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PBC-MBC-P · Professional

Medical Billing & Coding — Professional

Code complex, multi-specialty encounters; master modifiers, the global surgical package, NCCI edits, denials, audits, and risk adjustment. Aligned to the recognized CPC and CCS professional standard.

Duration

40h self-paced

Exam

65 Qs · 130min

Pass mark

75%

What you'll learn

This Professional track moves beyond standard encounters into the complex, error-sensitive coding that commands premium remote pay. It assumes you already code at the Associate level and takes you into advanced ICD-10-CM sequencing, surgical and E/M coding, full modifier mastery, payer rules and NCCI edits, denial management and appeals, coding audits, compliance, and risk-adjustment (HCC) coding. The curriculum is aligned to the professional industry standard set by the CPC and CCS credentials. PBridge's certificate is its own credential; this course prepares you toward that standard and proves competence with a peer-reviewed capstone. You finish with a peer-reviewed revenue-cycle project: code complex multi-specialty encounters, resolve a denial set, and pass a mock audit. Reviewers assess your work before it lands on your public PBridge portfolio. Self-paced (~40 hours). Text-based with worked examples, code-lookup drills, and per-module knowledge checks.

Course modules

  1. 01

    Advanced anatomy, pathophysiology & terminology for accurate coding

    The deeper clinical knowledge required to code complex and multi-system encounters: disease processes, staging, and the documentation details that change codes.

    ~300min
  2. 02

    Advanced ICD-10-CM: sequencing, combination & multi-system coding

    Combination codes, etiology/manifestation sequencing, comorbidities, 'code first / use additional code,' and complex multi-system encounters.

    ~360min
  3. 03

    Advanced CPT: surgical coding, E/M leveling & the global package

    Surgical section structure, the surgical package concept, global periods, separate procedures, and advanced E/M medical-decision-making.

    ~360min
  4. 04

    Modifier mastery

    The professional modifier toolkit: global-period modifiers (-24/-58/-78/-79), -22, -51, -59 vs X{EPSU}, -76/-91, and correct application.

    ~300min
  5. 05

    NCCI edits, payer rules & medical necessity in depth

    NCCI PTP edits and MUEs, modifier indicators, LCD/NCD coverage, prior authorization, and building audit-proof claims.

    ~300min
  6. 06

    Denial management, appeals & revenue-cycle optimization

    Reading CARC/RARC, root-causing denials, the Medicare appeals levels, writing effective appeals, and reducing denial rates.

    ~300min
  7. 07

    Coding audits, compliance programs & fraud-and-abuse law

    Internal/external audits (RAC, CERT), the elements of a compliance program, the False Claims Act, OIG, and defensible documentation.

    ~300min
  8. 08

    Risk-adjustment (HCC) coding, specialties & career advancement

    The CMS-HCC model and RAF scores, capturing chronic conditions, specialty coding pathways, and the credential ladder to advance.

    ~240min

What you walk away with

Not just a certificate. A career-grade credential built to open doors.

01

A credential employers verify in one click

Unique cert ID, QR code, and tamper-evident signature. No more wondering if your certificate is taken seriously.

02

A portfolio piece, not just a paper

Your capstone project lives on your public PBV portfolio. Recruiters click and see actual work — that beats a cert badge every time.

03

Lifetime access, no expiry

Once you earn it, it's yours. No renewals, no subscriptions, no surprises.

04

A profile that stands out

Verified PBV credentials show up on your PBridge freelancer profile, putting you ahead of unverified candidates in client searches.

Why PBC works

  • USD pricing, transparent and global. Pay in USD, accepted globally.
  • Built for the global context. Case studies and capstone briefs use real-world business scenarios.
  • Reviewed capstone project. A human reviews your final project.
  • Verifiable digital certificate. QR code and cryptographic hash for one-scan verification.
  • PBridge job board access. Featured in front of employers hiring on PBridge.

Medical Billing & Coding — Professional certification FAQs

How much does the Medical Billing & Coding — Professional certification cost?+

The PBridge Certified Medical Billing & Coding — Professional certification costs $199 for the exam-only path and $319 for the full path which includes the capstone project review. Both prices are in US Dollars. Payment via secure international checkout (Visa, Mastercard, Amex).

Is the PBridge Certified Medical Billing & Coding — Professional certification recognized internationally?+

Yes. PBridge Certified certifications are issued with verifiable digital credentials including a unique cert ID, QR code, and hash signature. Hiring managers anywhere in the world can verify any cert at https://www.pbridgeco.com/verify/{cert-id}.

How long does it take to complete the Medical Billing & Coding — Professional certification?+

The Medical Billing & Coding — Professional certification takes approximately 40 hours of self-paced study. The exam itself is 130 minutes with 65 questions. Most candidates complete the full path including the capstone project in 4-8 weeks studying part-time alongside work.

What makes PBridge Certified the right fit for learners and employers globally?+

PBridge Certified is built for the global market — USD pricing, capstone scenarios drawn from real-world business cases, international hiring manager recognition, and direct integration with the PBridge job board so certified holders get featured in front of employers actively hiring.

Can I get a job after the Medical Billing & Coding — Professional certification?+

PBridge Certified cert holders get priority access to the PBridge job board where global and remote employers post medical billing & coding — professional roles. Pair the certification with the capstone project as a portfolio piece — most certified holders see callbacks within 30 days.