Revenue Cycle Management & Medical Billing for Intermediates

Master RCM & Medical Billing (Level 2 of 5): Intermediate skills in prior auth, coding, CMS-1500/1450, EDI, denials, A/R

What you'll learn
- Map the full RCM lifecycle—from patient access to zero balance.
- Prepare and submit clean CMS-1500 and CMS-1450 claims with payer-specific rules.
- Execute prior authorization and eligibility workflows that reduce denials.
- Apply intermediate medical coding to support accurate charge capture.
- Post payments/ERAs and reconcile using 835/EDI remittances.
- Run A/R management & A/R calling with aging, follow-ups, and appeals.
- Prevent and resolve denials with root-cause analysis and KPIs.
- Use reports, automation, and analytics to optimize US healthcare revenue.

Requirements
- Basic familiarity with medical billing/coding and the US healthcare payer landscape.
- Ability to read EOB/ERA is helpful
- Prior exposure to claim forms (CMS-1500, UB-04/CMS-1450) is helpful.
- Motivation to practice with case studies, sample claims, and denial scenarios.

Description
Level up your revenue cycle management (RCM) and medical billing skills for US healthcare.This intermediate course turns real-worldhealthcare claimswork into repeatable workflows—prior authorization,medical coding, clean claim creation (CMS 1500/CMS 1450),EDI(837/835),payment posting,denial management, and hands-onAR management/AR calling. You’ll practice readingmedical recordsto support coding, prevent preventable denials, and navigateMedicareand 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, linkingmedical codingto covered benefits, securingprior authorization, building clean claims, and trackingEDItransactions (837P/837I and 835). You’ll practice denial prevention, structured appeals,A/R callingscripts, andpayment postingwith reconciliation, includingMedicareand 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-endRCMlifecycle

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

Executeprior authorizationand eligibility to reduce first-pass denials

Apply intermediatemedical codingto support clean claims

Interpret EOB/ERA and performpayment posting& reconciliation

ConductA/R management&A/R callingusing 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 forCMS-1500&CMS-1450 (UB-04)plusEDIcheckpoints (837/835)

Denial reason/remark code playbooks with appeal templates and timelines

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

Scenario-based practice forprior 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, andA/Rspecialists

Office managers and RCM leads standardizing team operations

Healthcare admins and analysts improving claims throughput

Anyone preparing for intermediate roles in USRCM/medical billing

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

Who this course is for:
- Medical billers moving from beginner to intermediate roles.
- A/R specialists and payment posters seeking stronger denial resolution skills.
- Medical coders who want end-to-end billing proficiency.
- Clinic/RCM office managers standardizing team workflows.
- RCM analysts and healthcare ops professionals focused on KPIs and automation.
- International learners targeting US healthcare billing and Medicare nuances.
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