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Become A Reimbursement Specialist

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Working As A Reimbursement Specialist

  • Getting Information
  • Processing Information
  • Documenting/Recording Information
  • Interacting With Computers
  • Organizing, Planning, and Prioritizing Work
  • Mostly Sitting

  • Repetitive

  • $42,000

    Average Salary

What Does A Reimbursement Specialist Do

Medical records and health information technicians, commonly referred to as health information technicians, organize and manage health information data by ensuring that it maintains its quality, accuracy, accessibility, and security in both paper files and electronic systems. They use various classification systems to code and categorize patient information for insurance reimbursement purposes, for databases and registries, and to maintain patients’ medical and treatment histories.

Duties

Health information technicians typically do the following:

  • Review patients’ records for timeliness, completeness, accuracy, and appropriateness of data
  • Organize and maintain data for clinical databases and registries
  • Track patient outcomes for quality assessment
  • Use classification software to assign clinical codes for reimbursement and data analysis 
  • Electronically record data for collection, storage, analysis, retrieval, and reporting
  • Maintain confidentiality of patients’ records

Health information technicians document patients’ health information, including their medical history, symptoms, examination and test results, treatments, and other information about healthcare services that are provided to patients. Their duties vary by employer and by the size of the facility in which they work.

Although health information technicians do not provide direct patient care, they work regularly with registered nurses and other healthcare professionals. They meet with these workers to clarify diagnoses or to get additional information to make sure that records are complete and accurate.

The increasing adaptation and use of electronic health records (EHRs) will continue to change the job responsibilities of health information technicians. Technicians will need to be familiar with, or be able to learn, EHR computer software, follow EHR security and privacy practices, and analyze electronic data to improve healthcare information, as more healthcare providers and hospitals adopt EHR systems.

Health information technicians can specialize in many aspects of health information. Some work as medical coders, sometimes called coding specialists, or as cancer registrars.

Medical coders typically do the following:

  • Review patient information for preexisting conditions, such as diabetes
  • Assign appropriate diagnoses and procedure codes for patient care, population health statistics, and billing purposes
  • Work as a liaison between the health clinician and billing offices

Cancer registrars typically do the following:

  • Review patients’ records and pathology reports to verify completeness and accuracy
  • Assign classification codes to represent the diagnosis and treatment of cancers and benign tumors
  • Conduct annual followups to track treatment, survival, and recovery
  • Compile and analyze cancer patient information for research purposes
  • Maintain facility, regional, and national databases of cancer patients

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How To Become A Reimbursement Specialist

Health information technicians typically need a postsecondary certificate to enter the occupation, although some may need an associate’s degree. Certification is often required.

Education

Postsecondary certificate and associate’s degree programs in health information technology typically include courses in medical terminology, anatomy and physiology, health data requirements and standards, classification and coding systems, healthcare reimbursement methods, healthcare statistics, and computer systems. Applicants to health information technology programs may increase their chances of admission by taking high school courses in health, computer science, math, and biology.

A high school diploma or equivalent and previous experience in a healthcare setting are enough to qualify for some positions, but most jobs for health information technicians require postsecondary education.

Important Qualities

Analytical skills. Health information technicians must be able to understand and follow medical records and diagnoses, and then decide how best to code them in a patient’s medical records.

Detail oriented. Health information technicians must be accurate when recording and coding patient information.

Integrity. Health information technicians work with patient data that are required, by law, to be kept confidential. They must exercise caution and a strong sense of ethics when working with this information in order to protect patient confidentiality.

Interpersonal skills. Health information technicians need to be able to discuss patient information, discrepancies, and data requirements with other professionals such as physicians and finance personnel.

Technical skills. Health information technicians must be able to use coding and classification software and the electronic health record (EHR) system that their healthcare organization or physician practice has adopted.

Licenses, Certifications, and Registrations

Most employers prefer to hire health information technicians who have certification, or they may expect applicants to earn certification shortly after being hired. A health information technician can earn certification from several organizations. Certifications include the Registered Health Information Technician (RHIT) and the Certified Tumor Registrar (CTR), among others.

Some organizations base certification on passing an exam. Others require graduation from an accredited program. Many coding certifications also require coding experience in a work setting. Once certified, technicians typically must renew their certification regularly and take continuing education courses.

A few states and facilities require cancer registrars to be licensed. Licensure requires the completion of a formal education program and the Certified Tumor Registrar (CTR) certification.

