Medical Insurance Coder/Biller – Certificate

The Medical Insurance Coder/Biller Certificate program prepares the student to work in a medical office, clinic, surgical center, emergency center, or hospital. Emphasis is placed on:  interpersonal, written and oral communication; business math; medical terminology; use of computers; medical financial management, disease conditions, diagnostic and procedure coding and billing.

Gainful Employment

Program Requirements

Minimum credits 38
Minimum cumulative GPA 2.0
Minimum grade in all courses 2.0
Minimum grades in MIC 101, MIC 141, MIC 150, MIC 201, MIC 211 and MIC 242 2.5
Minimum Jackson College credits 15

GENERAL EDUCATION REQUIREMENTS (7 credits)

Choose one of the following:

Course # Course Name Credits Prerequisites Notes
ENG 131 Writing Experience I 3 ENG 085 and ENG 091

This is an intensive writing course. Narrative and descriptive modes are stressed. Basic research strategies are introduced. An end-of-the-semester portfolio is required.

ENG 132 Writing Experience II 3 ENG 131

This is an intensive writing course. Analytical and persuasive modes are stressed. Advanced research writing strategies are used. Database and primary research methods are emphasized. An end-of-the-semester portfolio is required.

Take the following:

Course # Course Name Credits Prerequisites Notes
MAT 130 Quantitative Reasoning 4 MAT 030

Quantitative Reasoning develops student skills in analyzing, synthesizing and communicating quantitative information. Cultivates algebraic reasoning and modeling skills through a quantitative literacy lens. Emphasizes critical thinking and the use of multiple strategies in applied contexts. Topics include proportional and statistical reasoning, probability, and evaluation of bias and validity.

RELATED REQUIREMENTS (7 credits)

Choose one of the following:

Course # Course Name Credits Prerequisites Notes
BIO 132 Human Biology 4 ENG 085* and MAT 020* or higher

Students focus on the structure and function of the human body, the unity and diversity of life, the nature of scientific inquiry, and the principles and processes of evolution as well as contemporary issues that relate to biology. Course includes a laboratory component which focuses on human anatomy.

BIO 253 and 254 Human Anatomy and Physiology I & II 8

Human Anatomy and Physiology I
This is the first course of a two-semester course sequence in which students study the anatomy and physiology of the human body. The course includes introductions to basic chemistry, biology and histology and extends to the survey of the integumentary, skeletal, muscular and nervous systems. This course includes a laboratory component in which students are responsible for performing dissections and making original observations on dissected material. The laboratory experience culminates with the use of a plastinated human specimen for observation. A strong background in biology and/or chemistry is highly recommended.

Human Anatomy and Physiology II
This is the second course of a two-semester course sequence in which students study the anatomy and physiology of the human body. The course includes the autonomic nervous system, sensory, motor, and integrative systems, special senses, endocrine system, cardiovascular systems, lymphatic system and immunity, respiratory systems, digestive system, metabolism and nutrition, urinary system and reproductive systems. This course includes a laboratory component in which students are responsible for performing dissections and making original observations on dissected material. The laboratory experience culminates with the use of a plastinated human specimen for observation. Because physiological processes are based on the principles of chemistry, prior chemistry coursework is strongly recommended for this course.

PNC 100 Body Structure & Function 4 ENG 085*

(SAME AS MOA 141) This course is a body systems approach to the body structures and functions providing a foundation of understanding normal and abnormal body functions and disease processes.

MOA 141 Body Structure & Function 4 ENG 085*

(SAME AS LPN 141) This course is a body systems approach to the body structures and functions providing a foundation of understanding normal and abnormal body functions and disease processes.

Take the following:

Course # Course Name Credits Prerequisites Notes
MOA 120 Medical Terminology 3 ENG 085*

A programmed learning word building system approach is used to teach basic medical terminology word roots, prefixes, suffixes, language origins, plural formation and grammar rules are studied. Emphasis is placed on word building, definitions, spelling, usage, pronunciation and acceptable medical abbreviations.

CORE REQUIREMENTS (24 credits)

Take the following:

Course # Course Name Credits Prerequisites Notes
MIC 101 ICD-CM Coding 3 BIO 132 or BIO 254 or MOA 141 or LPN 141 and MOA 112, MOA 120, MIC 141, and HOC 132 or NUR 121

This course is an introduction to basic coding principles utilizing the International Classification of Diseases, Clinical Modification Coding System, with an emphasis on ICD-CM conventions, coding steps and guidelines, V and E codes, symptoms, signs, and ill-defined conditions and use of the medical record as a source for coding. The Uniform Hospital Discharge Data Set (UHDDS) and guidelines for coding neoplasms, injuries, burns, poisonings, adverse effects of drugs, and complications of surgery and medical care are also included.

