have advanced knowledge and skills in this area, which could make it easier for you to find better job opportunities. A certificate also serves as a way of validating your knowledge and expertise in the field, which can be helpful when looking for promotions or higher-paying jobs.

On the other hand, if you are just starting out in medical billing, then a certificate may not be necessary. You can still learn the basic skills and knowledge needed for the job without one, such as coding basics, understanding different types of insurance plans, and dealing with patient inquiries. However, if you want to become an expert in the field, then getting a certificate might be worth considering. It can provide more detailed instruction on topics like healthcare regulations and compliance standards that can help you stand out from other applicants in the job market.

Ultimately, it’s up to you to decide whether or not getting a medical biller certificate is right for your career goals. Consider your current experience level and what kind of job opportunities are available in your area before making a decision.

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FAQs About Medical Biller Certifications

1. What is a Medical Biller Certification?

A Medical Biller Certification is a credential that validates an individual's knowledge and skills in medical billing processes and procedures. It is designed to demonstrate the ability to accurately process healthcare claims and manage patient accounts.

2. How long does it take to get a Medical Biller Certification?

The length of time required to obtain a Medical Biller Certification varies depending on the program chosen, but typically takes between 6-12 months.

3. What are the requirements for obtaining a Medical Biller Certification?

Requirements for obtaining a Medical Biller Certification vary depending on the provider, but may include completing coursework in medical coding, medical billing, health care regulations, and other related topics; passing an exam; and/or having prior work experience in the field of medical billing.

4. What types of jobs can I get with a Medical Biller Certification?

With a Medical Biller Certification, you may be eligible for positions such as medical billers, insurance claim processors, coding specialists, health information technicians, and more.

5. Is there any continuing education required after obtaining my certification?

Yes, some providers require ongoing continuing education credits in order to maintain your certification status.