Level up your revenue cycle management (RCM) and medical billing skills for US healthcare. This intermediate course turns real-world healthcare claims work into repeatable workflows—prior authorization, medical coding, clean claim creation ( CMS 1500 / CMS 1450 ), EDI (837/835), payment posting, denial management, and hands-on AR management/AR calling. You’ll practice reading medical records to support coding, prevent preventable denials, and navigate Medicare and commercial payer rules—then measure improvements with analytics and reconciliation.

This course is designed to help learners with foundational billing experience apply intermediate RCM skills in real healthcare settings. Whether you’re working in billing, coding, A/R, payment posting, provider offices, or RCM operations, this program strengthens your command of end-to-end revenue processes—with a focus on practical usage, not theory.

You’ll master intake through zero balance: verifying eligibility, capturing charges, linking medical coding to covered benefits, securing prior authorization, building clean claims, and tracking EDI transactions (837P/837I and 835). You’ll practice denial prevention, structured appeals, A/R calling scripts, and payment posting with reconciliation, including Medicare and multi-payer variance handling.

Designed for intermediate learners, the course offers clear explanations, case-based exercises, and realistic examples from EHRs, claim forms, and payer remittances. No advanced clinical knowledge is required—just baseline billing familiarity and a willingness to practice.

What You’ll Learn

• Understand and apply the end-to-end RCM lifecycle

• Build compliant CMS-1500/CMS-1450 claims with payer rules

• Execute prior authorization and eligibility to reduce first-pass denials

• Apply intermediate medical coding to support clean claims

• Interpret EOB/ERA and perform payment posting & reconciliation

• Conduct A/R management & A/R calling using aging worklists

• Prevent and resolve denials with data-driven root-cause analysis

• Track KPIs and use automation/analytics to improve cash flow
  

Understand and apply the end-to-end RCM lifecycle

Build compliant CMS-1500/CMS-1450 claims with payer rules

Execute prior authorization and eligibility to reduce first-pass denials

Apply intermediate medical coding to support clean claims

Interpret EOB/ERA and perform payment posting & reconciliation

Conduct A/R management & A/R calling using aging worklists

Prevent and resolve denials with data-driven root-cause analysis

Track KPIs and use automation/analytics to improve cash flow

Course Features

• 70+ concise lessons with step-by-step workflows and real artifacts (claims, ERAs, EOBs)

• Field-by-field guides for CMS-1500 & CMS-1450 (UB-04) plus EDI checkpoints (837/835)

• Denial reason/remark code playbooks with appeal templates and timelines

• Downloadable trackers for payment posting, A/R aging, and follow-ups

• Scenario-based practice for prior authorization, edits, rejections, and resubmissions

• ESL-friendly explanations with checklists and visuals

• Accessible on mobile, desktop, or tablet

• Organized into 10 sections for focused practice:
  Advanced Foundations of RCM · Insurance-Specific Billing Guidelines · Specialty-Specific Coding & Billing · Intermediate Coding Mastery · Claims Management at Scale · Denial Prevention & Resolution (Intermediate Level) · Payment Posting & Reconciliation · Technology, Automation & Analytics in RCM · Compliance, Audits & Risk Management · Career Growth & Industry Insights
  

70+ concise lessons with step-by-step workflows and real artifacts (claims, ERAs, EOBs)

Field-by-field guides for CMS-1500 & CMS-1450 (UB-04) plus EDI checkpoints (837/835)

Denial reason/remark code playbooks with appeal templates and timelines

Downloadable trackers for payment posting, A/R aging, and follow-ups

Scenario-based practice for prior authorization, edits, rejections, and resubmissions

ESL-friendly explanations with checklists and visuals

Accessible on mobile, desktop, or tablet

Organized into 10 sections for focused practice:
Advanced Foundations of RCM · Insurance-Specific Billing Guidelines · Specialty-Specific Coding & Billing · Intermediate Coding Mastery · Claims Management at Scale · Denial Prevention & Resolution (Intermediate Level) · Payment Posting & Reconciliation · Technology, Automation & Analytics in RCM · Compliance, Audits & Risk Management · Career Growth & Industry Insights

Who This Course Is For

• Aspiring and current medical billers, coders, posters, and A/R specialists

• Office managers and RCM leads standardizing team operations

• Healthcare admins and analysts improving claims throughput

• Anyone preparing for intermediate roles in US RCM/medical billing
  

Aspiring and current medical billers, coders, posters, and A/R specialists

Office managers and RCM leads standardizing team operations

Healthcare admins and analysts improving claims throughput

Anyone preparing for intermediate roles in US RCM/medical billing

Disclosure: This course contains the use of artificial intelligence for clear voiceovers.