Coding & Reimbursement Specialist

Coding and reimbursement processing is performed by specialists employed in health care settings. Coding & reimbursement specialists (C&RS) assign ICD, CPT, and HCPCS codes to diagnoses and procedures/services provided to patients in a variety of healthcare environments. The C&RS program offers individuals the opportunity to pursue a business-related career that is an essential part of the health care industry.

C&RS courses are offered as part of the health information technology/medical records program through the Internet using course management software that is maintained by the State University of New York. On-campus and Internet-based students complete C&RS course work online and are enrolled together in the same courses. On-campus students complete general education course requirements on the Alfred State College campus in a traditional classroom setting, and Internet-based students complete these requirements through the Internet or in a traditional classroom at a college close to home. Each C&RS student is assigned to an academic adviser who assists with course selection and sequencing, and serves as the student's advocate.

Internet-based course offerings are of the same quality and meet the standards of traditional on-campus courses, and they are designed and delivered to meet established course objectives.

Students enrolled in the coding and reimbursement specialist program must complete 38 credits and earn grades of "C" or higher in all MEDR-prefix courses.

Professional Practice Experience

Students complete a non-paid professional practice experience in the coding and billing departments of an acute care hospital (240 hours). Practice arrangements are made in consultation with each student so that a convenient location is selected. Students are required to earn a grade of at least "C" in each BIOL- and MEDR-prefix course prior to placement. Students must also earn a grade of at least "C" in the MEDR 1313 and MEDR 1323 professional practice experience to graduate from the coding and reimbursement specialist program. Students are not a substitute for paid staff during professional practice experience, which means they are expected to receive appropriate supervision and mentoring during completion of all tasks.

The Joint Commission on Accreditation of Healthcare Organizations Hospital Accreditation Standards Manual requires hospitals to implement "a process to ensure that a person's qualifications are consistent with his/her job responsibilities." This standard "applies to staff, students and volunteers," and it further states that the hospital is responsible for verifying "the following according to law, regulation or hospital policy: information on criminal background." As such, Alfred State College students who complete professional practice experiences in the coding and reimbursement specialist and health information technology/medical records programs may be required to undergo a criminal background check prior to placement at the facility. In addition, the facility may require students to undergo a physical examination (on-site at the facility or by the student's primary care provider) prior to beginning the professional practice experience. The physical examination includes drug screening, a Tb test, and/or DTB, hepatitis B, and/or MMRV immunization or status. Students may be required to incur costs associated with the criminal background check and/or physical examination.

Once a professional practice experience placement has been arranged, students are expected to contact the professional practice supervisor (e.g., Director of Health Information Department) to arrange a schedule for attendance. Students may be required to attend an on-site orientation at the professional practice facility, which could be several days in length. Students also may be required to undergo a physical examination, either on-site at the facility or at his/her primary care provider's office. Students may be expected to incur the expense of the physical examination.