GMCTA · Certificate Program
Medical Coding & Billing Specialist
Launch your career in revenue cycle operations. Complete this certificate in ~1–2 months with 100 total hours covering ICD-10-CM, CPT/HCPCS, claim submission, denials, and payer guidelines.
Program Overview
Build job-ready skills for front-end and back-end medical office revenue workflows. You’ll practice translating clinical documentation into ICD-10-CM and CPT/HCPCS codes, preparing clean claims, working ERA/EOBs, and addressing denials under payer policies and compliance rules.
What You’ll Learn
- Coding Foundations: ICD-10-CM diagnosis coding, CPT/HCPCS procedure coding, modifiers.
- Claims & Payer Rules: CMS-1500, UB-04 basics, payer guidelines, medical necessity.
- Billing Workflows: eligibility, charge capture, claim edits, ERAs/EOBs, denials.
- Compliance & Ethics: documentation standards, audit awareness, HIPAA, OIG basics.
- Insurance Fundamentals: Medicare/Medicaid, commercial plans, referrals, authorizations.
- Practice Tools: basic EHR/PM navigation, code books, encoder introduction.
Sample Curriculum
| Module | Topics |
|---|---|
| Medical Coding Basics | ICD-10-CM structure, CPT/HCPCS overview, guidelines |
| Diagnosis & Procedure Coding | Case-based coding, modifiers, bundling/unbundling concepts |
| Billing & Claims | CMS-1500/UB-04, clearinghouses, ERA/EOB reconciliation |
| Payer Policies & Denials | Medical necessity, edits, prior auth, appeals |
| Compliance & Documentation | HIPAA, audit readiness, ethical coding practices |
| Career & Professional Skills | Resume, interview prep, workplace communication |
FAQ
Does this prepare me for certification?
Yes, it aligns with common industry exam domains. Always verify current eligibility and requirements with your chosen credentialing organization.
Is this program fully online?
Yes—coursework and coding/billing labs are delivered online through guided modules and scenarios.
What roles can I pursue?
Entry-level medical coder, billing specialist, reimbursement coordinator, or claims support, depending on local market needs.