MIC 141 Principles of Medical Coding and Billing 3

Study principles and practices in health information management as it relates to documentation for medical billing. Introduction to ICD and CPT coding, private insurance, and government program claim processing, legal and health care finance issues, HIPAA and release of information guidelines are emphasized.

MIC 150 CPT Coding 3 BIO 132 or BIO 254 or MOA 141 or LPN 141 and MOA 112, MOA 120, MIC 141, and HOC 132 or NUR 121

This course provides an introduction to the study of Current Procedure Terminology (CPT) Coding. Simulation of outpatient coding, including ambulatory surgery, diagnostic testing and procedures, physician services using patient records, and encoder software are essential parts of this course. Emphasis is placed on the use of official CPT coding guidelines, compliance and Ambulatory Payment Classification (APC) calculations.

MIC 211 Advanced Coding 3 MIC 101 and MIC 150 and MOA 242 and HOC 132 or NUR 121.

This course serves as a continuation of basic ICD-CM Coding with application of guidelines in more advanced case scenarios. The content includes simulation of inpatient and outpatient coding of diseases, procedures and services of all body systems using patient records and encoder software. Emphasis is placed on the use of official coding guidelines and compliance.

MIC 242 Advanced Medical Billing 3 ACC 216 or ACC 231 and MIC 141

Designed to teach advanced skills in medical insurance billing. Correct preparation of major carrier claims including use of modifiers and rebilling skills emphasized.

MIC 255 Coder/Biller Capstone 3 MIC 211 and Instructor Permission

A student may choose to take the capstone instead of the practicum. In the capstone, you will not be performing hours at an external site, but rather perform extensive coding and billing exercises to prepare for the CPC exam, build a portfolio, and prepare for employment. Expect to spend approximately 10 hours a week minimum, outside of class time working on assigned items.

MOA 112 Medical Law and Ethics 3 CIS 095* and ENG 090*

Principles and concepts of medical law and bioethics, as well as an overview of health care financing through third party payers are the main focus of this course. Topics include: medical practice management, medical law, liability and malpractice prevention, health information management, HIPAA and confidentiality of patient information, employment practices, consent, billing collections, insurance and government healthcare programs, codes of ethics and contemporary bioethical issues.

Choose one of the following:

Course # Course Name Credits Prerequisites Notes
HOC 150 Electronic Health Records Specialist 3 ENG 085 and MAT 020 or Higher, CIS 095

This course provides students with skills necessary to work with Electronic Health Records. This course is ideal for those currently working in the health field or those looking to enter into a health-related program who are hoping to learn more about key concepts and the use of Electronic Health Records in the medical setting. Topics include the cost and needs to consider when implementing an EHR system, how to utilize an EHR system to meet government requirements and medical practice needs, and practical application of various EHR tasks. The course will also cover basic medical terminology and basic medical coding principles. Students who complete this course with a passing grade will be eligible to sit for the Certified Electronic Health Record Specialist exam.

MIC 201 Billing Systems 3 CIS 101, MIC 101, MIC 150, and MOA 242

This course provides an introduction to the study of the billing and reimbursement processes of hospitals and ambulatory health care settings including: scheduling, registration, insurance verification, fee schedules, encounter forms, charge capturing, billing process, reimbursement process, patient payment and collections. Computer laboratory work with billing software is included.

Sample Course Map

The following is a sample course map for informational purposes and will not suit every student’s situation. A detailed, individualized course map will be created when a student meets with their Student Success Navigator.

SEMESTER 1

Course # Course Name Credits Prerequisites Notes
BIO 132 Human Biology 4 ENG 085* and MAT 020* or higher

Students focus on the structure and function of the human body, the unity and diversity of life, the nature of scientific inquiry, and the principles and processes of evolution as well as contemporary issues that relate to biology. Course includes a laboratory component which focuses on human anatomy.

ENG 131 Writing Experience I 3 ENG 085 and ENG 091

This is an intensive writing course. Narrative and descriptive modes are stressed. Basic research strategies are introduced. An end-of-the-semester portfolio is required.

