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Revenue Cycle Management in Medical Billing (Accredited)

Name: Revenue Cycle Management in Medical Billing (Accredited)
Rating: 4.5 (352 reviews)

Includes Real World Setup Simulation | Practical Revenue Cycle Management (RCM) with Exam, Feedback and Certification.

Role Play

Created byLearndrive Courses

Last updated 6/2025

English

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What you'll learn

You will gain an understanding of the 16 steps involved in Revenue Cycle Management in Healthcare.
You’ll learn how to explain and clear up financial transactions in medical billing, including pre-registration and insurance verification.
You will Learn what makes up a high performance pre-registration unit and what information is needed during patient registration.
You will discover how to verify a patient's insurance coverage and the financial responsibility of the patient in medical billing.
You’ll learn about the three categories of CPT along with an overview of ICD-10-CM and HCPS.
You will discover the definition, five step process, and best practices for charging in medical billing.
You will learn what is included in a medical claim, how to submit a claim in 4 steps, and what happens after submission.
You’ll Know about the KPIs that needs to be tracked to maintain healthy accounts in medical billing.
You will learn how to improve the efficiency of your A/R process by automation.
You will discover the six steps of an effective denial management process, master best practices, and devise strategies to effectively manage denials.
you will actively engage with supplemental materials, course notes, and quizzes in each section of thisto measure and enhance your understanding in RCM.
You'll utilize the RCM Course audiobook provided in the resource section of each unit to deepen your understanding and complement your learning experience.
You will receive tutor support & communicate with tutor through inbox.
You will obtain a Certificate of Completion in Revenue Cycle Management (RCM) in Medical Billing 2024।

Course content

12 sections • 70 lectures • 3h 14m total length

What is Revenue Cycle Management?2:57
Learn about the three functions of Revenue Cycle Management (RCM) from this lecture.
Function 1: Generate Revenue1:31
Function 2: Capture Revenue1:12
Document every service accurately during a patient encounter from check-in to departure to capture revenue at the highest level and avoid under coding.
Function 3: Collect Revenue0:27
The Importance of RCM in Healthcare1:45
You will understand the Importance of RCM in Healthcare from this video.
THe Steps of An RCM Process6:16
You will learn about the 16 steps involved in Revenue Cycle Management (RCM).
Knowledge Check: Time for a Short Quiz Test
Medical Terminology and Language Rules3:10
In this video, we’ll cover medical terminology—the specialized language used in healthcare to describe various issues. It’s also useful for those in the medical transcription field.
Becoming a Specialist2:13
What are the language rules for medical transcrription? You need to know the rules for medical writing. This knowledge will also come handy in revenue cycle management. We will cover this topic in this lecture.
Short Summary3:26
Your Feedback0:43
Offer your feedback to improve this revenue cycle management course by leaving a positive review on the My Learning page, using the resource section link.

What is Pre-Registration0:45
Verify insurance and complete pre-registration to ensure uninterrupted revenue, explain financial transactions clearly, collect patient payments, and communicate out-of-pocket expenses to patients.
The Role of Pre-Registration in RCM2:45
Learn the roles of pre-registration in collecting and verifying patient information in revenue cycle management.
Pre-registration requirements0:36
Streamlining Patient Onboarding0:46
Learn what information must be collected during patient registration and what a high-performance pre-registration unit entails.
The Benefits o Pre-registration Process1:05
Highlight the time-saving and educational benefits of pre-registration for patients and staff, enable at-home form completion, access to medical histories, and support individualized, patient-centered care and stronger clinician relationships.
What is Insurance Verification1:34
Verify a patient’s insurance coverage and financial responsibility in revenue cycle management. Early verification helps estimate costs, obtain authorizations, optimize billing order across policies, and reduce surprise bills.
The Importance of Insurance Verification1:26
Verify patient insurance to secure the revenue cycle and reduce claim rejections. Implement efficient eligibility checks to identify costs before care and explain financial responsibility clearly.
Methods of Insurance Verification3:44
Learn the methods of insurance verification in medical billing to determine a patient’s insurance coverage for medical services, as well as the patient’s financial responsibility.
The Insurance Verification Process1:51
Short Summary4:06
Knowledge Check: Pre-Registration and Insurance Verification in RCM
Role Playing Meeting: Conducting an Insurance Verification Call with a Payer

