Medical claims specialists are medical professionals who are responsible for obtaining and processing medical insurance claim information for healthcare providers and patients. Their duties include, but are not limited to, determining which medical claims are covered under various health insurance policies, documenting, denying, or accepting these claims, respond to customer inquiries, providing legal support if needed by assembling documentation for possible insurance settlements, and adjusting insurance claims.
Medical claims specialists work directly with insured clients by helping them understand their insurance coverage, to examine and resolve medical claims, documenting claims, and ensuring that all claims are processed within company and legal guidelines. As such, it is essential for medical claims specialists to have excellent customer service skills, as well as above-average written and verbal communication skills.
There is no advanced degree requirement for obtaining a job as a medical claims specialist. The majority of medical claims specialists make up to $35,000 a year, with job growth in the U.S. expected to grow by 11% by 2028.
There is more than meets the eye when it comes to being a medical claims specialist. For example, did you know that they make an average of $17.79 an hour? That's $37,008 a year!
Between 2018 and 2028, the career is expected to grow 11% and produce 23,100 job opportunities across the U.S.
There are certain skills that many medical claims specialists have in order to accomplish their responsibilities. By taking a look through resumes, we were able to narrow down the most common skills for a person in this position. We discovered that a lot of resumes listed integrity, technical skills and analytical skills.
If you're interested in becoming a medical claims specialist, one of the first things to consider is how much education you need. We've determined that 38.5% of medical claims specialists have a bachelor's degree. In terms of higher education levels, we found that 4.0% of medical claims specialists have master's degrees. Even though some medical claims specialists have a college degree, it's possible to become one with only a high school degree or GED.
Choosing the right major is always an important step when researching how to become a medical claims specialist. When we researched the most common majors for a medical claims specialist, we found that they most commonly earn bachelor's degree degrees or associate degree degrees. Other degrees that we often see on medical claims specialist resumes include high school diploma degrees or diploma degrees.
You may find that experience in other jobs will help you become a medical claims specialist. In fact, many medical claims specialist jobs require experience in a role such as customer service representative. Meanwhile, many medical claims specialists also have previous career experience in roles such as administrative assistant or cashier.