MOA 120 Medical Terminology 3 ENG 085*

A programmed learning word building system approach is used to teach basic medical terminology word roots, prefixes, suffixes, language origins, plural formation and grammar rules are studied. Emphasis is placed on word building, definitions, spelling, usage, pronunciation and acceptable medical abbreviations.

MAT 130 Quantitative Reasoning 4 MAT 030

Quantitative Reasoning develops student skills in analyzing, synthesizing and communicating quantitative information. Cultivates algebraic reasoning and modeling skills through a quantitative literacy lens. Emphasizes critical thinking and the use of multiple strategies in applied contexts. Topics include proportional and statistical reasoning, probability, and evaluation of bias and validity.

SEM 140 Seminar in Life Pathways 3

Seminar in Life Pathways is a gateway course to Jackson College. This course is designed to help all students develop the skills, inner qualities and external behaviors needed to take charge of their academic and career success. Students will be guided through an extensive process in making career choices and selecting an academic program of study at Jackson College and beyond. With the exception of second-admit programs, SEM 140 is required of all students.

SEMESTER 2

Course # Course Name Credits Prerequisites Notes
MIC 101 ICD-CM Coding 3 BIO 132 or BIO 254 or MOA 141 or LPN 141 and MOA 112, MOA 120, MIC 141, and HOC 132 or NUR 121

This course is an introduction to basic coding principles utilizing the International Classification of Diseases, Clinical Modification Coding System, with an emphasis on ICD-CM conventions, coding steps and guidelines, V and E codes, symptoms, signs, and ill-defined conditions and use of the medical record as a source for coding. The Uniform Hospital Discharge Data Set (UHDDS) and guidelines for coding neoplasms, injuries, burns, poisonings, adverse effects of drugs, and complications of surgery and medical care are also included.

MIC 150 CPT Coding 3 BIO 132 or BIO 254 or MOA 141 or LPN 141 and MOA 112, MOA 120, MIC 141, and HOC 132 or NUR 121

This course provides an introduction to the study of Current Procedure Terminology (CPT) Coding. Simulation of outpatient coding, including ambulatory surgery, diagnostic testing and procedures, physician services using patient records, and encoder software are essential parts of this course. Emphasis is placed on the use of official CPT coding guidelines, compliance and Ambulatory Payment Classification (APC) calculations.

MOA 112 Medical Law and Ethics 3 CIS 095* and ENG 090*

Principles and concepts of medical law and bioethics, as well as an overview of health care financing through third party payers are the main focus of this course. Topics include: medical practice management, medical law, liability and malpractice prevention, health information management, HIPAA and confidentiality of patient information, employment practices, consent, billing collections, insurance and government healthcare programs, codes of ethics and contemporary bioethical issues.

MIC 141 Principles of Medical Coding and Billing 3

Study principles and practices in health information management as it relates to documentation for medical billing. Introduction to ICD and CPT coding, private insurance, and government program claim processing, legal and health care finance issues, HIPAA and release of information guidelines are emphasized.

SEMESTER 3

Course # Course Name Credits Prerequisites Notes
MIC 201 Billing Systems 3 CIS 101, MIC 101, MIC 150, and MOA 242

This course provides an introduction to the study of the billing and reimbursement processes of hospitals and ambulatory health care settings including: scheduling, registration, insurance verification, fee schedules, encounter forms, charge capturing, billing process, reimbursement process, patient payment and collections. Computer laboratory work with billing software is included.

MIC 211 Advanced Coding 3 MIC 101 and MIC 150 and MOA 242 and HOC 132 or NUR 121.

This course serves as a continuation of basic ICD-CM Coding with application of guidelines in more advanced case scenarios. The content includes simulation of inpatient and outpatient coding of diseases, procedures and services of all body systems using patient records and encoder software. Emphasis is placed on the use of official coding guidelines and compliance.

MIC 242 Advanced Medical Billing 3 ACC 216 or ACC 231 and MIC 141

Designed to teach advanced skills in medical insurance billing. Correct preparation of major carrier claims including use of modifiers and rebilling skills emphasized.

MIC 255 Coder/Biller Capstone 3 MIC 211 and Instructor Permission

A student may choose to take the capstone instead of the practicum. In the capstone, you will not be performing hours at an external site, but rather perform extensive coding and billing exercises to prepare for the CPC exam, build a portfolio, and prepare for employment. Expect to spend approximately 10 hours a week minimum, outside of class time working on assigned items.