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Facts About Medical Insurance Specialists


Medical insurance specialists, also known as health insurance specialists/coders, make sure the doctor’s office is properly reimbursed by the insurance company. They are responsible primarily for submitting insurance claims. They also handle a variety of other financial elements for patients and take care of every detail of medical billing.

Job Duties Of A Medical Insurance Specialist

Medical insurance specialists spend the workday calculating medical bills to prepare claims. You have to update patient paperwork and verify their coverage from the insurance company. You will communicate closely with the insurance companies as well as speak with the patients to make them aware of their medical benefits. You have to be knowledgeable about all aspects of regulations and coding procedures, so the money goes where it needs to. You may also have front desk duties such as greeting and checking in patients for the office.

What Kind Of Classes Will I Need?

Certified medical insurance specialist courses are usually offered through vocational school and community colleges. Employers show preference to those who hold an associate degree, which usually takes two years to get. The certified medical insurance specialist program will prepare you to process insurance claims, understand medical terminology and medical coding, handle or reject claims, and ensure compliance with the medical insurance industry.

Common courses that are offered are insurance processing techniques, current procedural terminology, medical terminology, medical ethics, and anatomy. These are just some of the courses required to become a certified medical insurance specialist.

Is may be also a good idea to major in medical billing or coding, health informatics, or health information technology. There are also bachelor’s and master’s degree programs available, which would help with career and pay advancement.

Do I Need To Be Certified?

There is a certification required which is given through the Practice Management Institute. Study options are available online, but the exam must be taken in person.

There is also a credential available for those who work in a doctor’s office, which is taken through The American Academy of Professional Coders. You must have two years work experience prior to taking the exams.

What Is A Medical Insurance Specialist’s Salary?

Medical insurance specialists’ annual average salary in 2022 was $51,090, according to the Bureau of Labor Statistics. Entry-level average salary was listed at around $31,710, and the top 10 percent earned $75,460 annually. The top industries for highest salaries are professional, scientific, and technical services. 

Train, Then Continue Your Education

The job outlook for medical insurance specialists is expected to grow 8 percent through 2032, which is faster than the national average for all occupations nationwide. 

The information you learn and new tasks you can pick up through certifications are a great way to keep the career you’ve picked and enjoy fresh and interesting!

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