Course Overview
Medical Billing & Revenue Cycle Management Fundamentals is a foundational course designed to introduce learners to the end-to-end billing and revenue processes used in healthcare organizations. This course explains how healthcare services are converted into claims, submitted to payers, and reimbursed, while ensuring compliance and financial accuracy.
The course is suitable for learners in India and globally who want to build a strong base in medical billing and revenue cycle operations before progressing to US-specific billing, denial management, or advanced RCM roles.
Who This Course Is For
- Aspiring medical billers and RCM professionals
- Life science graduates entering healthcare operations
- Clinical coders transitioning into billing roles
- Healthcare administrators and operations staff
- Professionals interested in US healthcare outsourcing roles
No prior billing experience is required.
What You’ll Learn
By the end of this course, you will be able to:
- Understand the healthcare revenue cycle from patient registration to payment
- Explain the role of medical billing in healthcare organizations
- Identify key billing and reimbursement workflows
- Understand payer types and claim lifecycles
- Recognize common billing errors and compliance risks
- Prepare for advanced billing and US-focused RCM training
Course Curriculum
Module 1: Introduction to Medical Billing & RCM
- Overview of revenue cycle management
- Importance of accurate billing and reimbursement
- Roles within the RCM workflow
Module 2: Patient Registration & Insurance Basics
- Patient demographics and eligibility
- Insurance verification and authorization
- Common insurance terminology
Module 3: Charge Capture & Coding Basics
- Charge entry and documentation
- Relationship between coding and billing
- Overview of diagnosis and procedure codes
Module 4: Claim Creation & Submission
- Components of a medical claim
- Electronic vs paper claims
- Claim submission workflows
Module 5: Payers & Reimbursement Process
- Government and commercial payers
- Claim adjudication process
- Explanation of benefits (EOB)
Module 6: Payment Posting & Reconciliation
- Posting payments and adjustments
- Understanding contractual write-offs
- Reconciliation basics
Module 7: Denials & Revenue Leakage
- Common reasons for claim denials
- Basics of denial management
- Preventing revenue loss
Tools & Standards Covered
- Medical billing workflows
- Revenue cycle management concepts
- Healthcare payer processes
Career Outcomes
After completing this course, learners can pursue:
- Medical Billing Executive roles
- RCM Associate positions
- Healthcare operations support roles
This course also prepares learners for advanced training in:
- US Medical Billing & RCM
- Denials Management
- Healthcare Compliance & Audits
Course Format
- Structured learning modules
- Practical billing workflow examples
- Real-world healthcare scenarios
- Downloadable reference materials
Certification
Certificate of Completion provided by ClinicalCoding.in
