Health Insurance Specialist Certificate

Health Insurance Specialist Certificate at Harper College

Get real-world experience working in the health insurance field

Program facts  Education icon


  • Credit hours: 34
  • Stackable to degree: Yes
  • Potential job outcomes: Health insurance specialist, insurance billing specialists

Complete this concentrated 34-credit-hour certificate program to begin a successful career as a health insurance specialist. This program is designed for students interested in becoming insurance billing specialists, billers/coders in outpatient/ambulatory care facilities or claims approvers at an insurance company.

You’ll receive a general overview of the health care field, plus specialized training in International Classification of Disease (ICD) and Current Procedural Terminology (CPT) coding, billing reimbursement and collections procedures. Additional focus areas of study include health care technology and informatics, medical terminology, basic pharmacology, legal and ethical issues in health care and health care records management.

During the final semester of the program, you’ll complete a 160-hour externship at a medical facility, gaining hands-on experience working in the field. Credit earned for the Health Insurance Specialist Certificate can be applied toward the Health Care Office Manager AAS Degree.

Certificate program requirements

This concentrated 34 credit-hour certificate program is designed for the individual who is interested in becoming an insurance billing specialist or biller or coder in an outpatient/ambulatory care facility or a claims approver in an insurance company. The program provides a generalized orientation to the health care field, plus specific training in International Classification of Disease (ICD) and Current Procedural Terminology (CPT) coding, billing reimbursement and collections procedures. Some keyboarding skills and knowledge of computers is recommended. A 160-hour externship in a medical facility is offered during spring and fall semesters only, during the last semester of the program. For more information attend a Health Career Information Session or schedule an appointment with your Student Development Faculty Counselor.

Required:

A grade of C or better is required for all courses.

Number Course Title Credits
BIO 135 4

Description: Surveys the human body, with emphasis on basic physical and chemical concepts, anatomy, physiology and embryology. Designed to meet the needs of students in certain allied health career programs. Knowledge of high school biology is assumed. (NOTE: Not Lab science credit.)

BIO 136 3

Description: Surveys the nature of human disease with emphasis on the functional disturbances within the body systems. Designed to meet the needs of students in certain allied health career programs. Knowledge of high school biology assumed. (NOTE: Not Lab science credit.)

ENG 101 3

Description: Emphasizes the writing of expository prose. Introduction to the critical reading of nonfiction prose. IAI C1 900

Prerequisite: ENG 100 with a grade of C or better. Other placement options. ENG_Placement_Grid.pdf ESL students need one of the following options: ESL 073 and ESL 074 with grades of B or better; ESL 073 and ESL 086 with grades of B or better; ESL 073 and ESL 099 with grades of B or better; ESL 073 with required writing placement test score; or ESL 074 with required reading placement test score.

HIT 196 3

Description: Examines and interprets health record documentation, conventions and guidelines for the Health Care Procedure Coding System (HCPSC). HCPSC Level I (Current Procedural Terminology (CPT) and Level II (National Codes) are utilized to represent procedures provided in the ambulatory care setting and services rendered by providers across all healthcare settings. Emphasis is on the six sections of the CPT Coding Manual. Basic and intermediate coding scenarios are analyzed and interpreted in compliance with official guidelines and ethical coding practices. Reimbursement considerations are explored.

Prerequisite: BIO 135 or (BIO 160 and BIO 161), BIO 136, HSC 112 and HSC 165 with grades of C or better.

HIT 197 3

Description: Examines and interprets health record documentation, conventions and guidelines for the current International Classification of Diseases (ICD) in use in the United States. ICD codes capture information related to diagnoses documented in all healthcare settings and procedures provided in the inpatient setting. ICD codes are utilized for statistical purposes, quality reporting, and reimbursement. Basic and intermediate coding scenarios are analyzed and interpreted in compliance with official guidelines and ethical coding practices. Reimbursement considerations are explored.

Prerequisite: BIO 135 or (BIO 160 and BIO 161), BIO 136, HSC 112 and HSC 165 with grades of C or better.

HSC 104 2

Description: Introduces student to informatics and the use of technology in health care delivery systems. This includes a review of hardware and software, and an in-depth look at hospital/health care-based user interfaces, data bases, telecommunications and networks, and healthcare-based information systems. Also includes research methods and patient education via computers.

HSC 112 2

Description: Emphasizes the origin and the basic structure of medical words, including prefixes, suffixes, word roots, combining forms and plurals. Offers pronunciation, spelling, and definition of medical terms based on the body systems approach. Emphasis on rendering a professional vocabulary required for work in the health care field.

HSC 165 1

Description: Examines the mechanism of action of the major medication groups as they relate to the physiology and pathology of disease. Identifies examples in each major pharmacological category in order to understand pharmacological activity within each group. Addresses areas of drug action, clinical application, and adverse events for each medication discussed. Considers needs of patients undergoing drug therapy and the role of the allied health provider.

Prerequisite: Prior or concurrent enrollment in BIO 135, BIO 160 or HSC 112 with a grade of C or better.

HSC 213 2

Description: Introduces the legal and ethical issues that pertain to various health care delivery settings. Discusses how these issues impact the health care practitioner in a diverse culture. Practices and standards are discussed as they relate to professional behavior and ethical decision-making.

MOA 145 2

Description: Introduces types of patient-care records prepared and maintained by health care personnel. Includes elements of records, record keeping, medical records ethics and confidentiality, correction techniques and use of health care references, with transcription and computer applications. Electronic Medical Records (EMR) is introduced. Beginning transcription techniques including grammar, punctuation and proof-reading skills are emphasized. Basic keyboarding skills and knowledge of Microsoft Word are necessary for this course.

Prerequisite: Prior or concurrent enrollment in ENG 101, and HSC 112 with a grade of C or better.

MOA 195 3

Description: Explores and compares major types of health insurance contracts and describes benefits and limitations. Provides practice in processing insurance claim forms (CMS-1500). Current Procedural Terminology (CPT) and International Classification of Disease (ICD) coding techniques are introduced. Emphasis is on insurance rules and regulations including Medicare and Medicaid, claim submission, reimbursement and collections.

Prerequisite: BIO 135 and HSC 112 with grades of C or better.

MOA 235 1 3

Description: Offers development of skills in medical front office procedures used in a health care facility. Emphasizes patient relations in health care by using office simulations including computer programs with introduction to electronic medical records. Strong emphasis on cultural diversity issues and application in the health care field.

Prerequisite: HSC 112 and MOA 145 with grades of C or better.

MOA 275 1 3

Description: Provides 160 hours during the semester of supervised experience in a health care office/facility to enhance the student's technical skills. NOTE: The program's health requirements must be completed prior to placement in on-site externship.

Prerequisite: HIT 196, HIT 197 and MOA 235 with grades of C or better.

1 - Students must submit an American Heart Association Cardiopulmonary Resuscitation for the Health Care Provider (CPR) certificate before entering externship.

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Resources

Next steps

For more information about the Health Insurance Specialist Certificate, contact Admission Outreach at 847.925.6700, or submit a request information form. You can also apply online.