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Health Care Insurance: Customer Service

Attention: This program is offered through an educational partnership. Employment by the partnership organization is required for admission.

This award is not eligible for Financial Aid

The Certificate of Completion (CCL) in Health Care Insurance: Customer Service program is designed to provide students with the knowledge and skills to meet basic job requirements in health care insurance programs. The courses will cover various health care benefit plans and providers as well as claims processing systems, guidelines, and procedures. Claim status determination, correspondence inquiries, and service culture objective and standards will also be emphasized.

Details

Details iconImportant information you’ll need when applying for admission:
Field of Interest: 
Business, Entrepreneurialism, and Management
Type: 
Certificate
Academic Plan Code: 
5876N
Total credits required: 
18
Effective term: 
2020 Fall
Award notes

This program is not eligible for Title IV Federal Financial Aid.
Students must earn a grade of C or better for all courses required within the program.

Admission criteria

This program is offered through an educational partnership. Employment by the partnership organization is required for admission.

Academic Plan: 
Health Care Insurance: Customer Service (CER)
Required courses
Course #Course TitleCredits
Credits:18
CSR110Federal Employee Program Systems: Claims and Inquiries4
CSR112Federal Employee Program Systems: Correspondence2
CSR114Federal Employee Program Systems: Processing Claims4
CSR116Federal Employee Program Systems: Advanced Procedures4
CSR136Health Care Insurance: Claims I4
 
OR
 
CSR136Health Care Insurance: Claims I4
CSR137Health Care Insurance: Claims II2
CSR138Health Care Insurance: Claims III4
CSR147Health Care Insurance: Correspondence4
CSR148Health Care Insurance: Customer Service4
Competencies
  • Access appropriate screens and codes for processing applications, claims, correspondence, and recalculations. (CSR110, CSR112, CSR114, CSR116, CSR136)
  • Differentiate between various types of benefit plans. (CSR110, CSR112, CSR114, CSR116, CSR136)
  • Access applicable healthcare systems and screens. (CSR110, CSR112, CSR114, CSR116, CSR136)
  • Use appropriate medical terminology. (CSR110, CSR112, CSR114, CSR116, CSR136)
  • Demonstrate service culture objectives and standards. (CSR110, CSR112, CSR114, CSR116, CSR136)
  • Complete customer service solutions processes. (CSR110, CSR112, CSR114, CSR116, CSR136)
  • Process internal and external correspondence inquiries. (CSR112)
  • Explain and use the Health Insurance Portability and Accountability Act. (CSR114)
  • Determine member and provider eligibility. (CSR114, CSR116, CSR136)
  • Compare and contrast various types of healthcare providers. (CSR116, CSR136)
  • Determine claim status. (CSR114, CSR136)
  • Demonstrate procedures for completing advanced claims procedures. (CSR116)
  • OR
  • Access appropriate screens and codes for processing relevant applications, claims, correspondence, adjustments and appeals. (CSR136, CSR137, CSR138, CSR147)
  • Differentiate between various types of benefit plans. (CSR136, CSR137, CSR138, CSR147, CSR148)
  • Access applicable healthcare systems and screens. (CSR136, CSR137, CSR138, CSR147, CSR148)
  • Determine member and provider eligibility. (CSR136, CSR137, CSR138, CSR148)
  • Compare and contrast various types of healthcare providers. (CSR136, CSR138, CSR148)
  • Review adjudication steps and collection points in claims processing. (CSR137, CSR138)
  • Determine claim status. (CSR137, CSR138, CSR147, CSR148)
  • Differentiate between individual and employer group contracts. (CSR137, CSR138, CSR148)
  • Explain guidelines and procedures for reconsiderations, adjustments and appeals. (CSR137, CSR147)
  • Use appropriate medical terminology. (CSR137, CSR148)
  • Summarize policies and procedures for the Health Insurance Portability and Accountability Act (HIPAA). (CSR138, CSR147, CSR148)
  • Explain provisions of the Affordable Care Act and its application to the insurance industry. (CSR138, CSR148)
  • Process internal and external correspondence inquiries. (CSR147)
  • Summarize service culture objectives and standards. (CSR148)
  • Complete customer service solutions processes. (CSR148)

At Maricopa, we strive to provide you with accurate and current information about our degree and certificate offerings. Due to the dynamic nature of the curriculum process, course and program information is subject to change. As a result, the course list associated with this degree or certificate on this site does not represent a contract, nor does it guarantee course availability. If you are interested in pursuing this degree or certificate, we encourage you to meet with an advisor to discuss the requirements at your college for the appropriate catalog year.