What Is A CPB Certification & How Do You Get One

When we begin our journey of choosing our career paths, the options are endless. Take into consideration that fields of study greatly overlap, and that may make our choice even harder. Within the field of accounting, we know that it is pertinent to every business and the successful operation of a business to have an accountant or a finance manager overseeing financial operations.

This means that in businesses such as shops, car washes, and yes, even medical practices as these are essentially businesses, you need a finance expert and accountant to manage the inflow and outflow of money.

Owing to this need, specifically in the medical field, the role of a certified professional biller (CPB) has been developed. They are responsible for overseeing and managing all aspects of the revenue cycle within a medical or healthcare environment.

Let us delve deeper into the role of a CPB, what it is that they do, the credentials that they need for this role, and how they would go about obtaining these credentials.

What Is A CPB?

Given the complexity of the healthcare system, knowing, and understanding the billing nuances within this field is extremely important. It is important to know what the payer requirements are for medical bills, it is important to know how medical insurance payment works, and it is important to keep track of all these financial transactions that occur within a medical practice.

Over and above knowing the transactional and billing information that is required by a healthcare provider, CPBs also need to know how to remain compliant with government regulations and policies as it pertains to payments for medical treatment, and private payer policies.

When working with medical insurance, CPBs are required to assess and track all claims, they are required to ensure accuracy on such claims, they need to know and understand why claims may have been denied, and they need to have alternate strategies in place to make sure that financial loss is not incurred.

They also need to manage all incoming finances whether from a private payer or medical insurance, and they are responsible for posting payments and receiving payments. In a nutshell, this role involves executing as many duties as that of a bookkeeper but with a specific focus on the medical field.

Given the intense responsibility that CPBs are required to have and how closely they are required to work with financial elements within a healthcare facility, certified professional billers need to be just that – certified.

Obtaining A CPB Certification

While being a bookkeeper allows you to work in any business and allows you to manage financial transactions in any industry, a CPB is specifically required for bookkeepers who are working in a physician's office, a clinic, a hospital, or any other medical facility.

To qualify as a CPB, you need to take the certification examination. But first, there are some requirements needed before you are eligible for taking the exam. You would need to make sure that, at the very least, you have an associate's or a bachelor's degree in accounting, or in a finance-related field, where bookkeeping and bookkeeping processes were a part of your coursework.

Next, you will take the certified professional billing examination. Made up of around 200 multiple choice questions, the examination aims to test your knowledge, understanding, and expertise of the entire billing process as it pertains specifically to healthcare.

When preparing for the exam, it is best to prepare for long hours of sitting as the exam takes more than five hours to complete.

The examination will comprise questions related to types of insurance, the billing regulations that are required, the Health Insurance Portability and Accountability Act (HIPAA) and compliance regulations, financial reimbursements and collection of funds, case analysis, and even coding. Additionally, you need to know everything there is to know about managed patient care, Medicare, and Medicaid, draft billing documentation and adhere to regulatory stipulations, and conduct case analysis.

You can prepare for the exam by studying for it on your own, or in groups, making the load easier and gaining deeper insight and understanding through the input of others.

When you are taking the examination, it is important to know that there are costs incurred when pursuing this certification and the cost of taking the exam can range from anywhere between $22 and $75, depending on whether or not you are a member of the American Association of Professional Coders (AAPC) or not.

Salary and Outlook Information

According to the U.S. Bureau of Labor Statistics, medical records specialists earn a median annual salary of $46,660 and have a projected career outlook of 7%.

While the BLS does state that no necessary degree is required, the post-secondary certification of the CPB exam is required to fulfill this role. And while no degree is explicitly required, it is best to have a background in accounting, finances, or bookkeeping in the form of an associate's or bachelor's degree.

Demonstrated skills and understanding that you would have acquired when completing your CPB exam include a better understanding of medical insurance plans, a knowledge of policy and regulatory requirements, an understanding of how to accurately execute billing procedures, and expertise in effectively following up on pending claims.

Conclusion

If you are hoping to pursue a role as a bookkeeper within the medical field, there are some specific requirements you would need to meet. Obtaining your CPB is an absolute must and can fast-track your career by knowing exactly how you would need to conduct financial duties in a medical setting.

Knowing exactly the career path you are hoping to follow will allow you to effectively prepare for certification once you have decided to pursue the role of a CPB. This will give you the upper hand when studying for the exam and knowing exactly how to ace the course.