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Top 10 Medical Billing Clerk Certifications

This article provides an overview of the top certifications available for medical billing clerks, including requirements and benefits.

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Brenna Goyette
Certified Professional Resume Writer, Career Expert

Published 16 min read

Certifications are important for medical billing clerks in the job market because they demonstrate to employers that the individual has a deep understanding of the job and is qualified to perform it. Certification can also help individuals stand out from other applicants and show potential employers that they have taken the initiative to gain specialized knowledge. Certifications also provide proof of competency, which is especially important in the medical field where accuracy and attention to detail are essential. Finally, certifications may provide access to more job opportunities due to increased demand for certified personnel in certain areas.

This article reviews some of the top certifications for Medical Billing Clerks and explains how they can enhance a medical billing clerk's career by providing valuable credentials and knowledge.

What are Medical Billing Clerk Certifications?

Medical billing clerk certification is a type of professional certification that provides an individual with the knowledge, skills, and abilities necessary to work as a medical billing clerk. This type of certification can help individuals become more proficient in their job roles and increase their career potential within the healthcare industry.

With medical billing clerk certification, individuals will learn how to accurately process and manage patient information, including filing insurance claims, verifying coverage eligibility, entering data into the system correctly and efficiently, and handling any discrepancies or issues that arise during the process. They will also learn important concepts related to coding, auditing processes, managing accounts receivable, and other key aspects of medical billing.

By obtaining medical billing clerk certification, individuals can demonstrate their commitment to excellence in the field and gain an edge over other applicants when seeking employment. It is also beneficial for those already employed in medical billing positions as it helps them stay up-to-date on new industry trends and regulations while providing them with a greater understanding of how to complete tasks more effectively. Ultimately, having a medical billing clerk certification can help individuals become more confident in their duties while giving them the tools needed to be successful in this demanding role.

Pro tip: Consider obtaining a Certified Medical Billing and Coding Specialist (CMBCS) certification to demonstrate your expertise in medical billing and coding. The CMBCS certification is offered by the American Academy of Professional Coders (AAPC) and requires passing an exam, completing a course or having two years of experience in the field. Having this certification will make you more marketable and help you stand out from other job applicants.

Related: What does a Medical Billing Clerk do?

Top 10 Medical Billing Clerk Certifications

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

1. Certified Professional Coder (CPC)

Certified Professional Coder (CPC) is a certification offered by the American Academy of Professional Coders (AAPC). It is a professional credential that demonstrates mastery of medical coding and billing.

To become certified, applicants 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, ICD-10-CM/PCS coding, HCPCS Level II coding, CPT® coding, reimbursement methodologies and more. The exam takes approximately five hours to complete and can be taken at any of the AAPC’s testing centers located throughout the United States.

The cost of the CPC exam is $399 for members of the AAPC and $499 for non-members. The cost includes access to study materials such as textbooks, online courses and practice exams. In addition to passing the exam, applicants must also have at least two years of professional experience in medical coding or billing in order to qualify for certification.

Once certified, CPCs are required to recertify every two years by either completing continuing education credits or retaking the CPC exam.

2. Certified Medical Reimbursement Specialist (CMRS)

A Certified Medical Reimbursement Specialist (CMRS) is a professional who specializes in the medical billing and coding process. The CMRS credential is awarded by the American Medical Billing Association (AMBA), which is an independent, non-profit organization that certifies individuals in the medical reimbursement field.

The CMRS certification requires applicants to pass a comprehensive exam that covers topics such as medical terminology, coding systems, insurance regulations, and medical reimbursement processes. In order to qualify for the exam, applicants must have at least two years of experience in medical reimbursement or related fields.

The exam consists of 150 multiple-choice questions and takes approximately four hours to complete. It is offered twice per year at designated testing centers throughout the United States.

To apply for the CMRS certification, applicants must submit an application form along with a $150 fee. Once approved, they will be sent an authorization letter that includes instructions on how to register for the exam and pay the $250 exam fee.

Once certified, CMRSs are required to complete continuing education requirements every two years in order to maintain their credentials.

3. Certified Electronic Health Records Specialist (CEHRS)

A Certified Electronic Health Records Specialist (CEHRS) is an individual who has achieved a professional certification demonstrating expertise in the use of electronic health records (EHRs). The CEHRS credential is awarded by the National Healthcareer Association (NHA) and is designed to recognize individuals who have demonstrated knowledge, skills, and abilities related to EHRs.

The CEHRS certification requires passing a comprehensive exam that covers topics such as privacy and security, data management, patient safety and quality assurance, system implementation and maintenance, and legal compliance. The exam consists of 150 multiple-choice questions that must be completed within three hours.