Advancement

Health information technicians may advance to other health information positions by receiving additional education and certifications. Technicians may be able to advance to a position as a medical or health services manager after completing a bachelor’s or master’s degree program and taking the required certification courses. Requirements vary by facility.

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Reimbursement Specialist Career Paths

Reimbursement Specialist
Office Manager Case Manager Registered Nurse Case Manager
Nursing Director
9 Yearsyrs
Office Manager Case Manager
Director Of Social Services
6 Yearsyrs
Office Manager Account Manager
Client Services Manager
7 Yearsyrs
Medical Coder Consultant Senior Accountant
Accounting Manager
7 Yearsyrs
Medical Coder Consultant Case Manager
Patient Care Manager
5 Yearsyrs
Medical Coder Consultant Supervisor
Unit Manager
6 Yearsyrs
Team Leader Manager Director
Administrative Director
8 Yearsyrs
Team Leader Supervisor Clinical Supervisor
Clinical Manager
8 Yearsyrs
Team Leader Manager Operations Manager
Practice Manager
9 Yearsyrs
Supervisor Manager Assistant Director
Director Of Admissions
7 Yearsyrs
Assistant Manager Department Manager
Administrative Manager
6 Yearsyrs
Assistant Manager Assistant General Manager Front Office Manager
Revenue Manager
8 Yearsyrs
Assistant Manager Property Manager
Compliance Manager
9 Yearsyrs
Billing Manager Business Office Manager
Business Office Director
8 Yearsyrs
Billing Manager Accounts Receivable Manager Accounting Manager
Business Office Manager
7 Yearsyrs
Billing Manager Accounting Manager Business Office Manager
Accounts Receivable Manager
6 Yearsyrs
Account Manager Project Manager Information Technology Director
Director Of Information Management
10 Yearsyrs
Account Manager Owner/Operator Food Service Manager
Patient Services Manager
7 Yearsyrs
Business Office Manager Business Manager Property Manager
Office Manager Of Human Resources
6 Yearsyrs
Accountant Administrator Registered Nurse Case Manager
Medical Case Manager
8 Yearsyrs
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Help others decide if this is a good career for them

Average Length of Employment
Claim Specialist 3.3 years
Billing Specialist 3.0 years
Revenue Specialist 2.9 years
Account Specialist 2.7 years
Top Careers Before Reimbursement Specialist
Cashier 5.4%
Specialist 3.0%
Internship 2.8%
Supervisor 2.5%
Top Careers After Reimbursement Specialist
Cashier 3.9%
Supervisor 3.8%
Specialist 3.8%
Manager 3.5%

Do you work as a Reimbursement Specialist?

Reimbursement Specialist Demographics

Gender

Female

75.2%

Male

13.6%

Unknown

11.2%
Ethnicity

White

62.6%

Hispanic or Latino

15.1%

Black or African American

12.7%

Asian

6.3%

Unknown

3.4%
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Foreign Languages Spoken

Spanish

67.4%

French

12.6%

German

3.7%

Carrier

3.0%

Chinese

1.5%

Hindi

1.5%

Tagalog

1.5%

Portuguese

0.7%

Filipino

0.7%

Vietnamese

0.7%

Bosnian

0.7%

Amharic

0.7%

Cantonese

0.7%

Urdu

0.7%

Polish

0.7%

Korean

0.7%

Italian

0.7%

Arabic

0.7%

Croatian

0.7%
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Reimbursement Specialist Education

