The Certified Medical Reimbursement Specialist (CMRS) Certification

The Certified Medical Reimbursement Specialist (CMRS) Certification is one of several nationally prominent credentials recognized in the medical billing and coding profession, offered through the American Medical Billing Association (AMBA), an organization featured in a previous post.

The CMRS, like all certifications in the medical billing and coding field, is not required by federal or state legislation. It is a voluntary certification for anyone who would like to increase their credentials, however private and public companies can always state a preference or requirement that applicants have the CMRS Certification. The American Medical Billing Association has offered the CMRS Certification for over a decade and a half, and this can be viewed as a testament to its value.

AMBA states that the purpose of CMRS Certification is to set a high-bar national standard for excellence through ethics and professionalism in the field of medical billing. Contrary to several other national certifications, the CMRS focuses more on medical billing and claims management, with less attention paid to medical coding.

To become CMRS-certified, candidates will need to pass the CMRS Certification Exam. This is comprised of 17 sections consisting of 763 questions in total. These are:

  • 82 questions – Anatomy and physiology
  • 81 questions – Medical terminology
  • 64 questions – CMS 1500 claim form
  • 63 questions – CPT-4 coding
  • 55 questions – ICD-10-CM coding
  • 54 questions – ICD-9-CM coding
  • 51 questions – Terms in common health care use and acronyms
  • 49 questions – Computers and information technology
  • 46 questions – Insurance carriers
  • 41 questions – General
  • 30 questions – Case studies
  • 29 questions – Information technology and the world wide web
  • 28 questions – EDI clearinghouses and transactions
  • 27 questions – Compliance
  • 23 questions – Managed care
  • 22 questions – Insurance
  • 18 questions – Fraud and abuse

The answers for the exam can be found in the following sources:

  • 85 percent from AMBA’s CMRS Study Guide
  • 10 percent from the ICD-10-CM, HCPCS, CPT-4, and 2014 ICD-9-CM code manuals
  • 5 percent from the internet

A passing score is considered anything that is 85 percent or above. The exam for certification is completed online over a period of 45 days at the candidate’s own pace, and is open book. This should signal to the attentive reader that the exam is more about completing procedures and interpreting information correctly than it is about memorizing facts and figures.

Candidates will have a chance to review each of the 17 sections before submitting them, and will receive their score shortly after each submission. They will also be able to have two free retakes, provided these are spaced 30 days apart from each other and the initial exam, and are completed within 60 days after the original exam is submitted in its entirety.

The Certifying Board of the American Medical Billing Association (CBAMBA) is the awarding body for the CMRS Certification. After completing the entire exam, the CMRS certificate will be mailed to successful candidates within 15-20 business days. The CMRS Certification can be renewed each year by completing 15 AMBA-approved continuing education units (CEUs) and maintaining an AMBA membership.

Those interested in taking the CMRS Certification Exam will need the following:

  • High school diploma or GED
  • Experience or an educational foundation in the medical billing field
  • AMBA membership – $99 for an individual membership, $199 for a business membership of up to three people.

Renewing the CMRS Certification, which expires each year, requires holders to pay for the cost of 15 CEUs and an annual AMBA membership renewal for $99. It should be noted that AMBA provides free opportunities to acquire 15 CEUs each year. The AMBA CMRS study guide can be purchased for $199.