Medical Code, Charge Entry and Claim Submission - What You'll Learn?5:56
Discover how medical coding assigns ICD-10-CM diagnostic codes, CPT procedure codes, and HCPCS codes to support medical necessity, ensure accurate billing, and reduce insurance denials within revenue cycle management.
Medical Code and Coding Standards5:18
Learn about medical coding standards and systems such as ICD-10-CM, CPT and HCPA.
Importance of Medical Coding in Healthcare1:09
Translate patient information into a universal language through medical coding to ensure accurate diagnoses, support bills and payments, and enable insurer-provider communication amid health care reform.
Benefits of Medical Code and Medical Coding2:49
Learn about the 5 benefits of medical coding.
Understand What is Charge Entry3:06
Know about charge entry and it’s significance.
Learn The Process of Charge Entry5:02
Find out what charge entry in medical billing is, and how it can be done in 5 steps.
What is Claim Submission2:26
Know what a medical claim includes from this lecture.
Clean Claim Submission Process for Revenue Cycle Management3:10
This short tutorial teached you how to submit claim in four steps.
Know What Happens After a Claim Submission1:29
Payers adjudicate claims after submission, deciding whether they are accepted, rejected, or denied. Electronic claims are created by billing software and must be clean, accurate, and timely to receive payment.
Short Summary3:22
Knowledge Check: Medical Code, Charge Entry and Claim Submission
Key Points: Medical Code, Charge Entry and Claim Submission2:07
Role Play: Resolving a Claim Rejection with a Payer Representative

Categories of CPT Codes3:57
Explore the structure and classification of CPT codes across category one, two, and three, including modifiers and symbols, to accurately document and bill medical procedures.
Code Format and Organization5:31
CPT Symbols1:49
Understanding Code Modifiers2:53
Understand CPT code modifiers, including level one modifiers by the AMA and level two HCPCS by CMS, to indicate altered services and improve reimbursement while preventing claim denials.
Summary2:59

Account Receivable in Medical Billing: What You will Learn1:18
Importance of Account Receivable in Revenue Cycle Management (RCM)0:59
Learn about the definition and importance of A/R in RCM.
Account Receivable (A/R) Benchmark1:05
Know about the KPIs that needs to be tracked to maintain healthy accounts in medical billing.
Account Receivable in RCM: Understanding the A/R Process1:37
Understand the 4 key process of account receivable in healthcare industry.
The Challenges of A/R in RCM3:19
Know about the unique challenges that Accounts receivable in healthcare present.
Reducing A/R Days in Revenue Cycle Management4:35
Learn how you can improve your accounts receivable by evaluating the process.
Best Practices for Managing Accounts Receivable in RCM4:43
Get 7 proven tips for efficiently manage your accounts receivable in medical billing.
Automate Your A/R Workflow4:22
Learn how automation improves the efficiency of many A/R processes.
Short Summary4:08
Knowledge Check: Accounts Receivable Process and Follow-up in Revenue Cycle Mana
Key Points: Accounts Receivable Process and Follow-up in Revenue Cycle Managemen1:41
Role Play: Communicating with Patients About Outstanding Balances

Denial Management in Healthcare2:18
Types of Denials2:16
You will know about the five categories of denial.
The Denial Management Process4:39
Know about the 6 steps in effective denial management process.
The Benefits of Denial Management in RCM1:56
Challenges Involving Denial Management1:41
Multiple challenges present obstacles to physician practices lowering their denial rate.Let’s find out.
Best Practices and Strategies in Denial Management3:03
Master best practices and devise strategies to effectively manage denials in healthcare.
Medical Writing and Reporting in Revenue Cycle Management3:59
The Metrics of Reporting2:36
Know about the four key types of metrics in revenue reporting process in revenue cycle management.
Improving RCM Process Through a Feedback Cycle6:20
Short Summary4:17
Knowledge Check: Denial Management and Reporting in Revenue Cycle Management
Key Points: Denial Management and Reporting in Revenue Cycle Management1:57

Requirements

Basic computer literacy and strong organizational skills are necessary to manage complex billing cycles and adhere to deadlines.
Open to all with no prior experience in medical billing or RCM; ideal for beginners eager to explore the field.

Description

Master Revenue Cycle Management with Real-World Skills

Join thousands of learners already benefiting from our top-rated Revenue Cycle Management (RCM) course — now with enhanced, hands-on features designed to take your understanding of medical billing to the next level.

With nearly 250 five-star reviews, this course stands out for its clarity, depth, and practicality. And now, it’s even more powerful.