To become certified as a CEHRS, applicants must have at least one year of experience working with EHRs or be enrolled in an accredited healthcare program. Applicants must also complete an online application form and submit the required fees. Once approved for the exam, applicants will receive an authorization to test letter from NHA with instructions on how to schedule their exam.

The cost for the CEHRS certification varies depending on whether you are taking the exam at a Pearson VUE testing center or through NHA's online proctoring service. For Pearson VUE testing centers, the cost is $299; for NHA's online proctoring service, it is $199.

4. Certified Medical Billing and Coding Specialist (CMBCS)

A Certified Medical Billing and Coding Specialist (CMBCS) is a professional who specializes in the coding, billing, and reimbursement of healthcare services. This certification is offered through the American Academy of Professional Coders (AAPC). The CMBCS credential demonstrates that the individual has achieved a high level of knowledge and expertise in medical billing and coding.

It typically takes about 6-12 months to complete the training required for the CMBCS certification. Training can be completed online or in person at an accredited institution such as a community college or technical school. The cost of training varies depending on the program chosen, but generally ranges from $2,000-$5,000.

The exam for the CMBCS certification costs $399 and must be taken at an approved testing center. The exam consists of multiple-choice questions covering topics such as medical terminology, anatomy and physiology, coding systems, insurance policies, reimbursement procedures, legal issues related to medical billing and coding, and more. Once you pass the exam you will receive your official CMBCS certificate from AAPC.

5. Certified Revenue Cycle Professional (CRCP)

Certified Revenue Cycle Professional (CRCP) is a professional certification program offered by the Healthcare Financial Management Association (HFMA). The program is designed to recognize individuals who have achieved a high level of expertise in revenue cycle management.

The CRCP certification requires that applicants demonstrate their knowledge and understanding of the revenue cycle process, including patient access, billing and collections, coding, and compliance. To become certified, applicants must pass an online exam that consists of multiple-choice questions covering topics such as healthcare reimbursement, coding principles, and regulations.

It typically takes about three months to prepare for the CRCP exam. Applicants should review the HFMA's study guide and practice exams to ensure they are adequately prepared for the test. Additionally, applicants may benefit from taking an online course or attending a live seminar to gain additional knowledge on revenue cycle management topics.

The cost of obtaining the CRCP certification varies depending on whether you choose to take an online course or attend a live seminar. Generally speaking, it will cost between $200-$500 for the application fee and exam fee combined.

6. American Academy of Professional Coders (AAPC) Certification

The American Academy of Professional Coders (AAPC) is a professional organization that provides certification for medical coders. It is the largest and most recognized certification for medical coding in the United States. AAPC Certification is designed to provide employers with a measure of assurance that an individual has the knowledge and skills necessary to accurately code medical services and procedures.

It typically takes about 6 months to complete the AAPC Certification process, depending on how quickly you can study and pass the exams. To get certified, you must first become a member of AAPC, which requires an application fee and annual membership dues. Then, you must take and pass two exams: The CPC (Certified Professional Coder) Exam and either the COC (Certified Outpatient Coder) or CPC-P (Physician-based Certified Professional Coder) Exam.

The cost of becoming certified through AAPC varies depending on your chosen exam(s). The CPC Exam costs $399 USD, while the COC Exam costs $299 USD and the CPC-P Exam costs $349 USD. Additionally, there are optional practice tests available for each exam at an additional cost of $99 USD each.

7. Certified Outpatient Coding (COC)

Certified Outpatient Coding (COC) is a certification program offered by the American Academy of Professional Coders (AAPC). It is designed to validate the knowledge and skills of outpatient coders who work in hospitals, physician offices, and other healthcare settings. The COC credential certifies that an individual has mastered the critical coding skills necessary to accurately interpret and assign codes for diagnoses, procedures, and services provided in an outpatient setting.

The COC exam consists of 150 multiple-choice questions covering topics such as medical terminology, anatomy, physiology, disease processes, coding guidelines and regulations, reimbursement systems, and ICD-10-CM diagnosis coding. To become certified as a COC professional takes approximately 6 months to complete all requirements.

To become certified as a COC professional you must first join the AAPC by paying their membership fee. After joining you must then pass the COC exam with a score of 70% or higher. The cost for taking the exam is $399 USD for members or $499 USD for non-members. Once you have passed the exam you will receive your certification card within 4 weeks of passing the exam.

8. Certified Physician Practice Manager (CPPM)

Certified Physician Practice Manager (CPPM) is a professional certification designed to recognize the knowledge and skills of healthcare professionals who manage physician practices. The CPPM credential is awarded by the American Academy of Medical Management (AAMM).

The CPPM certification requires passing an exam that covers topics such as practice management, financial management, human resources, and information technology. It also includes a comprehensive review of medical office operations and business principles. Candidates must have at least two years of experience in a physician practice setting to qualify for the exam.

