Revenue Cycle Management and Medical Billing for Experts
Medical billing expert training: RCM, prior authorization, EDI, CMS-1500/1450, denials & A/R management. Level 4 certification.
Course Content
Revenue Cycle Management and Medical Billing for Experts is an advanced Udemy course taught by RCM Academy. It runs 1h 39m, is taught in English, and includes a certificate of completion. Learners rate it 5.0 out of 5 from 2 reviews, with 610 students enrolled. It is a paid course, first published October 2025.
Master Enterprise Revenue Cycle Management (RCM) & Medical Billing
Elevate your expertise in US healthcare revenue cycle management with this comprehensive program. Gain mastery over critical areas including medical billing, prior authorization, medical coding, payment posting, and managing high-complexity healthcare claims. Learn to optimize AR management and AR calling strategies, all directly linked to medical records and payer policies.
Key Skills & Strategies You'll Develop:
- Pricing & Contract Governance: Operationalize pricing strategies and master CMS 1500/CMS 1450 governance. Design actuarial payer contracts for maximum revenue capture.
- Interoperability & Data Engineering: Engineer seamless FHIR/X12 integrations to streamline data flow. Develop robust data pipelines and governance frameworks.
- Denial Management & AR Optimization: Implement effective denial management processes and optimize AR management through data-driven insights and predictive analytics.
- Advanced Revenue Cycle Functions: Deep dive into pharmacy revenue cycle, 340B compliance, and strategies for managing post-acute & facility payment systems.
- Value-Based Care & Analytics: Drive value-based operations (ACO/MSO/IPA) and leverage ML for forecasting denials and AR.
- Risk & Compliance: Harden privacy and security beyond HIPAA, and establish robust audit trails and risk management protocols.
Course Features:
- 120+ Expert Lessons with Templates: Access practical resources like pricing models and contract math tools.
- Interop Blueprints: Detailed FHIR/X12 mappings, edit taxonomies, routing, and SLAs.
- Playbooks for Complex Scenarios: Strategies for 340B, PBM, high-cost episodes (NICU/transplant), and post-acute care.
- Data Science & ML Workbooks: Hands-on notebooks for denial prediction, AR aging, and payment posting variance analysis.
- Compliance Toolkits: Risk registers, audit trails, privacy controls, and incident workflows.
- Operational System Artifacts: Templates for org design, KPIs, incentives, OKRs, and governance dashboards.
- Mobile-Friendly Learning: Access content on any device.
- Structured Learning: Organized into 6 focused sections:
- Pricing, Chargemaster Strategy & Revenue Economics
- Advanced Payer Contract Actuarial Modeling
- FHIR/X12 Interoperability Engineering
- Pharmacy & PBM Revenue Cycle
- 340B Program & Split-Billing
- Post-Acute & Facility Payment Systems
Who Should Take This Course?
This course is ideal for:
- Health-system executives
- Revenue Cycle Directors/VPs
- Enterprise RCM Leaders
- Senior Consultants & Actuaries
- EDI/IT & Data Leaders
- Pharmacy/340B, PBM, & Specialty Program Leaders
- Compliance, Privacy & Audit Leaders
- M&A/Roll-Up Operators
Disclosure: This course utilizes artificial intelligence for clear voiceovers.
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