Certified MBCS Specialists have demonstrated
1. understanding of the various types of insurance plans
2. Application of payer policy, Local Coverage Determinations (LCD), and National Coverage Determinations (NCD) for successful claim submissions
3. Knowledge of CPT®, ICD-9-CM, and HCPCS Level II coding guidelines
4. Successful navigation of the varying rules and regulations applying to the healthcare industry, including HIPAA, False Claims Act, Fair Debt Collections Act, and Stark
5. Understanding of the life cycle of a medical billing claim and how to improve the revenue cycle
6. Expertise in effective claim follow-up, patient follow-up, and denial resolution
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