National Healthcareer Association (NHA)

Certified Billing and Coding Specialist (CBCS)

Credential: Certified Billing and Coding Specialist (CBCS)  GI Bill resource  NCCA resource
Credentialing Agency: National Healthcareer Association (NHA)

Renewal Period: 2 years

The National Healthcareer Association (NHA), Certified Billing & Coding Specialist (CBCS) are essential to hospitals, physician offices, surgery centers, nursing homes, dental offices, home healthcare agencies, mental health facilities, insurance companies, and consulting firms. CBCS's keep the healthcare industry moving efficiently by gathering and reviewing patient information, verifying required documentation before patients are released, preventing fraud/abuse by auditing billing, assigning codes for diagnoses and procedures, submitting claims for reimbursement, and coaching healthcare providers to achieve optimal reimbursement. CBCS applicants must successfully pass a written exam, in addition to meeting education and training or work experience eligibility requirements.

More information can be found on the certifying agency's website.

Certified Billing and Coding Specialist (CBCS)

MINIMUM REQUIREMENTS

 

Eligibility Requirements (View Details)

  • Credential Prerequisite
  • Experience: 1 year
  • Education: High School Diploma/GED
  • Training
  • Membership
  • Other
  • Fee

Note: This credential may have multiple options for becoming eligible. Listed are the minimum requirements based on the minimum degree required. To view other options, see the Eligibility tab.

Exam Requirements (View Details)

  • Exam
  • Written Exam
  • Oral Exam
  • Practical Exam
  • Performance Assessment

RECERTIFICATION SUMMARY

Renewal Period: 2 years

  • Continuing Education
  • Exam
  • Continuing Education OR Exam
  • Fee
  • Other

AGENCY CONTACT INFORMATION

National Healthcareer Association (NHA)

11161 Overbrook Road
Leawood, KS  66211

Phone: (913) 661-5592

Fax: (913) 661-6291
Email: info@nhanow.com

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Applicants must have a high school diploma or the equivalent.

Option 1:

Applicants must have successfully completed an NHA approved training program within the past five (5) years.

Note: Formal medical services training in the field offered by any branch of the U.S. Military fulfills the training program.

Note: Applicants who completed training five or more years ago must also have one (1) year of relevant, supervised work experience within the past three (3) years.

Option 2:

Applicants must have at least one (1) year of supervised work experience in the field within the past three (3) years.

The Certified Billing and Coding Specialist (CBCS) credential has the following other requirements:

  • Applicants must be at least 18 years of age.

Written Exam

  • Regulatory compliance
    • Identify appropriate documentation required for release of patient information.
    • Audit billing against medical documentation to prevent fraud and abuse.
    • Identify major laws, regulations, and administrative agencies relevant to medical billing.
  • Claims processing
    • Apply procedures for transmitting claims to third-party payers.
    • Apply knowledge of the CMS-1500 form to accurately complete the appropriate fields.
  • Front-end duties
    • Ensure accurate collection of appropriate patient demographic and insurance information.
    • Verify insurance eligibility to determine benefits.
    • Compare and contrast government and private insurance.
    • Process appropriate patient authorization and referral forms.
    • Prior to the visit, determine appropriate balances due.
  • Payment adjudication
    • Analyze aging report.
    • Post payment accurately.
    • Interpret remittance advice to determine financial responsibility of patient and insurance company.
    • Determine reason for insurance company denial.
  • Apply Knowledge of Coding
    • Apply specific coding guidelines and conventions for diagnoses and procedures.
    • Abstract the medical documentation by applying knowledge of medical terminology and anatomy and physiology.

Exam Preparation Resources

There are a number of resources available to help you prepare for the Certified Billing and Coding Specialist (CBCS) examination:

Testing Information

Testing for this credential is handled by PSI. The test centers are located in the U.S.

To find out more, use the following links on the PSI website:

For more information on the National Healthcareer Association (NHA) testing process, visit the agency website.

RECERTIFICATION

Certified Billing and Coding Specialist (CBCS)

Renewal Period: 2 years

The Certified Billing and Coding Specialist (CBCS) credential has the following recertification information:

  • The CBCS is renewed every 2 years; renewal requires earning continuing education units and paying a fee. More information about renewing NHA credentials is available on the NHA Renewal page.

In Demand

This certification is considered in demand

COOL Bucks

See your installation Education Service Officer for credential exam information and coordinating instructions.

COOL Summary

Click to go to the COOL Summary page for this MOC.

COOL Summary

Click to go to the COOL Summary page for this MOC.