The CPPM exam is offered twice a year, usually in March and September. The cost of the exam is $495, which includes all materials needed to take the test.

In order to maintain their certification, CPPMs must complete 50 hours of continuing education credits every three years. These credits can be earned through attending conferences or workshops related to practice management or completing online courses.

9. Certified Healthcare Access Associate (CHAA)

Certified Healthcare Access Associate (CHAA) is a professional certification program offered by the National Association of Healthcare Access Management (NAHAM). The CHAA certification is designed to recognize individuals who demonstrate proficiency in healthcare access management. This includes patient registration, scheduling, insurance verification, and other related activities.

The CHAA program consists of two parts: an online course and an exam. The online course covers topics such as patient rights and responsibilities, customer service skills, medical terminology, and coding. It takes approximately 8-12 hours to complete the coursework. After completing the coursework, candidates must pass a proctored exam with a score of 70% or higher in order to receive their certification.

The cost for the CHAA program varies depending on whether you are a NAHAM member or not. For non-members, the cost is $295 for the online course plus $195 for the exam fee. For members, the cost is $245 for the online course plus $145 for the exam fee.

In addition to passing the proctored exam with a score of 70% or higher, applicants must also meet certain eligibility requirements in order to become certified. These requirements include having at least one year of experience working in healthcare access management and being employed in an active healthcare access management position at least 20 hours per week.

10. American Health Information Management Association (AHIMA) Certification

The American Health Information Management Association (AHIMA) Certification is a professional credential that recognizes individuals who have achieved a high level of expertise in the field of health information management. The certification is based on knowledge and skills acquired through formal education, experience, and/or training. AHIMA certifications are recognized by employers across the country as a mark of excellence in the field.

It typically takes between six months to one year to complete the requirements for an AHIMA certification. The process begins with an application and includes passing an exam that covers topics related to health information management, such as coding, data security, privacy, legal compliance, and more.

To get an AHIMA certification, you must first meet certain eligibility requirements which vary depending on the type of certification you are seeking. These include having a certain amount of work experience or educational background in the field of health information management. Once these requirements are met, you can apply for the exam and begin studying for it.

The cost of taking an AHIMA certification exam varies depending on the type of certification you are seeking. Generally speaking, exams range from $200-$400 USD per exam. There may also be additional fees associated with applying for and maintaining your certification such as membership dues or continuing education credits.

Do You Really Need a Medical Billing Clerk Certificate?

The answer to this question depends on the individual's goals and experience. For someone who is just starting out in medical billing, a certificate can be an excellent way to gain basic knowledge of the field and demonstrate commitment to employers. It may also help a person stand out from other applicants, as having a certification shows dedication to learning and understanding the concepts behind medical billing.

On the other hand, if someone already has experience in medical billing or related fields, then a certificate may not be necessary. Employers are usually more interested in demonstrable skills and practical knowledge than certificates. However, even if a person has experience, they may still benefit from obtaining additional certifications as it can open up new job opportunities or allow them to move up within their current organization.

In conclusion, whether or not you need a medical billing clerk certificate will depend on your individual goals and experience level. While it can be beneficial for those starting out in the field, experienced professionals may find that their skillset is enough for them to advance without one.

Related: Medical Billing Clerk Resume Examples

FAQs About Medical Billing Clerk Certifications

1. What is a Medical Billing Clerk Certification?

Answer: A Medical Billing Clerk Certification is a professional certification that demonstrates expertise in medical billing and coding processes. It is typically awarded by an accredited organization such as the American Academy of Professional Coders (AAPC) or the National Healthcareer Association (NHA).

2. What are the benefits of having a Medical Billing Clerk Certification?

Answer: Having a Medical Billing Clerk Certification can help you stand out from other applicants when applying for jobs, increase your salary potential, and provide recognition for your knowledge and skills. Additionally, it can open up new opportunities in medical billing and coding roles.

3. How much does it cost to obtain a Medical Billing Clerk Certification?

Answer: The cost of obtaining a Medical Billing Clerk Certification varies depending on the certifying organization and the type of certification you are seeking. Generally, most certifications range from $150 to $500 depending on additional materials such as study guides or practice tests.

4. How long does it take to become certified?

Answer: Generally, most certifications require between six months to one year of study time before taking the exam. However, some organizations may offer accelerated programs which allow you to complete the certification in less time.

5. Are there any prerequisites for obtaining a Medical Billing Clerk Certification?

Answer: Most certifying organizations require that applicants have at least two years of experience working in medical billing or coding prior to taking the exam. Additionally, some organizations may require applicants to pass an entrance exam before they are eligible to take the certification exam.