Schools

University of Phoenix

36.7%

Strayer University

7.2%

Ashford University

5.2%

American InterContinental University

4.6%

The Academy

4.2%

Towson University

3.6%

Kaplan University

3.6%

Walden University

3.4%

University of Memphis

3.4%

University of Maryland - University College

3.4%

Anne Arundel Community College

2.8%

Arizona State University

2.7%

Liberty University

2.5%

Webster University

2.5%

Saint Louis Community College

2.4%

Ultimate Medical Academy - Clearwater

2.4%

Remington College

2.4%

University of Maryland - College Park

2.4%

Colorado Technical University

2.4%

University of Houston

2.2%
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Majors

Business

27.0%

Health Care Administration

22.9%

Accounting

7.9%

Nursing

5.6%

Medical Assisting Services

4.8%

Management

4.1%

Psychology

3.3%

Computer Information Systems

3.1%

Insurance

2.9%

Criminal Justice

2.8%

General Studies

2.1%

Communication

1.8%

Education

1.7%

Pharmacy

1.6%

Biology

1.5%

Finance

1.5%

Public Health

1.4%

Human Resources Management

1.3%

Computer Science

1.3%

Human Services

1.3%
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Degrees

Bachelors

30.3%

Other

28.6%

Associate

17.6%

Masters

10.0%

Certificate

8.1%

Diploma

4.3%

License

0.7%

Doctorate

0.4%
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Job type you want
Full Time
Part Time
Internship
Temporary
Average Yearly Salary
$42,000
View Detailed Salary Report
$25,000
Min 10%
$42,000
Median 50%
$42,000
Median 50%
$42,000
Median 50%
$42,000
Median 50%
$42,000
Median 50%
$42,000
Median 50%
$42,000
Median 50%
$71,000
Max 90%
Best Paying Company
Teleflex
Highest Paying City
Columbia, MD
Highest Paying State
Delaware
Avg Experience Level
2.8 years
How much does a Reimbursement Specialist make at top companies?
The national average salary for a Reimbursement Specialist in the United States is $42,773 per year or $21 per hour. Those in the bottom 10 percent make under $25,000 a year, and the top 10 percent make over $71,000.

Real Reimbursement Specialist Salaries

Job Title Company Location Start Date Salary
Clinical Reimbursement Specialist North Westchester Restorative Therapy and Nursing Lake Mohegan, NY Nov 29, 2012 $87,000
Clinical Reimbursement Specialist North Westchester Restorative Therapy and Nursing Lake Mohegan, NY Nov 27, 2012 $87,000
Clinical Reimbursement Specialist North Westchester Restorative Therapy and Nursing Lake Mohegan, NY Dec 10, 2012 $87,000
Senior Reimbursement Specialist Lee Memorial Health System, A Special Purpose Unit Cape Coral, FL Nov 11, 2012 $72,301 -
$112,986
Reimbursement Specialist The Methodist Hospital Houston, TX Jun 13, 2011 $72,000
Reimbursement Specialist The Methodist Hospital Houston, TX Jun 06, 2011 $72,000
Provider Reimbursement Specialist United Healthcare Services, Inc. Columbia, MD Apr 26, 2016 $57,907 -
$63,000
Senior Reimbursement Specialist Lee Memorial Health System Cape Coral, FL Oct 01, 2010 $55,265 -
$84,635
Reimbursement Specialist Centra Health, Inc. Lynchburg, VA Oct 01, 2015 $44,408
Reimbursement Specialist I Healthsouth Corporation Birmingham, AL Aug 08, 2013 $43,600
Clinical Reimbursement Specialist RN Express Staffing Registry LLC New York, NY Oct 01, 2012 $43,500
Reimbursement Specialist Centra Health, Inc. Lynchburg, VA Oct 01, 2012 $42,825
Clinical Reimbursement Specialist RN Express Staffing Registry LLC New York, NY Sep 27, 2012 $38,000
Reimbursement Specialist Quizena L Walker Stafford, TX Jul 15, 2013 $35,396

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Top Skills for A Reimbursement Specialist

  1. Insurance Companies
  2. Medical Records
  3. Medicaid
You can check out examples of real life uses of top skills on resumes here:
  • Perform benefit investigation with insurance companies when required.
  • Resolved errors by resubmitting corrected or unacknowledged claims, medical records, appeals and other documentation required for timely payments.
  • Maintain current knowledge of payer requirements for accounts receivable including Medicare and Medicaid regulations across the nation.
  • Prepared financial models to estimate effect of changes in Medicare reimbursement methodologies on revenues for HealthSouth hospitals.
  • Recommended and implemented new business phone system to increase productivity, and improve customer service.

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Top 10 Best States for Reimbursement Specialists

  1. Alaska
  2. Minnesota
  3. District of Columbia
  4. Delaware
  5. Connecticut
  6. Massachusetts
  7. North Dakota
  8. Rhode Island
  9. New York
  10. Michigan
  • (31 jobs)
  • (369 jobs)
  • (96 jobs)
  • (46 jobs)
  • (158 jobs)
  • (427 jobs)
  • (39 jobs)
  • (56 jobs)
  • (704 jobs)
  • (497 jobs)

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