Health Care Access and Information (HCAI) - Training Program

Training Program Objectives:

In the Medical Billing and Coding Credentialing and Enrollment Internship Pathway Training Program, learners are introduced to healthcare revenue cycle operations with a focus on medical billing, coding, and provider credentialing processes. Participants develop an understanding of how healthcare services are documented, coded, credentialed, enrolled with insurance payers, and reimbursed within healthcare organizations.

Learners gain foundational knowledge of the three primary healthcare code sets used in medical billing and coding:

· CPT

· ICD-10-CM

· HCPCS Level II

Participants will also develop an understanding of the health insurance industry, reimbursement methodologies, regulatory and compliance considerations, and the role credentialing and payer enrollment play in ensuring providers are authorized to deliver services and receive reimbursement from insurance payers.

Throughout the program, learners are introduced to the processes involved in:

· Provider credentialing and recredentialing

· Payer enrollment and provider network participation

· Documentation verification and provider data management

· Claim preparation, submission, and payment processing

· Revenue cycle workflows within healthcare organizations

This program prepares participants for careers supporting healthcare administrative and revenue cycle functions in physician practices, clinics, hospitals, and federally qualified health centers.

Overall, this program helps equip students for a rewarding future in medical billing/coding in a physician’s office, clinic, or similar setting. It also prepares students to test for the industry-recognized Billing and Coding certifications from the American Academy of Professional Coders (AAPC):

Learners participating in the Credentialing and Enrollment Internship Pathway will gain hands-on experience supporting credentialing and payer enrollment activities, which are essential for ensuring providers meet regulatory requirements and are properly enrolled with insurance payers prior to delivering billable healthcare services.

Participants in the Credentialing and Enrollment Internship Pathway will also receive exposure to provider credentialing and payer enrollment processes, which are critical components of healthcare revenue cycle operations.

Note: This program consists of 2 Phases:

1. Online classroom training (approximately 20 weeks)

2. Online Internship (approximately 19 weeks)

Participation in all components above is required and a commitment of 40 hours per week during standard business hours. The entire program as a whole is approximately 44 weeks in duration.

Training Program Eligibility Requirements:

· Must be 18 years or older

· Must have a high school diploma or GED

· Must be a U.S. Citizen or Permanent Resident/Green Card holder (not open to non-citizens or Visa holders)

· Familiarity with Microsoft Office Suite, particularly Word, Excel, and PowerPoint, is beneficial for this role

· Must be able to pass a national criminal background check successfully.

Note: This program includes both online classroom training and remote hands-on training.

Training Program Benefits:

· Learn everything other medical billing/coding institutions teach, plus specifics related to the unique needs of federally qualified health centers (FQHCs) and look-alikes.

· Exposure to credentialing and enrollment processes within healthcare organizations

· Upon successful program completion and a passed exam, become certified in medical billing and medical coding, and provider credentialing

Training Program Details:

· This is a temporary training program lasting approximately 44 weeks.

· This training program requires the learners to participate Mon-Fri, 8 AM-5 PM for the duration of the program.

· Participants are not eligible to receive paid holidays or paid time off (PTO), all missed time will need to be made up.

· The program includes remote learning and remote hands-on internship training. Accepted participants must complete 40 hours per week, Monday through Friday, during regular business hours for the entire duration of the program.

· Total Stipend: $31,200, This stipend is distributed over approximately 44 weeks for participation in both remote learning and remote hands-on internship/ externship training. Stipend payment is made on OCHIN’s semi-monthly pay schedule.

· Eligible for monthly Health Marketplace reimbursement up to $600 for 44 weeks (Participant cost only) - some restrictions apply.

· Internet Stipend $35/month for 44 weeks

MBC Credentialing and Enrollment Internship Pathway:

During the internship phase, learners gain practical experience supporting healthcare organizations with provider credentialing and payer enrollment processes.

Credentialing and enrollment teams ensure that healthcare providers are properly verified, credentialed, and enrolled with insurance payers so that services can be billed and reimbursed correctly.

Learners develop practical skills in data management, provider documentation review, payer enrollment processes, and regulatory compliance.

Internship duties include, but are not limited to:

· Provide efficient and accurate support to ensure complete provider information and timely processing of credentialing and enrollment requirements.

· Contribute to activities related to initial credentialing, recredentialing, and payer enrollment.

· Support communication with health centers, providers, and internal teams to keep credentialing and enrollment processes moving forward.

· Research and obtain required information from providers or clinic staff through Epic in-basket communication.

· Review and organize documents needed for payer enrollment, including hospital affiliations, collaborative agreements, and facility-specific materials.

· Validate and maintain accurate provider information in MD Staff and the Council for Affordable Quality Healthcare (CAQH) system.

· Assist with reviewing updated credentials in MD Staff and help ensure data remains accurate and consistent across systems.

· Participate in audits of practitioner files and other data integrity projects.

· Collaborate with health centers to ensure providers meet credentialing compliance requirements.

· Partner with OBS and other stakeholders to identify areas of concern and support resolution.

· Identify common errors that delay enrollment and reinforce best practices that support timely completion.

· Establish and maintain positive working relationships with payers, providers, team members, clients, and other stakeholders.

· Maintain confidentiality of patient and organizational information in compliance with HIPAA.

· Perform data entry and computer-based project tasks as needed.

· Meet assigned productivity goals.

· Other duties as assigned.

OCHIN Workforce Development Equal Opportunity Statement

OCHIN is an equal opportunity educational provider committed to fostering an inclusive and equitable environment for all. We are dedicated to a policy of non-discrimination for all members of the OCHIN community, including learners, team members, and applicants. We do not discriminate based on race, creed, color, sex, sexual orientation, gender identity or expression, religion, national origin, age, disability, genetic information, marital status, veteran status, or any other legally protected status.

OCHIN is committed to making decisions for program entry, training, and educational opportunities based on individual qualifications and abilities. We actively seek to attract learners and team members from diverse backgrounds and affirmatively support equal access and opportunity for women, minorities, individuals with disabilities, special disabled veterans, and other covered veterans, in accordance with applicable federal, state, and local laws.

We strive to create an inclusive learning environment that fosters the success of every individual and reflects the diverse communities we serve.

OCHIN Workforce Development Health Screenings and Immunization Requirements

To ensure the safety of our learners, partners, and communities, OCHIN requires all program participants—including those attending remote and in-person training, internships, and externships—to be vaccinated with a COVID-19 vaccine, as recommended by state and federal public health officials. Participants must provide proof of full vaccination or receive approval for a medical or religious exemption prior to program acceptance.

Additionally, for on-site internships and externships, participants must provide proof of meeting the immunization requirements specific to the host site prior to acceptance into the program. These requirements may include, but are not limited to, vaccinations for influenza, hepatitis B, and MMR. Requests for exemptions based on medical or religious grounds will be reviewed and must comply with applicable laws and site-specific policies.

Please note that many sites require participants to complete tuberculosis (Tb) testing and drug screening before beginning their placement. Participants are responsible for ensuring that all required health screenings are completed by the site’s deadline to avoid delays in program participation.

OCHIN is committed to working collaboratively with program participants and host sites to ensure compliance with these health and safety requirements while maintaining respect for individual beliefs and circumstances.