Certified Medical Software/Insurance/Pre-authorization Specialist
BECOME A MEDICAL SOFTWARE INSURANCE/PREAUTHORIZATION Specialist

Overview

Medical Software, Insurance and Pre-authorization Specialist work in physicians’ offices, hospital, urgent care center, billing companies, insurance companies and many more places. Their main duty is to input data into the Medical Billing Software to process the claims for reimbursements. Moreover, they must have an understanding on various types of insurances and the procedures to billing for the services rendered to the patient, apart from this their other main duty includes verifying insurance benefit eligibility and obtaining pre-authorization for services. 

 

Requirements

Candidates registering for the exam must qualify in (at-least 1) of the GROUPS (A or B or C) as shown below. Training and experience may be completed within united states of america or outside united states of america. 

GROUP A

EDUCATION

Training or

Equivalent

(Nationally or Internationally)

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GROUP b

experience

Have work experience

or

Equivalent

Veteran Memorial Service

GROUP C

MILITARY

Must submit proof of education or experience.

 

Duties

Skills

  • Communication Skills (Verbal and Written)

  • Computer Skills

  • Customer Service Skills

  • Accurately Code (CPT & ICD)

  • Perform Pre-authorization

  • Check Eligibility

  • Input Data into Medical Billing Software

  • Review Patient Reports

  • Prepare Claim

  • Review Claim

  • Submit Claim Electronically

  • Check Claim Status

Skills

  • Communicate with Provider, Patient, Insurance

  • Billing Primary, Secondary of Tertiary Insurance

  • Appeal Denied Claims

  • Post Insurance Claims

  • Post Charges

  • Post Payments Received (Electronically or Manually)

  • Resolve Patient Billing Issues

  • Perform Pre-authorization for Patients

  • A/R Management

  • Collections Process

  • Other Duties as Assigned

Exam Test Plan

The exam content topic includes the following:

  1. Revenue Cycle Management

  2. Medical Billing Software

  3. Pre-Authorization

  4. Insurance (Medicare, Medicaid, Tricare, BCBS, Workers Comp)

 
 

Renewal

AECA believes in continuing education more frequently so that the candidate can have a constant touch with knowledge, Candidate’s are required to attend the continuing education units / credits every year to renew their certification.

Renewal: 

Certification is required to be renewed annually.

On submitting a renewal application the candidate will receive an email with links to CEUs that must be completed and submitted online. 

Fee Schedule for Renewal

Renewal Fee: $50

Reinstatement

Certification that are expired must apply for reinstatement.

If you wish to apply to reinstate your expired certification you may proceed by submitting a reinstatement application. 

 

Fee Schedule for Reinstatement

Expired Less than 1 Year: $99  

Expired More than 1 Year but Less than 2 Years: $199

 
 

Frequently asked questions

What is the VI4 Artist-in-Residence program?


To explore and advocate for art as a science communication tool, we established ArtLab as a cross-disciplinary program in 2017. The overarching goal is to support visual science communication approaches and outreach. ArtLab is supported by multiple internal institutional funding sources from Vanderbilt, including The Curb Center for Art, Enterprise and Public Policy; The Wond'ry, Vanderbilt Center for Innovation, The Communication of Science and Technology program, and Vanderbilt University School of Medicine, Basic Sciences. ArtLab has become a hub for cross-disciplinarity activity across the Vanderbilt campus. In 2019, we initiated the Vanderbilt Institute for Infection, Immunology, and Inflammation (VI4)-ArtLab Artist-in-Residence (AiR) program, connecting undergraduate artists with research laboratories to create artwork that visually represents the latest research carried out by esteemed laboratories at Vanderbilt. The program is a 10-week summer program open to undergrdaute students.




What happens during the summer program?


This program is entirely virtual. Undergradute artists are matched with laboratories and the AiR leadership hosts a virtual orientation meeting. The purpose of the orientation is to begin building community relationships, provide expectations for both the students and the faculty about the program, and to begin brainstorming project ideas. The hosting labs will be asked to assign an artist to a scientific mentor who can orient the artist to the laboratory's projects and approaches. These program mentors serve as the primary contact persons for the program. The artist will be asked to participate in at least some of the laboratory's meetings virtually. If the laboratory meetings happen in person, the laboratory contact will make accommodations such that the student artist will have the option to attend virtually. Throughout the summer, the artist will be asked to create at least two art pieces that are representative of the laboratory. One of the art pieces will be abstract, exploring the overall scientific research area. This abstract piece can be used as a cover art submission. The second piece of artwork can either be another abstract piece or more concrete, like a graphical abstract representing a specific research discovery.

Both pieces must be submitted by the end of the program in late August. This artwork will be collected by the AiR leadership, who will assemble the works in a digital magazine and schedule a virtual art exhibit. All AiR participants from current and past years will be invited to participate in the virtual art exhibit. We will work hard to ensure broad participation from others outside of the program.




Who are the eligible faculty?


Faculty who are members of VI4 are invited to participate. We are particularly interested in recruiting assistant professors that bring multidisciplinary approaches to study human infectious diseases. Our goal is to support early investigators, to promote and highlight their work on the point at which the systems of humans and potentially infectious agents connect. Ideally this program would bring increased attention to the science behind issues which as colonization, infection, commensalism, and other relationships at levels ranging from molecular interactions to systemic ones. Faculty will be selected for the following year’s summer program by the end of the precedding calendar year.




Who are eligible students?


Once faculty have been selected in January, application and recruitment for undergraduate student artists will begin. Ideally, undergraduate artist participants should have completed basic biology courses and submit statement demonstrating their passion for research and knowledge of the scientific process. Most importantly, the ideal candidate has intellectual curiosity, drive, and perseverance to explore the cross-disciplinarity between science and art. Students will be asked to submit samples of their work, a personal statement, and a program proposal that identifies the skills and experiences that the student wishes to cultivate as part of their experience. Applications will be reviewed by an advisory panel that selects the final students. We are interested in a cohort that is diverse in background, talent, experience, and personalities.