How to Become a Medicare Specialist: Education and Career Roadmap

Jul 16, 2018

Research the requirements to become a Medicare specialist. Learn about the job description and duties and read the step-by-step process to start a career as a Medicare specialist.

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  • 0:34 Career Requirements
  • 1:24 Career Steps

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Become a Medicare Specialist

The term Medicare specialist can refer to a variety of jobs related to Medicare billing, coding, inquiry handling, or compliance. Entry-level jobs mainly deal with duties related to Medicare enrollment or billing. Higher-level positions include tasks such as overseeing enrollment specialists, determining payment eligibility, ensuring compliance with federal laws, and obtaining approvals for Medicare processes. This work often requires spending many hours seated at a desk in front of a computer.

Career Requirements

Degree Level A high school or diploma for entry-level jobs, bachelor's degree for higher-level positions
Experience Entry-level positions may require several months of on-the-job training experience
Key Skills Auditing and quality assurance skills, detail-oriented, excellent written and oral communication skills, and knowledge of Medicare regulations, billing, coding, quality-management requirements, forms, and processes; ability to use database and contact management software
Salary (2015) $37,110 per year (Median salary for Medical Records and Health Information Technicians)

Source: U.S. Bureau of Labor Statistics, (May 2015)

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

Career Steps

Step 1: Gain Work Experience

Although the specific requirements to work as a Medicare specialist differ depending on the employer and job type, entry-level Medicare billing or enrollment positions often require a high school diploma or the equivalent and at least several months of work experience. Working in one of these positions provides an individual with the experience necessary to progress in his or her career.

Step 2: Consider Earning a Bachelor's Degree

Some employers prefer to hire Medicare specialists who have bachelor's degrees. Few employers, however, specify the field of study they seek, instead stating that they prefer that candidates have completed a degree in a related field. Bachelor's degree programs in health service or health care administration include instruction about the managerial and business aspects of running a health facility. Classes in these four-year programs cover topics such as health care law, medical terminology, quality management in health care, and health care information systems.

You may want to consider completing an internship. Some bachelor's degree programs allow students to complete an internship during their studies. Having hands-on experience working in administration of a health facility may impress employers and make it easier to find a job after graduation.

Step 3: Advance Your Career

After gaining experience as a Medicare specialist, consider a master's degree in health care administration. The Bureau of Labor Statistics predicts that opportunities for health care administrators will grow 17% from 2014 to 2024. There will be increased need for high-level managers with post-grad degrees.

To recap, with a high school diploma, experience, and post-secondary education, an entry-level Medicare specialist can earn about $37,000 a year to oversee Medicare enrollment and billing, ensure compliance with federal laws, and obtain approvals for Medicare processes.

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