How to Become Medical Claims Specialist

medical claims specialist

Who should become a medical claims specialist?

The medical claims specialist is an engaging and ever-changing career choice. It’s a great option for people who are precise with details, but don’t want to ever feel bored. Medical claims specialist are often people who enjoy the medical field, but perhaps aren’t interested in or capable of providing hands-on care.

What is the career outlook for medical claims specialists?

Employment in medical claims, also known as health claims or medical billing and coding, is in high demand. While it may seem that medical claims specialists have been outmoded by electronic medical records (EMRs), that’s not the case. EMRs do not directly generate bills. While care providers take electronic notes on patients during visits, the information they record only makes the medical claims specialist’s job easier, since their notes are now streamlined and accessible electronically.  Health care providers still need the medical claims specialist to ensure that the bills get paid.

What else do claims specialists do?

Medical claims professionals also provide customer service over the phone to patients and often act as a liaison among the health care provider, patient, and health insurance provider. That’s where their people skills and ability to analyze and problem solve become particularly useful.

Why is medical claims specialist a good career option?

Selecting this career can ensure employment anywhere across the country, as the credential is nationwide. That’s pretty rare in any job in the medical field. According to the US Department of Labor’s Bureau of Labor Statistics, employment for these positions is expected to grow 13% in the next few years. That’s great news for anyone entering the medical claims specialist career path.

What’s the first step in becoming a medical claims specialist?

Working in medical claims begins with a medical claims specialist education. Any background in care giving, such as working as a certified nurse assistant, personal aide, or licensed practical nurse would be extremely helpful.  Medical claims specialists must know medical terminology, anatomy and physiology to succeed; however, they also must master insurance forms, diagnostic codes, procedural codes, and procedures for processing medical claims.  While the educational requirements vary from facility to facility, most require that applicants have passed the Insurance and Coding exam offered by the National Center for Competency Testing.

The Branford Difference

Many vocational schools offer education in medical billing or medical coding or health insurance. While many larger healthcare systems employ separate individuals for each of these roles, smaller providers, such as an independent doctor’s office, outpatient surgical center, diagnostic lab, long-term care facility, or rural hospital, may combine any or even all of these roles. That’s why our comprehensive Medical Billing and Coding/Health Claims Specialist program equips our students with the knowledge and experience they need to fill these positions with the sense of confidence that’s essential for success.