Some

Credential is related to some tasks associated with the duties of the military occupation (at least one critical task but less than 80%)

Most

Credential is directly related to most of the major duties associated with the military occupation (at least 80%)

Other

Credential is related to this military occupation, but is more advanced or specialized and therefore will likely require additional education, training, or experience

Promotion Points

This certification has been approved for promotion points.

Click for more information.

Star

Star credentials are MOS enhancing, as designated by the Proponent. MOS enhancing credentials are directly related to an MOS or ASI, are taught either partially or completely as part of a Program of Instruction (POI), and improves the MOS technical proficiency.

Skill Level

The Skill Level reflects the level, based on MOS training and/or experience, the Soldier should be the most prepared to successfully earn the credential. See the Table Legend for details about each level.

Proponent Funded

Indicates the credential may have funding through the MOS proponent. Some proponents offer credentialing opportunities in conjunction with military training and/or as part of MOS development beyond the training base.

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Navy Bucks

Credential voucher or reimbursement for credential exam, re-certification, or maintenance fee has been approved for payment through the Navy's Credential Program Office. To get a voucher request form, click 'Complete Voucher and Apply' at the top of any page.

CG Bucks

Coming Soon - Coast Guard policy regarding service member eligibility requirements to participate in the Voluntary Credentialing Program is under review with a projected release date of first quarter FY20.

Early Career

1-3 years experience; Enlisted E1 through E4

Mid Career

4-10 years experience; Enlisted E5 through E6

Late Career

10+ years experience; Enlisted E7 and Above

Early Career

1-3 years experience; Enlisted “A” School through E5

Mid Career

4-10 years experience; Enlisted E6 through E7

Late Career

10+ years experience; Enlisted E8 and Above

LaDR

This credential is recommended on the rating Learning and Development Roadmap (LaDR) for Sailors currently in the pay grade indicated on the icon, BUT MAY BE TAKEN BY SAILORS IN OTHER PAY GRADES.

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GI Bill®

Reimbursement for exam fees has been approved for payment through the GI Bill. Click for external link to GI Bill licensing and certification information.

Note: GI Bill approval data is updated quarterly. For the latest information, visit the WEAMS Licenses/Certifications Search page. Make sure to select "Both" in the LAC Category Type drop-down before searching.

Click here for more information.

ANSI

This credential has been accredited by ANSI. Click for external link to the ANSI web site.

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ICAC

This credential has been accredited by ICAC. Click for external link to the ICAC web site.

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ABSNC

This credential has been accredited by ABSNC. Click for external link to the ABSNC web site.

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NCCA

This credentialing program has been accredited by NCCA. Click for external link to the NCCA web site.

Click here for more information.

IAS

This credential has been accredited by IAS. Click for external link to the IAS web site.

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Low

May be difficult to attain: minimum education requirement is a Bachelor's degree, and/or minimum experience is 10 or more years.

Note: In some cases “years of experience” refers to time actively on duty or while holding a certain occupation or prior certification and not always in consecutive calendar years. Additional years required for certain preliminary stages may not be included in this classification. For requirements measured in hours, 1080 hours was considered a year. For days, 365 days was considered a year. Please review all prerequisites and requirements for eligibility, and additional information for details.

Medium

Moderate ease of attainment: minimum education requirement = Associate's and/or prerequisite and/or minimum experience = more than 2 years and less than 10 years of experience.

Note: In some cases “years of experience” refers to time actively on duty or while holding a certain occupation or prior certification and not always in consecutive calendar years. Additional years required for certain preliminary stages may not be included in this classification. For requirements measured in hours, 1080 hours was considered a year. For days, 365 days was considered a year. Please review all prerequisites and requirements for eligibility, and additional information for details.

High

Highly attainable: mimum education requirement = HS or less and/or minimum experience = 2 years or less experience and no additional requirements.

Note: In some cases “years of experience” refers to time actively on duty or while holding a certain occupation or prior certification and not always in consecutive calendar years. Additional years required for certain preliminary stages may not be included in this classification. For requirements measured in hours, 1080 hours was considered a year. For days, 365 days was considered a year. Please review all prerequisites and requirements for eligibility, and additional information for details.

MOS is Military Occupational Specialty
ASI is Additional Skill Identifier
WOMOS is Warrant Officer Military Occupational Specialty

Army e-learning

State-of-the art Computer Based Training available for free to the Army Workforce. Click for more information.

Click here for more information.

NKO e-learning

Credential preparation courses are provided at no cost through Navy e-Learning. Click for external link to the Navy Knowledge Online (NKO) web site, then select the “Navy e-Learning” link within the “Learning” tab to proceed to Navy e-Learning.

Bright Outlook – new job opportunities are very likely in the future for this job
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Updated: October 16, 2019
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