Introduction
Medical billing is a critical component of the healthcare industry, ensuring that providers are reimbursed for their services while maintaining compliance with insurance and government regulations. As the demand for skilled medical billing professionals grows, obtaining a certification can help individuals stand out in the job market, increase earning potential, and improve career advancement opportunities.
Medical billing certifications validate a professional’s expertise in insurance claims, coding procedures, regulatory compliance, and revenue cycle management. This article explores the top medical billing certifications, their benefits, eligibility requirements, costs, and steps to get certified.
Why Get Certified in Medical Billing?
While medical billing does not require a formal degree, obtaining a certification offers several advantages:
✔ Increases job opportunities – Many employers prefer certified billing specialists.
✔ Boosts earning potential – Certified professionals often earn 20–30% more than non-certified billers.
✔ Enhances knowledge and skills – Certification ensures mastery of ICD-10, CPT, and HCPCS coding.
✔ Improves job security – Certified professionals are less likely to be replaced by automated systems.
✔ Ensures compliance with regulations – Certification covers HIPAA, Medicare, Medicaid, and insurance policies.
Top Medical Billing Certifications
1. Certified Professional Biller (CPB) – AAPC
Overview:
The Certified Professional Biller (CPB) credential, offered by the American Academy of Professional Coders (AAPC), is one of the most recognized certifications for medical billing professionals. It focuses on claims processing, insurance guidelines, and revenue cycle management.
Eligibility Requirements:
✔ No formal education required, but medical billing experience or training is recommended.
Exam Details:
✔ Duration: 4 hours
✔ Number of Questions: 200 multiple-choice questions
✔ Passing Score: 70%
✔ Exam Fee: $399 (AAPC members)
✔ Format: Online or in-person
How to Get Certified:
✔ Step 1: Enroll in an AAPC-approved CPB training course (optional but recommended).
✔ Step 2: Study medical billing codes, insurance policies, and claim processing.
✔ Step 3: Take and pass the CPB exam.
✔ Step 4: Maintain certification by completing 36 continuing education units (CEUs) every two years.
2. Certified Medical Reimbursement Specialist (CMRS) – AMBA
Overview:
The Certified Medical Reimbursement Specialist (CMRS) credential, offered by the American Medical Billing Association (AMBA), is ideal for independent billers and professionals working in private practices. It covers claims submission, compliance, and reimbursement management.
Eligibility Requirements:
✔ At least one year of medical billing experience is recommended.
✔ AMBA membership required ($99 annually).
Exam Details:
✔ Duration: Open-book exam, self-paced within 45 days
✔ Number of Questions: 800 questions (graded in sections)
✔ Passing Score: 85%
✔ Exam Fee: $499 (includes study guide)
✔ Format: Online
How to Get Certified:
✔ Step 1: Become an AMBA member.
✔ Step 2: Enroll in a medical billing course (optional but helpful).
✔ Step 3: Take and pass the CMRS exam.
✔ Step 4: Maintain certification with 15 CEUs per year.
3. Certified Billing and Coding Specialist (CBCS) – NHA
Overview:
The Certified Billing and Coding Specialist (CBCS) credential, offered by the National Healthcareer Association (NHA), is ideal for entry-level professionals looking to enter the medical billing and coding industry.
Eligibility Requirements:
✔ High school diploma or equivalent.
✔ Completion of a medical billing and coding program or one year of work experience.
Exam Details:
✔ Duration: 2 hours
✔ Number of Questions: 100 multiple-choice questions
✔ Passing Score: 390/500
✔ Exam Fee: $117
✔ Format: Online or in-person
How to Get Certified:
✔ Step 1: Enroll in a billing and coding training program.
✔ Step 2: Gain hands-on experience with medical billing software.
✔ Step 3: Register and pass the CBCS exam.
✔ Step 4: Maintain certification with 10 CEUs every two years.
4. Certified Medical Billing Specialist (CMBS) – MAB
Overview:
The Certified Medical Billing Specialist (CMBS) credential, offered by the Medical Association of Billers (MAB), focuses on medical claims, reimbursement laws, and compliance.
Eligibility Requirements:
✔ No formal prerequisites, but medical billing training is recommended.
Exam Details:
✔ Duration: 2 hours
✔ Number of Questions: 100 multiple-choice questions
✔ Passing Score: 70%
✔ Exam Fee: $199 (includes study guide)
✔ Format: Online
How to Get Certified:
✔ Step 1: Study medical billing regulations and insurance laws.
✔ Step 2: Register for the CMBS exam.
✔ Step 3: Pass the exam and obtain certification.
✔ Step 4: Maintain certification with CEU requirements.
5. Registered Medical Billing Specialist (RMBS) – MAB
Overview:
The Registered Medical Billing Specialist (RMBS) credential is another certification by MAB, focusing on billing ethics, reimbursement policies, and healthcare regulations.
Eligibility Requirements:
✔ No experience required.
Exam Details:
✔ Duration: 90 minutes
✔ Number of Questions: 75 multiple-choice questions
✔ Passing Score: 70%
✔ Exam Fee: $150
✔ Format: Online
How to Get Certified:
✔ Step 1: Take a medical billing training program.
✔ Step 2: Register and pass the RMBS exam.
✔ Step 3: Complete ongoing education to maintain certification.
How to Choose the Right Certification?
Choosing the right certification depends on:
✔ Career goals – If you want to specialize in billing only, CPB or CMRS is a great choice. If you want to combine coding and billing, CBCS may be better.
✔ Experience level – If you are new, CBCS or RMBS may be ideal. If you have experience, CPB or CMRS may be more beneficial.
✔ Cost and time – Consider the exam fee, preparation time, and renewal requirements before committing.
Conclusion
Medical billing certifications provide a competitive edge in the healthcare industry, improving job prospects and earning potential. Whether you choose CPB, CMRS, CBCS, CMBS, or RMBS, obtaining certification validates your expertise and commitment to ethical billing practices.
✔ Key Takeaways:
- Certification enhances job opportunities and ensures compliance.
- Top certifications include CPB, CMRS, CBCS, CMBS, and RMBS.
- Each certification has different eligibility, exam formats, and costs.
- Continuing education is required to maintain certification.
By selecting the right certification and following the proper steps to prepare, you can build a successful career in medical billing and healthcare administration.
