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Top 10 Medical Billing Specialist Certifications

This article provides an overview of the best certifications available for medical billing specialists, including details on prerequisites, cost and expected job outcomes.

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Brenna Goyette
Certified Professional Resume Writer, Career Expert

Published 17 min read

Certifications for medical billing specialists are important in the job market because they demonstrate a level of knowledge and expertise that employers look for when hiring. Certification also shows employers that a candidate has gone beyond the educational requirements and has taken the initiative to gain additional skills or knowledge to help them perform their job better. Employers often favor those with certifications over those without, as certifications help to ensure quality of work and reduce potential liability issues. Certification also provides candidates with an added edge in the competitive job market, allowing them to stand out from other applicants and increase their chances of being hired.

The purpose of the article is to provide an overview of the top certifications for Medical Billing Specialists and how they can help to further a Medical Billing Specialist's career.

What are Medical Billing Specialist Certifications?

Medical billing specialist certification is a credential that verifies an individual’s competency and knowledge in the field of medical billing. Certification is available through several organizations, including the American Academy of Professional Coders (AAPC) and the National Healthcareer Association (NHA).

The certification process typically includes passing an exam, completing continuing education requirements, and meeting certain work experience or educational requirements. The exams cover topics such as coding systems, medical terminology, reimbursement methods, claims processing, insurance regulations and compliance standards. By obtaining a certification in medical billing, individuals demonstrate their proficiency in this field to potential employers.

Having a certification helps professionals stand out from other applicants when applying for positions within the healthcare industry. It also provides them with more opportunities for advancement and higher salaries. Additionally, certified medical billing specialists are often seen as more reliable than non-certified professionals by employers. This can lead to increased job security and better chances of getting promoted or hired at a different organization. Furthermore, having a certification can help individuals gain access to exclusive resources such as conferences and seminars related to medical billing.

Pro Tip: Before pursuing medical billing specialist certification, it's important to verify that the certifying organization is accredited by an independent third-party accreditation organization. This will ensure that you are receiving quality training and a valuable certification.

Related: What does a Medical Billing Specialist do?

Top 10 Medical Billing Specialist Certifications

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

1. Certified Professional Coder (CPC)

Certified Professional Coder (CPC) is a certification program offered by the American Academy of Professional Coders (AAPC). It is designed to recognize and validate the coding expertise of medical coders in the United States. The CPC credential is widely recognized as the gold standard for medical coding professionals, and it is a requirement for many employers.

To become certified, candidates must pass an exam that covers topics such as anatomy and physiology, medical terminology, coding guidelines, reimbursement methodologies, and compliance. The exam consists of 150 multiple choice questions and takes approximately five hours to complete.

The cost for taking the CPC exam varies depending on whether you are an AAPC member or not. For non-members, the fee is $399; for members, it is $299. Additionally, there are fees associated with registering for the exam and purchasing study materials.

The amount of time it takes to become certified depends on each individual's preparation level prior to taking the exam. Generally speaking, it can take anywhere from four weeks to several months to prepare for the exam depending on how much time you have available to dedicate to studying.

2. Certified Electronic Health Record Specialist (CEHRS)

Certified Electronic Health Record Specialist (CEHRS) is a certification that recognizes individuals who have achieved a high level of competence in the use and management of electronic health records (EHRs). CEHRS certification is offered by the National Healthcareer Association (NHA) and is designed to demonstrate an individual’s knowledge, skills, and abilities in the use of EHRs.

The CEHRS certification program consists of two parts: a written examination and a performance-based assessment. The written exam covers topics such as data entry, record maintenance, security protocols, system functionality, and other related topics. The performance-based assessment requires applicants to demonstrate their proficiency in using EHR systems by completing tasks such as creating patient records, entering orders into the system, retrieving information from the system, and more.

It typically takes about six months to complete the CEHRS certification program. Applicants are required to register for both the written exam and performance-based assessment with NHA prior to taking either portion of the exam.

The cost for registering for both portions of the CEHRS certification program is $365 USD.

3. Certified Medical Reimbursement Specialist (CMRS)

A Certified Medical Reimbursement Specialist (CMRS) is a professional designation that is awarded to individuals who have demonstrated a high level of knowledge and expertise in the field of medical reimbursement. The CMRS certification is offered by the American Medical Billing Association (AMBA).

The CMRS certification requires applicants to pass an exam that covers topics such as medical coding, billing, insurance claims processing, payment processing, and other related topics. Applicants must also demonstrate a minimum of two years of experience in medical reimbursement or related activities.

It typically takes 3-6 months to prepare for the exam and obtain the certification. To get started, interested individuals should review the eligibility requirements on the AMBA website and then register for the exam. Once registered, applicants will be able to access study materials and practice exams to help them prepare for the test.

The cost of obtaining a CMRS certification varies depending on how you choose to take the exam. If you take it online, it costs $295; if you take it at a testing center, it costs $395.

