Health Insurance Specialist Careers

Health Insurance Specialist Careers

What is a Health Insurance Specialist?

The term “Health Insurance Specialist” is an umbrella term that encompasses positions such as insurance billers, medical coders, and claims examiners. Often, Health Insurance Specialists have experience in education and computer skills. Health Insurance Specialists process insurance claims, using standard medical coding.


What Is A Health Insurance Specialist Responsible For?

In general, Health Insurance Specialists Jobs are responsible for maintaining patient records in different healthcare settings. Health Insurance Specialists process medical claims, perform medical coding, and keep patient records up to date. Health Insurance Specialists often manage financial considerations for patients and create, control, and organize health information. They maintain the integrity, quality, and security of health information data.


Where Does a Health Insurance Specialist Work?

Health Insurance Specialists fulfill a wide array of positions in healthcare. Most often, Health Insurance Specialists work as medical coders, insurance billers, and claims examiners.

Entry-level Health Insurance Specialists are usually employed in jobs that create, manage, and organize data. A couple of these jobs are listed below:

  • Medical Coders
  • Medical Examiners

Health Insurance Specialist

Senior Health Insurance Specialists interpret and analyze data at a more advanced level. They work in finances and health economics. Top Health Insurance Specialists can obtain government positions and are employed to analyze policies and trends. Some work in IT and design systems for data research and to improve internal operations. Some areas Senior Health Insurance Specialists work in include the following:

  • Government
  • Medicare and Medicaid
  • IT
  • Management Analysts


What Degree Do You Need to Become A Health Insurance Specialist? What Do They Study?

Health Insurance Specialists are required to complete a Health Insurance Specialist program. Some Health Insurance Specialists acquire optional certification as a Certified Professional Coder (CPC).

The primary requirement for a Health Insurance Specialist is a high school diploma combined with several years of experience in a healthcare field. There are educational programs for Health Insurance Specialists, and most employers prefer additional education. Many community colleges and technical schools offer medical billing and coding programs.


Many jobs require a baccalaureate degree in a related field as the minimum educational requirement.

Certificate and associate degree programs that relate to health insurance billing include courses on the following:

  • Data
  • Coding
  • Classification Systems
  • Healthcare Statistics
  • Billing
  • Reimbursement
  • Computer Science
  • Medical Terminology


Certifications Recommended for Health Insurance Specialists

Industry standard certifications are available but not required. They do increase the candidate’s chances of obtaining the most competitive job. The American Academy of Professional Coders (AAPC) offers a Certified Professional Coder (CPC) certificate for Health Insurance Specialists who have at least two years of work experience and relevant medical knowledge.

Another certification is the Registered Health Information Technician (RHIT) certificate. This certificate is for Health Insurance Specialists who specialize in electronic medical records and coding. The American Health Information Management Association (AHIMA) offers this certificate, and candidates for this certification must have at least an associate’s degree in a related field accredited by an agency named the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM).

The AHIMA offers a Certified Coding Associate certification examination for Health Insurance Specialists with a high school degree and six months’ experience.


How Much Money Does A Health Insurance Specialist Earn?

The average national yearly salary for a Health Insurance Specialist is around $44, 984, but experienced and certified Specialists can make substantially more money. Recent figures show that Health Insurance Specialists in Medicare and Medicaid positions earn about $89,142 a year and a job registered with the US Department of Health and Human Services offers up to $103,646 a year.