Offered at Cal State LA Downtown and in collaboration with Cedars-Sinai and Healthcare Business Insights (HBI), the certificate program in Healthcare Revenue Cycle Administration will prepare students to work as a patient financial services/patient accounting representative in a healthcare setting. The course will reflect experiences in all aspects of the hospital revenue cycle, with a focus on payment variance identification and resolution. Students will be awarded a certificate of completion as a Revenue Cycle Administrator after successfully completing this course with an 80% or better average.
Student Learning Outcomes
- Identify main functional areas in key tasks in the revenue cycle.
- Differentiate between compliant and noncompliant HIPAA practices.
- Analyze whether a person is/is not eligible for Medi-Cal based on specific factors.
- Identify the benefits and best practices for preventing financial variance in the revenue cycle.
- Identify best practices for successful communication and service.
- Differentiate between demographic, financial, and clinical data elements (CDEs).
- Identify and interpret codes in various fields on the UB-04 form.
- Name methods for managing and preventing variance.
- Identify key denial management practices and steps for following up on common denials.
- Interpret an EOB (Explanation of Benefits) statement.
- Identify key insurance card elements.
- Differentiate among various types of insurance coverage.
- Identify typical appeal timelines and the most common issues causing underpayments.
- List best practices for preventing COB (Coordination of Benefits) denials.
- Differentiate among CMS prospective payment systems.
- Demonstrate the procedures needed to deal effectively with a claim denial.
Healthcare is one of the fastest-growing industries in Los Angeles County, however, many large healthcare employers in the area report a shortage of qualified individuals to fill roles in revenue cycle operations.
To help facilitate career transition, Cedars-Sinai, a national healthcare leader, will select up to two top-performing students for paid internship positions, creating a potential pathway to full-time employment.
Who Should Enroll?
Individuals interested in jump starting their career in the healthcare industry by gaining an industry-recognized certification.
Tuition & Fees
Federal financial aid is not currently available for the Healthcare Revenue Cycle Administration Certificate Program.
For inquiries about the Healthcare Revenue Cycle program, please contact PaGE Programs via email.