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How to Become a Medical Insurance Specialist

Research the requirements to become a medical insurance specialist. Learn about the job description and read the step-by-step process to start a career in medical insurance. View article »

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  • 0:01 Medical Insurance Specialist
  • 0:52 Career Requirements
  • 1:36 Career Steps

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Video Transcript

Medical Insurance Specialist

Medical insurance specialists, also known as medical billing specialists or insurance coders, submit insurance claims for payments to insurance companies or Medicare so that healthcare providers can receive reimbursement for rendered services. Medical insurance specialists, like other types of medical records and health information technicians, usually work in medical office settings, such as those in a doctor's office or a hospital. As such, there is a small risk of exposure to infectious diseases, though these specialists do not have a lot of direct contact with patients.

Most medical insurance specialists work during office hours on a full-time basis. There is little physical activity associated with this career and much of such specialists' time is spent on the phone and/or in front of a computer screen.

Career Requirements

Degree Level High school diploma or equivalent; associate and certificate programs available
Certification Voluntary from AAPC
Experience 1+ years of experience in a professional setting
Key Skills Critical thinking, management, and communication skills; use of office equipment; knowledge of the insurance claims process
Salary $37,110 (2015 median salary for medical records and health information technicians)

Sources: U.S. Bureau of Labor Statistics, Indeed.com in December 2012

Although a high school degree or GED usually prepares an individual to work in the field, post-secondary training is available. Voluntary certification is available from AAPC. Additionally, more than a year of experience in a professional setting is typically required. The key skills for medical insurance specialists include critical thinking, management skills, communication skills and knowledge of the operation of office equipment and the insurance claims process. In 2015, medical records and health information technicians earned a median annual salary of $37,110, according to the U.S. Bureau of Labor Statistics.

Career Steps

Now let's check out the career steps for medical insurance specialists.

Step 1: Graduate from High School

Most medical insurance specialist job positions require having at least a high school education. Therefore, earning a GED certificate or graduating from high school prepares an individual to work in the field.

To really prepare for this career in high school, complete computer courses. Most high school programs allow students to complete courses in computer use. Being knowledgeable about how to enter data, use a computer and type at a rapid pace may impress employers.

Step 2: Begin Working in the Field

Medical insurance specialists can work for a hospital, clinic, physician's office, nursing home, insurance company, government agency or billing service company. Individuals in these positions process insurance claims and may also manage medical records, schedule appointments and handle patient complaints.

Step 3: Consider Post-Secondary Training or Education

Certificate and associate's degree programs related to the field are available. These programs often include classes in medical terminology, anatomy, medical coding, medical insurance procedures, computer applications and medical office management. Having advanced knowledge of the field may impress employers.

To really stand out in the work field, become certified. The American Academy of Professional Coders offers the Certified Professional Coder (CPC) credential to insurance specialists in physicians' offices and the Certified Professional Coder-Hospital (CPC-H) credential to specialists working in hospitals. Earning either of these credentials requires possessing at least two years of work experience, being an AAPC member and passing an exam.

To recap, with a high school diploma, experience, and postsecondary education a medical insurance specialist can earn about $37,000 a year to submit insurance claims for payments to insurance companies or Medicare so that healthcare providers can receive reimbursement for rendered services.


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