4. Certified Medical Billing and Coding Specialist (CMBCS)

Certified Medical Billing and Coding Specialist (CMBCS) is a professional certification program that provides individuals with the knowledge and skills to work in the medical billing and coding industry. This certification is offered by the American Academy of Professional Coders (AAPC).

The CMBCS certification requires applicants to have at least two years of experience in medical billing and coding, or a relevant degree from an accredited college or university. The program also requires applicants to pass a comprehensive exam that covers topics such as medical terminology, anatomy, physiology, coding systems, reimbursement methods, and other related topics.

It typically takes between six months and one year to complete the program depending on how often you are able to study. To get started you will need to register for the exam online through the AAPC website. Once registered you will be given access to online resources such as practice tests and study guides which can help you prepare for the exam.

The cost of taking the CMBCS exam varies depending on your location but typically ranges from $300-$400 USD. This fee includes all of your materials as well as access to practice exams and study guides.

5. Certified Professional Biller (CPB)

Certified Professional Biller (CPB) is a professional certification offered by the American Academy of Professional Coders (AAPC). It is designed to recognize individuals who have demonstrated proficiency in medical billing and coding. The CPB certification validates an individual’s knowledge of medical billing and coding, as well as their ability to effectively communicate with insurance companies, providers, and patients.

It typically takes about 6-12 months to complete the requirements for the CPB certification. To become certified, applicants must pass a comprehensive exam that covers topics such as medical terminology, anatomy and physiology, health insurance plans, claim forms, coding systems, and more. Additionally, applicants must also have at least two years of medical billing experience or one year of experience plus an AAPC approved course.

The cost to take the CPB exam varies depending on the type of membership you choose with AAPC. The standard fee for non-members is $399 USD while members pay $299 USD. In addition to the exam fee, there may be additional costs associated with study materials or other resources needed to prepare for the exam.

Once certified, CPBs are expected to adhere to a code of ethics established by AAPC which includes maintaining confidentiality and accuracy in all aspects of their work. They also must complete continuing education credits every two years in order to maintain their certification status.

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. This certification is designed to demonstrate a coder's knowledge and proficiency in the field of medical coding.

To become certified, an individual must pass an AAPC-administered exam. The exam covers topics such as anatomy and physiology, medical terminology, coding guidelines, and reimbursement systems. It typically takes around 6-12 months of study to prepare for the exam.

In order to take the exam, individuals must first become members of AAPC by paying an annual membership fee of $99. After becoming a member, individuals can register for the exam which costs $399 for non-members or $299 for members. The exam consists of 150 multiple choice questions and must be completed within 3 hours.

Once the exam is passed, individuals will receive their AAPC certification which is valid for two years from the date it was issued. To maintain certification status, individuals must complete at least 20 continuing education credits every two years.

7. National Healthcareer Association (NHA) Certification

The National Healthcareer Association (NHA) is a non-profit organization that provides certification programs for healthcare professionals. NHA certifications are designed to demonstrate mastery of core competencies in specific healthcare fields. These certifications provide employers with assurance that the certified individual has the knowledge and skills necessary to perform their job effectively.

NHA offers a variety of certifications, including Certified Medical Assistant (CMA), Certified Billing and Coding Specialist (CBCS), Certified Clinical Medical Assistant (CCMA), and Phlebotomy Technician Certification (PTC). Each certification requires applicants to meet certain eligibility requirements and pass an exam. The length of time it takes to get certified depends on the individual’s preparation for the exam, but typically ranges from 6 months to 1 year.

To get an NHA certification, individuals must first meet the eligibility requirements for the specific certification they are seeking. Once these requirements have been met, individuals can apply for the exam online or by mail. After submitting their application, individuals will receive an email with instructions on how to register for the exam and pay any applicable fees. The cost of NHA exams varies depending on the certification sought; however, most exams range from $90-$130 USD.

8. American Health Information Management Association (AHIMA) Certification

The American Health Information Management Association (AHIMA) is a professional organization that provides certification and education for individuals who work in the health information management field. AHIMA certification is designed to recognize professionals who demonstrate expertise in the health information management field.

AHIMA offers several different certifications, including Registered Health Information Administrator (RHIA), Certified Coding Associate (CCA), Certified Tumor Registrar (CTR), and Certified Coding Specialist-Physician Based (CCS-P). Each certification requires successful completion of an exam, which can take anywhere from two to four hours depending on the type of exam.

In order to be eligible for AHIMA certification, applicants must have a minimum of an associate degree in health information technology or a related field. Applicants must also have at least one year of experience working in the health information management field. Once these requirements are met, applicants can register for an exam through AHIMA’s website.

The cost of each AHIMA certification exam varies based on the type of exam and the number of attempts required to pass it. The cost can range from $200-$400 per attempt. Additionally, there may be additional fees associated with registering for and taking the exams, such as application fees and proctoring fees.