New expert-led lectures
AI-powered role play scenarios to simulate real-world RCM conversations
Step-by-step demonstration of RCM process setup in actual healthcare environments
20+ downloadable resources and in-depth articles
Short quizzes and summaries after each section
Practice test and writing assignments with personalised feedback

You won’t just learn theory — you’ll apply it. Our AI Role Play Feature lets you engage with virtual case studies, giving you the confidence to handle RCM processes in real-life medical billing settings.

Do you know that you can help health care organizations identify inefficiencies, optimize processes, reduce denials, and increase revenues? The key to all these things is to master Revenue Cycle Management (RCM).

Our Accredited Revenue Cycle Management Course walks you through all the steps in revenue cycle management. Revenue cycle management is a way for healthcare providers to manage their administrative and clinical functions. With proper RCM, care providers can maximize their claim reimbursements, improve their medical billing process and increase their patient service revenue.

This course teaches you the 16 steps to revenue cycle management for effective medical billing. We'll teach you everything you need to know about pre-registration and insurance verification. You will also get a basic understanding of medical coding, charge entry and claim submission.

In addition, you'll learn about account receivable, denial management, and medical billing reporting best practices. If you are looking for a quick and effective guide to revenue cycle management, then this course may be the one for you.

Real World Examples!

This course now teaches real world demonstration and teaches how to set up and use Revenue Cycle Management systems in a real world. To provide practical insight into RCM software functionality, the course features a dedicated section demonstrating OpenEMR — a fully open-source electronic medical records and RCM system. This demonstration offers a clear, visual understanding of navigating typical RCM and medical records environments. Please note, this section is designed for illustrative purposes to help you familiarize yourself with system workflows and navigation.

Don't miss this chance to become a revenue cycle management expert. Earn an accredited certificate and enjoy lifetime access by enrolling today.

Enrol today and unlock practical skills, career-ready knowledge, and certified results.

This course comes with the following Sections:

Introduction to Revenue Cycle Management (RCM) in Healthcare : You will learn the basics of revenue cycle management in medical billing including the steps involved and knowledge requirement to become an expert in RCM.
Pre-Registration and Insurance Verification: We will show you how to explain and clarify financial transactions, including the steps involved in the pre-registration and insurance verification process.
Medical Coding, Charge Entry and Claim Submission: This section will teach you medical coding standards and systems, charge entry and claim submission to ensure accurate medical billing, reimbursement, and financial operations.
Introduction to CPT Coding: Learn the basics of CPT coding, its history, and its critical role in healthcare for accurate documentation, billing, and reimbursement processes.
Structure of CPT Codes: Understand the categories, format, symbols, and modifiers of CPT codes to accurately interpret and use them in medical billing and coding.
Accounts Receivable (A/R) and A/R Follow-up : We will cover accounts receivable (A/R) process, best practices and challenges in medical billing. You will also learn how to reduce A/R days and automate process from this RCM course.
Denial Management and Reporting in RCM: You will learn the strategic process of analysing, correcting, and preventing claim denials. We will also teach revenue reporting process metrics in revenue cycle management (RCM).
Whether you’re starting out or upskilling in healthcare admin, this course delivers exactly what you need to succeed in Revenue Cycle Management.

Who this course is for:

RCM specialists and medical billing experts aiming to update their skills with the latest practices and technologies in the field.
Healthcare professionals seeking to expand their knowledge in revenue cycle management and enhance their skills in medical billing.
Finance and accounting professionals in the healthcare sector looking to deepen their understanding of medical billing processes.
Health administrators and managers responsible for overseeing the financial operations of healthcare facilities.
Healthcare students and recent graduates aiming to establish a career in medical billing or RCM.
Individuals aspiring to work in hospitals, medical billing companies, or any healthcare facility, seeking a comprehensive understanding of RCM.
Career changers or individuals from non-medical backgrounds who have a keen interest in the healthcare industry, particularly in the financial and billing aspects.

Revenue Cycle Management in Medical Billing (Accredited)

What you'll learn

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Course content

Introduction to Revenue Cycle Management (RCM) in Healthcare10 lectures • 24min

KPIs1 lecture • 12min

Pre-Registration and Insurance Verification in RCM11 lectures • 19min

Medical Code, Charge Entry and Claim Submission12 lectures • 36min

Introduction to CPT Coding3 lectures • 5min

Structure of CPT Codes5 lectures • 17min

Accounts Receivable Process and Follow-up in Revenue Cycle Management11 lectures • 28min

Denial Management and Reporting in Revenue Cycle Management11 lectures • 35min

Root Cause Analysis in RCM3 lectures • 4min

Practice Test0

Requirements

Description

Who this course is for: