Insurance Specialist: Job Description and Education Requirements

Insurance specialists require little formal education. Learn about the training, job duties and certification options to see if this is the right career for you.

A postsecondary certificate or associate's degree is required for a career as an insurance specialist. Professional certification is optional, but can verify medical insurance credentials and may increase job prospects for those entering this field.

Essential Information

Insurance specialists are experts in interpreting insurance policies and determining coverage. With specialized training in billing and coding, they may work in medical and government offices, hospitals, and laboratories. Prospective insurance specialists can prepare for the job by earning an associate's degree, though most skills are learned on the job.

Required Education College coursework leading to certificate or associate's degree
Other Requirements Professional certification (optional)
Projected Job Growth (2014-2024)* 13% for billing and processing clerks,
15% for medical records and health information technicians
Median Salary (2015)* $35,050 for billing and processing clerks,
$37,110 for medical records and health information technicians

Source: *U.S. Bureau of Labor Statistics

Insurance Specialist Job Description

Insurance specialists are trained to decipher complicated insurance laws and policies. In a government capacity, insurance specialists may be responsible for ensuring that government programs, such as Medicare and Medicaid, comply with federal law, regulations, and contracts. Specialists may advise on issues related to eligibility and coverage, as well as monitor the compliance of government contractors.

Many insurance specialists are also employed in the health care industry. As such, they may deal with health insurance billing and payments including interpreting billing codes and processing claims. Specialists may also be expected to keep track of patient records and perform other functions integral to the running of a medical office.

Insurance Specialist Education Requirements

While many of the skills necessary to the profession may be learned on the job, prospective insurance specialists may want to consider specialized training in the field. In the health care arena, schools offer certificate and associate's degree programs for medical or health insurance specialists. These programs offer courses in medical coding, medical terminology, and health care law. Graduates may be qualified to earn Health Insurance Portability and Accountability Act (HIPAA) Certification, which shows a greater understanding of the federal statute, which governs privacy of patient medical information.


For those seeking additional credentials, there are certification programs available to highlight specific skills. For health insurance specialists, the National Center for Competency Testing (NCCT) and the American Academy of Professional Coders (AAPC) offer various certifications. The NCCT offers the Insurance and Coding Specialist certification. The certification exam for an NCCT credential tests knowledge of medical coding, procedures and terminology. The AAPC offers certifications that reveal expertise in medical coding such as the Certified Professional Coder and the Certified Interventional Radiology Cardiovascular Coder.

Salary Info and Job Outlook

According to the U.S. Bureau of Labor Statistics (BLS, www.bls.gov), medical records and health information technicians earned a median salary of $37,110 in May 2015, while billing and processing clerks earned a median of $35,050 a year. The employment of medical records and health information techs is projected by the BLS to increase by 15% between 2014 and 2024, just as billing and processing clerks should see job opportunities rise by about 13% during the same decade.

Insurance specialists analyze policies and determine the scope of a policy's coverage. They need to be familiar with insurance laws and policies. One common area of specialization is in health insurance, which is expected to have much faster than average job growth from 2014 to 2024.

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