9. Advanced Certified Medical Coder (ACMC)

Advanced Certified Medical Coder (ACMC) is a certification offered by the American Academy of Professional Coders (AAPC). It is designed for experienced medical coders who have at least two years of coding experience. The ACMC certification validates an individual’s knowledge and expertise in medical coding, as well as their ability to accurately assign codes to diagnoses and procedures.

It typically takes between six months and a year to complete the ACMC program. To become certified, candidates must pass an exam that consists of 150 multiple-choice questions covering topics such as anatomy and physiology, medical terminology, disease processes, ICD-10-CM/PCS coding, CPT coding, HCPCS Level II coding, modifiers, compliance regulations and reimbursement systems.

To get started on the path to becoming an ACMC certified coder, interested individuals should first become a member of the AAPC. Membership costs $99 per year for students or $199 per year for professionals. After joining the AAPC, individuals should then apply for the ACMC exam through the AAPC website. The cost of taking the exam is $399 for members or $499 for non-members.

Once individuals have passed their exam they will receive their certificate in the mail within 4-6 weeks after passing their exam. They will also be listed in the AAPC’s online directory of certified coders which can be used by employers to verify credentials.

10. Certified Medical Office Manager (CMOM)

Certified Medical Office Manager (CMOM) is a professional certification program designed to recognize and reward those who demonstrate a high level of knowledge, skills, and abilities in the management of medical office operations. The certification is offered by the American Academy of Professional Coders (AAPC).

The CMOM program consists of two parts: an online exam and an on-site practicum. The online exam tests your knowledge of medical office management, including topics such as billing, coding, compliance, customer service, human resources, information technology, insurance processing, patient relations, practice management software, and quality assurance. The practicum requires you to demonstrate your ability to manage a medical office by completing tasks such as scheduling appointments and managing patient records.

It typically takes about four months to complete the CMOM program. To get started with the program you must first register with AAPC and pay the registration fee. Once registered you will receive access to study materials for both the online exam and practicum. You can then begin studying for the exam at your own pace. After successfully passing the online exam you will be eligible to take part in the on-site practicum which includes completing various tasks related to medical office management.

The cost of registering for the CMOM program varies depending on where you live but generally ranges from $400-$600 USD. This cost includes access to study materials for both the online exam and practicum as well as taking part in the on-site practicum if needed.

Do You Really Need a Medical Billing Specialist Certificate?

If you are looking to enter the medical billing field, then a medical billing specialist certificate can be an invaluable asset. This certification is designed to give you the knowledge and skills needed to effectively manage patient billing processes and keep your workplace compliant with industry standards. It can also provide employers with a quick way to evaluate applicants’ qualifications for medical billing positions.

The core components of a medical billing specialist certificate include courses in health information management, coding and reimbursement, computer applications, and healthcare management. Depending on the program you choose, additional topics may also be covered such as accounting principles, customer service, and legal issues in healthcare.

In most cases, having a certificate from an accredited program is required for employment in the medical billing field. It can be beneficial for those who have experience in a related field but lack formal training or credentials. Certificates can also help individuals stand out from other candidates when applying for jobs or promotions. If you are interested in taking your career to the next level by becoming a certified professional biller or coder, then obtaining a certificate could be helpful in making this transition easier.

Overall, obtaining a medical billing specialist certificate is not absolutely necessary if you want to work as a medical biller or coder; however it may make it easier for you to find employment or advance your career within the field. The best way to determine whether or not this type of certification is right for you is by researching different programs and determining which one will best meet your needs and goals.

Related: Medical Billing Specialist Resume Examples

FAQs About Medical Billing Specialist Certifications

1. What type of certifications are available for Medical Billing Specialists?

Answer: The Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), and Certified Risk Adjustment Coder (CRC) certifications are the most commonly recognized certifications available for Medical Billing Specialists.

2. How long does it take to become certified as a Medical Billing Specialist?

Answer: The length of time it takes to complete a certification program varies based on the type of certification and the individual’s study habits. Generally, it can take anywhere from 6 months to 2 years to become certified as a Medical Billing Specialist.

3. What is the cost of becoming certified as a Medical Billing Specialist?

Answer: The cost for certification depends on the type of certification and may include exam fees, materials, and/or tuition costs. Generally, total costs range from $300 - $2,000 USD.

4. Are there any prerequisites for becoming certified as a Medical Billing Specialist?

Answer: Each certification has its own set of requirements that must be met before taking an exam, such as having at least two years of experience in medical billing or coding and completing specific courses or training programs.

5. What are the benefits of becoming certified as a Medical Billing Specialist?

Answer: Certification demonstrates expertise in medical billing practices which can lead to greater job opportunities and higher salaries. Additionally, some employers may require certification in order to qualify for certain positions or promotions.