Courses in this field are usually included in a claims examiner or medical billing certificate program. However, you may have access to some stand-alone courses. Programs can be found at trade schools, universities and community colleges. Potential students can expect to see these topics in their classes:
- Industry terminology
- Customer care
- Processing claims
- Customer feedback
- Client liability
List of Courses
Claims Management Course
A claims management course covers the entire claims process from start to finish, with close attention paid to the role of the claims examiner in this process. Students learn how to effectively manage their time as well as honing the negotiation skills necessary to settle claims efficiently. This course is perhaps the most important course a prospective claims manager takes in terms of outlining how claims examiners spend their time at work. This course is usually taken towards the end of a claims examiner program, after the student learns the terminology and the laws behind claims examination.
The claims terminology course is one of the first courses a student takes in a claims examiner program. The medical and insurance words and phrases learned in a claims terminology course create the foundation upon which a claims manager communicates. Prospective claims examiners learn more than just terminology; the roots of key words are covered, as are the common abbreviations and form types used by insurance companies and agents.
Insurance Law Course
Insurance law is a critical component of any claims examiner's training because it illustrates the legal side of claims and the ramifications of operating outside of the legal boundaries of claims examination. Topics such as worker's compensation, Medicaid and Medicare regulations are discussed, as are client liability and healthcare fraud. The insurance law course usually appears about halfway through most claims examiner training programs.
Customer Support Course
Claims examination requires a great deal of communication with customers, co-workers and insurance companies. Training in customer support helps claims examiners to effectively deal with the many people they need to interact with in order to settle claims. Particular attention is paid to assisting external customers with the claims process and handling any complaints these customers may have.