HCAI - MEDICAL BILLING AND CODING - TRAINING PROGRAM

Health Care Access and Information (HCAI) - Training Program

Training Program Objectives:

In our Medical Billing and Coding program, you will be introduced to health insurance, multiple healthcare settings, coding, and reimbursement. You will become familiar with the three main codebooks: CPT®, ICD-10-CM Code Set and HCPCS Level II. You will be introduced to health insurance, multiple healthcare settings, coding, and reimbursement. You will become familiar with the health insurance industry, legal and regulatory issues, differences in reimbursement methodologies, and the principles of medical billing related to proper claim form preparation, submission and payment processing, and the follow-up process.

Overall, this program helps equip students for a rewarding future in medical billing/coding in a physician’s office, clinic, or similar setting. It also prepares students to test for the industry-recognized Billing and Coding certifications from the American Academy of Professional Coders (AAPC):

• Certified Professional Biller (CPB)
• Certified Professional Coder (CPC)

Note: This program consists of 2 Phases:

1. Online classroom training (approximately 20 weeks)

2. Online Internship (approximately 19 weeks)

Participation in all components above is required and require a commitment of 40 hours per week during standard business hours. The entire program as a whole is approximately 39-44 weeks in duration.

Note: This program includes both online classroom training and remote hands-on training.

Training Program Eligibility Requirements:

• Bilingual Spanish speaker preferred but not required!!
• Must be 18 years or older
• Must have a high school diploma or GED
• Must be a U.S. Citizen or Permanent Resident/Green Card holder (not open to non-citizens or Visa holders)
• Familiarity with Microsoft Office Suite, particularly Word, Excel, and PowerPoint, is beneficial for this role
• Familiarity with California Billing is preferred but not required!!
• Must be able to pass a national criminal background check successfully.

Training Program Benefits:

• Learn everything other medical billing/coding institutions teach, plus specifics related to the unique needs of federally qualified health centers (FQHCs) and look-alikes.
• Upon successful program completion and a passed exam, become certified in medical billing and medical coding.

Training Program Details:

• This is a temporary training program lasting approximately 44 weeks.
• This training program requires the learners to participate Mon-Fri, 8 AM-5 PM for the duration of the program.
• Participants are not eligible to receive paid holidays or paid time off (PTO), all missed time will need to be made up.
• The program includes remote learning and remote hands-on internship training. Accepted participants must complete 40 hours per week, Monday through Friday, during regular business hours for the entire duration of the program.
• Total Stipend: $31,200, This stipend is distributed over approximately 44 weeks for participation in both remote learning and remote hands-on internship/ externship training. Stipend payment is made on OCHIN’s semi-monthly pay schedule.
• Eligible for monthly Health Marketplace reimbursement up to $600 for 44 weeks (Participant cost only) - some restrictions apply.
• Internet Stipend $35/month for 44 weeks

MBC Description:

The Medical Biller and Coder Specialist is responsible for providing high-quality healthcare billing and coding services. As a biller and coder, you will recognize potential high-risk trends, payor follow-up and denial management, and develop techniques to optimize revenue, improve coding accuracy, and collections and streamline the revenue cycle.

This position will escalate difficult or unique coding problems with the Billing Supervisor assigned to the clinic, resolve issues, apply new information to future issues, and make suggestions to enhance our efficiency and effectiveness through process improvement with the assistance of their immediate supervisor. The Medical Biller and Coder Specialist will enhance the billing and coding department’s reputation by accepting ownership for accomplishing new and different requests and exploring opportunities to add value to job accomplishments.

The MBC duties include, but are not limited to:

• Provide efficient and effective coding services on behalf of our member clients in accordance with Payer requirements and organizational policies, while ensuring compliance to all coding guidelines.
• Abstract clinical data (diagnoses and procedures) from patient medical records and on-line patient data.
• Review and interpret patient encounters for accurate code assignment of all relevant diagnoses and procedures.
• Help fulfill the reimbursement needs of the member through review and recommendation or correct assignment of diagnosis and procedure codes which are critical to third party reimbursement.
• Research and obtain necessary information from provider/office via Epic in-basket when necessary, per agreement.
• Assist with research for denied claims.
• Meet assigned productivity goals.
• Establish and maintain positive working relationships with patients, payers, team members, clients and other stakeholders.
• Maintain confidentiality of patient information, organization data and information, and in compliance with HIPAA regulations
• Perform other specific projects related to billing, data entry and computer operations as required.
• Provide efficient and effective account receivable services on behalf of our member clients to maximize their reimbursement and support OCHIN revenue cycle performance indicators for financial health.
• Accurately bill Medicare, Medicaid, self-pay/uninsured, and commercial insurance, processing claims in accordance with payer requirements and organization policy.
• Assist with the collection of receivables by monitoring accounts receivables, checking claim status and resubmitting claims of overdue accounts, filing corrected claims or appeals and alerting supervisor of seriously overdue accounts and trends.
• Post patient payments, electronic remits, and paper explanation of benefits (EOBs).
• Correct claim and charge errors.
• Thoroughly research and resolve credit balances.
• Answer phone calls from patients and responsible parties regarding account balances and/or other matters. Provide compassionate and empathetic customer service.
• Perform other specific projects related to billing, data entry, and computer operations as required.
• Other duties as assigned.

OCHIN Workforce Development Equal Opportunity Statement

OCHIN is an equal opportunity educational provider committed to fostering an inclusive and equitable environment for all. We are dedicated to a policy of non-discrimination for all members of the OCHIN community, including learners, team members, and applicants. We do not discriminate based on race, creed, color, sex, sexual orientation, gender identity or expression, religion, national origin, age, disability, genetic information, marital status, veteran status, or any other legally protected status.

OCHIN is committed to making decisions for program entry, training, and educational opportunities based on individual qualifications and abilities. We actively seek to attract learners and team members from diverse backgrounds and affirmatively support equal access and opportunity for women, minorities, individuals with disabilities, special disabled veterans, and other covered veterans, in accordance with applicable federal, state, and local laws.

We strive to create an inclusive learning environment that fosters the success of every individual and reflects the diverse communities we serve.

OCHIN Workforce Development Health Screenings and Immunization Requirements

To ensure the safety of our learners, partners, and communities, OCHIN requires all program participants—including those attending remote and in-person training, internships, and externships—to be vaccinated with a COVID-19 vaccine, as recommended by state and federal public health officials. Participants must provide proof of full vaccination or receive approval for a medical or religious exemption prior to program acceptance.

Additionally, for on-site internships and externships, participants must provide proof of meeting the immunization requirements specific to the host site prior to acceptance into the program. These requirements may include, but are not limited to, vaccinations for influenza, hepatitis B, and MMR. Requests for exemptions based on medical or religious grounds will be reviewed and must comply with applicable laws and site-specific policies.

Please note that many sites require participants to complete tuberculosis (Tb) testing and drug screening before beginning their placement. Participants are responsible for ensuring that all required health screenings are completed by the site’s deadline to avoid delays in program participation.

OCHIN is committed to working collaboratively with program participants and host sites to ensure compliance with these health and safety requirements while maintaining respect for individual beliefs and circumstances.