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Medical Claims Examiner Training and Education Program Options

Oct 13, 2019

Medical claims examiner or analyst certificate programs teach students the insurance claims process, medical terminology and billing coding. They receive hands-on training working with computers and entering data.

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Essential Information

Medical claims examiner students explore communication skills and learn data entry, medical terminology and medical coding. Most programs have no formal education prerequisites, although some require that applicants take a college placement exam to assess their math and English skills. These certificate programs are commonly offered by community colleges or vocational schools. Programs vary in length, but most can be completed in a year or less.


Medical Claims Examiner Education Programs

Medical claims examiners learn several different subject matters. They study health care and insurance, medical billing, medical laws and ethics as well as how to evaluate medical claims. Programs typically include general education classes, in addition to coursework in business software, such as Microsoft Excel and Access, and basic business skills, such as customer service and job hunting. Other medical claims examiner courses include the following:

  • Medical office practices
  • Anatomy and physiology
  • Hospital administrative practices
  • Basic psychology
  • 10-key computer skills

Employment Outlook

According to the U.S. Bureau of Labor Statistics (BLS), employment of insurance claims adjusters, examiners, appraisers and investigators is expected to decrease by 4% from 2018-2028, slower than the average growth for all occupations (www.bls.gov). The BLS indicated that health insurance would provide the most growth in business operations specialists. The BLS also stated that the mean annual wages, as of May 2018, for claims adjusters, examiners and investigators were $65,900.

Continuing Education

Completion of a medical claims examiner certificate is adequate preparation for employment in the field. People interested in broadening their qualifications may pursue an associate degree program in a related discipline, such as medical office specialist.

Medical claim examiners may also seek professional certification from an industry organization, such as the International Claims Association. The association offers programs that award life and health claims certifications at associate and fellow levels. These programs provide substantial training in health and life insurance claims and they may be used to demonstrate that their holders are committed to remaining knowledgeable and current in their careers.

Training for prospective medical claims examiners is available as a certificate program. Students will study medical office practice and basic psychology to prepare for a career in the field.

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