Coding & Reimbursement Specialist

Certificate – Code #1671

Tracy Locke MS, RHIA, Program Director

Email address: LockeTF@alfredstate.edu

Securing accurate and appropriate payment for health care services challenges health care providers, insurance companies, and patients. Today's complex health care insurance and governmental payment systems depend on medical coding to determine proper payment. The coding and reimbursement specialist program incorporates the knowledge and skills needed to assign the correct code for prompt and accurate reimbursement. C&RS professionals analyze patient records, assign ICD (ICD-9-CM, ICD-10-CM/ICD-10-PCS), CPT, and HCPCS codes to diagnoses, procedures, and services provided to patients for timely and accurate healthcare billing, reimbursement, and medical necessity.

Web-based instruction is organized under the health information technology program (HIT program). This means that if you initially select the C&RS program, you can transfer courses into the HIT program and earn your associate in applied science (AAS) degree.

Alfred State's comprehensive coding certificate program offers individuals the opportunity to pursue a business-related career that is an essential part of the health care industry.

PROGRAM STUDENT LEARNING OUTCOMES

PROFESSIONAL PRACTICE EXPERIENCE

Students complete non-paid professional practice experiences (PPEs) in the health information (coding) program of an acute care hospital (160 hours). PPE arrangements are made in consultation with each student so that a convenient location is selected. Students are not a substitute for paid staff during PPEs, which means they are expected to receive appropriate supervision and mentoring during completion of all tasks.

Joint Commission Hospital Accreditation Standards Manual requires hospitals to implement “a process to ensure that a person’s qualifications are consistent with his/her job responsibilities.” This standard “applies to staff, students, and volunteers,” and it further states that the hospital is responsible for verifying “the following according to law, regulation, or hospital policy: information on criminal background.” As such, Alfred State students who complete PPEs in the C&RS program may be required to undergo a criminal background check prior to placement at the facility. In addition, the facility may require students to undergo a physical examination (on-site at the facility or by the student’s primary care provider) prior to beginning the PPE. The physical examination includes drug screening, a TB test, and/or DTB, hepatitis B, and/or MMRV immunization or status. Students may be required to incur costs associated with the criminal background check and/or physical examination.

Once a PPE placement has been arranged, students are expected to contact the professional practice supervisor to arrange a schedule for attendance. Students may be required to attend an on-site orientation at the professional practice facility, which could be several days in length.

CRS ENTRANCE REQUIREMENTS & RECOMMENDATIONS

Required:

High School Biology or equivalent

Must be able to visually read computer monitor: must be able to use keyboard and mouse.

Must be able to attend Professional Practice Experience (PPE) course including 160 hours at a health care facility within reasonable driving/travel distance to their home.

Recommended:

Keyboarding, MS Office Professional

TRANSFER OPPORTUNITIES

Graduates are eligible to continue their education by completing the health information technology (HIT) program. The HIT program is also Internet-based.

OCCUPATIONAL OPPORTUNITIES

EMPLOYMENT STATISTICS

Employment and transfer rate of 100 percent – 100 are employed.

CERTIFICATION

Graduates are eligible to take national certification examinations offered by the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). AHIMA offers Certified Coding Specialist (CCS) exams, and the AAPC offers Certified Professional Coder (CPC) exams. It is strongly recommended students work for a minimum of one year full-time as a coder before taking the CCS and CPC exams.

ENTRANCE REQUIREMENTS/RECOMMENDATIONS

Required: High School Biology or equivalent

Must be able to visually read computer monitor; must be able to use keyboard and mouse.

Recommended: Keyboarding, MS Office Professional

RELATED PROGRAMS

Health Information Technology