The career path of a health insurance specialist is a challenging one. Fortunately, it exhibits many opportunities for professional advancement. Professionals who comprehend billing regulations and claims processing, possess great coding skills and have the ability to successfully appeal denied or underpaid insurance claims are in high demand in the United States today. Given the money that Americans spend on healthcare annually, health care is vital for citizens to reduce their out-of pocket medical expenses.
Insurance professionals are needed to oversee the medical insurance claims procedure. This makes health insurance a highly recommendable career path to follow. But what exactly is needed for a person to become a health insurance specialist? Herein is a comprehensive overview on all the aspects of a career as a health insurance specialist.
A health insurance specialist must have basic clinical skills to comprehend medical terms and codes for varied diseases, conditions, and injuries. Communication skills is crucial with the interpersonal ability to interact with physicians, patients, and carrier representatives.
Analytical skills are a necessity in order to check documents for billing and other errors. Filling of essential insurance forms will require an eye for detail and superior organizational skills. They also require technical skills to utilize coding software, electronic health records, and databases.
USHEALTH Advisors says that post-secondary training is necessary for a career as a claims specialist. Recruiters opt for specialists with at least a 2-year associate’s degree from an accredited tertiary institution. It is advisable for one to major in medical coding, medical billing, health information technology or health informatics.
Prospective specialists must also complete a health insurance specialist program from an accredited college. Although optional, having Certified Professional Coder (CPC) credentials is advantageous to prospective candidates.
KEY RESPONSIBILITIES/JOB DESCRIPTION
Health claims specialists are primarily tasked with utilizing the electronic health records of patients to examine insurance claims and code medical procedures, and there are many at US Health Advisors. They are responsible for records maintenance regarding health care costs, co-payments, adjustments and other billing information.
They communicate with insurance providers, update billing databases, store patient electronic data, file registration forms, detect coding errors, analyze insurance claims and verify medical coverage. Their overall role is to adhere to all coding procedures and regulations to facilitate due payment of health care services.
A qualified health care specialist can be employed in any facility or organization where healthcare insurance is accepted. These can include:
· Private medical office.
· Diagnostic center.
· Outpatient facility.
· Urgent care center.
· Long term care or nursing center.
· Dental office.
· Surgical center.
· Insurance company.
· Specialists’ office.
· Health Maintenance Organization (HMO).
· Medical billing agency.
· Preferred Provider Organization (PPO).
· Government agency.
It is clear that health care insurance is broadly accessible and adopted in the US today. The demand for medical insurance is projected to keep growing largely due to the Affordable Care Act (ACA) and an aging population that requires extra tests, treatments and medical procedures.
A report by The Bureau of Labor Statistics revealed that employment of medical claim specialists will increase by more than 20 percent by 2022. USHealth advisors suggest that the top job prospects are expected for claims specialists with formal training, previous experience in the insurance sector as well as CPC, RHIT, and CEHRS certification.
The annual pay of an insurance claims specialist in 2017 ranges from approximately $35,000 to $80,000. The salary is determined by years of experience, skill set, location and type of employment facility. Working as a health insurance specialist is the right path to becoming a health care administrator or health information manager later on. Learn more about USHealth Advisors job opportunities on Indeed.com.