Description
Certification Name: Certificate in Health Insurance & Claims Management
Course Id: CHICM/Q0001.
Eligibility: 10+2 or Equivalent.
Objective: The Certificate in Health Insurance & Claims Management course is designed to provide participants with the skills and knowledge required to efficiently manage health insurance claims and coordinate healthcare billing processes. The program covers the fundamentals of health insurance policies, patient eligibility verification, medical coding, and claims submission procedures.
Duration: Three Month.
How to Enroll and Get Certified in Your Chosen Course:
Step 1: Choose the course you wish to get certified in.
Step 2: Click on the “Enroll Now” button.
Step 3: Proceed with the enrollment process.
Step 4: Enter your billing details and continue to course fee payment.
Step 5: You will be redirected to the payment gateway. Pay the course and exam fee using one of the following methods:
Debit/Credit Card, Wallet, Paytm, Net Banking, UPI, or Google Pay.
Step 6: After successful payment, you will receive your study material login ID and password via email within 48 hours of fee payment.
Step 7: Once you complete the course, take the online examination.
Step 8: Upon passing the examination, you will receive:
• A soft copy (scanned) of your certificate via email within 7 days of examination.
• A hard copy (original with official seal and signature) sent to your address within 45 day of declaration of result.
Step 9: After certification, you will be offered job opportunities aligned with your area of interest.
Online Examination Detail:
Duration- 60 minutes.
No. of Questions- 30. (Multiple Choice Questions).
Maximum Marks- 100, Passing Marks- 40%.
There is no negative marking in this module.
| Marking System: | ||||||
| S.No. | No. of Questions | Marks Each Question | Total Marks | |||
| 1 | 10 | 5 | 50 | |||
| 2 | 5 | 4 | 20 | |||
| 3 | 5 | 3 | 15 | |||
| 4 | 5 | 2 | 10 | |||
| 5 | 5 | 1 | 5 | |||
| 30 | 100 | |||||
| How Students will be Graded: | ||||||
| S.No. | Marks | Grade | ||||
| 1 | 91-100 | O (Outstanding) | ||||
| 2 | 81-90 | A+ (Excellent) | ||||
| 3 | 71-80 | A (Very Good) | ||||
| 4 | 61-70 | B (Good) | ||||
| 5 | 51-60 | C (Average) | ||||
| 6 | 40-50 | P (Pass) | ||||
| 7 | 0-40 | F (Fail) | ||||
Key Benefits of Certification- Earning a professional certification not only validates your skills but also enhances your employability. Here are the major benefits you gain:
Practical, Job-Ready Skills – Our certifications are designed to equip you with real-world, hands-on skills that match current industry demands — helping you become employment-ready from day one.
Lifetime Validity – Your certification is valid for a lifetime — no renewals or expirations. It serves as a permanent proof of your skills and training.
Lifetime Certificate Verification – Employers and institutions can verify your certification anytime through a secure and reliable verification system — adding credibility to your qualifications.
Industry-Aligned Certification –All certifications are developed in consultation with industry experts to ensure that what you learn is current, relevant, and aligned with market needs.
Preferred by Employers – Candidates from ISO-certified institutes are often prioritized by recruiters due to their exposure to standardized, high-quality training.
Free Job Assistance Based on Your Career Interests – Receive personalized job assistance and career guidance in your preferred domain, helping you land the right role faster.
Assessment Modules:
Module 1: Introduction to Health Insurance: Overview of Health Insurance, Types of Health Insurance Plans, Key Terminology in Health Insurance, Role of a Health Insurance Coordinator, Legal and Ethical Considerations, Importance of Insurance in Healthcare
Module 2: Medical Coding and Billing Basics: Introduction to ICD-10 Coding, CPT and HCPCS Codes, Understanding Diagnosis vs Procedure Codes, Coding Guidelines and Conventions, Common Coding Errors, Documentation Requirements for Accurate Billing
Module 3: Claims Processing and Management: Overview of Claims Processing, Insurance Verification and Eligibility, Claim Creation and Submission, Electronic vs Paper Claims, Payment Posting and Reconciliation, Denials and Appeals Handling
Module 4: Healthcare Regulations and Compliance: HIPAA Overview and Patient Privacy, Fraud, Waste, and Abuse in Healthcare, Compliance Programs and Audits, Understanding Payer Policies, Legal Responsibilities of Claims Coordinators, Ethical Practices in Health Insurance.
Module 5: Advanced Claims Coordination: Coordination of Benefits (COB), Handling Complex Claims, Managed Care and Network Considerations, Working with Multiple Payers, Claim Follow-Up and Tracking, Reporting and Analysis of Claims Data.
Module 6: Professional Skills and Career Development: Effective Communication with Patients and Providers, Time Management and Organizational Skills, Using Practice Management Software, Problem-Solving in Claims Coordination, Continuous Learning and Certification, Career Advancement Strategies.
