Medical Claims Examiner

Healthcare Management Careers › Medical Claims Examiner

See Available Medical Claims Examiner Schools

Job Description:

The main role of a medical claims examiner is to investigate and verify the medical claims filed by the insurance holders. Medical claims examiner professionals are primarily tasked to protect insurance companies against monetary losses due to false and unreasonable claims. However, they should be careful as not to violate the rights of the insurance holders since they are protected by the Federal Government. Technically, they are hired by insurance companies to determine if the claims submitted are valid or not. Medical claims examiner professionals shield insurance companies from fraudulent activities while at the same time looking out for the best interest of the insurance holders.

As a medical claims examiner, you are expected to take on the following duties and responsibilities:

• carefully assess health-related claims
• check claims for accuracy and legitimacy
• conduct interviews to medical specialists and other healthcare professionals to establish the validity of medical claims
• endorse appropriate payments for verified claims
• collaborate with special investigators to investigate suspected fraud claims

Overall, medical claims examiner professionals have to closely examine each and every claim filed by the insurance holder to ascertain its validity in order to provide the claimant with the appropriate amount of reimbursements.

Work Environment:

Most medical claims examiner professionals are employed by life and health insurance companies. They work 5-days a week, and 8 hours a day in a typical office setting. They can also make special arrangement for their work schedule in order to accommodate evening and weekend appointments to clients.

Education and Training Requirements:

Although there is no standard educational requirement for aspiring medical claims examiner professionals, it is still highly recommended that they get formal education from accredited medical claims examiner schools.

Medical claims examiner courses are being offered in vocational schools, community colleges, and some universities. Online medical claims examiner training programs are also ideal for those who have time constraints.

It is advised that medical claims examiner aspirants pursue continuing studies program since the laws on insurance claims are always changing, thus, greatly affecting the way claims are being handled.

Salary Range:

The earnings of most medical claims examiners fall within the $42,400 - $70,689 income bracket. Their salary rate is typically affected by certain factors, including work experience, educational background, special skills, and expertise. Those who have acquired higher educational degrees will definitely receive lucrative compensation rates as compared to those who did not get any formal training.

Job Outlook:

The overall employment outlook for medical claims examiner professionals is very promising. In fact, the demand for medical claims examiners is anticipated to increase by 7% in the next 10 years. Job openings for medical claims examiners will spawn from the growth of the health insurance industry. Moreover, their expertise will be greatly needed to scrupulously examine the increasing number of medical claims.

Jumpstart a rewarding medical claims examiner career by browsing through our extensive list of medical claims examiner schools so you can start your training today

Alabama
Virginia College  (Birminghan, Huntsville, Mobile*) - Diagnostic Medical Sonography - Associate, Health Services Management, Healthcare Reimbursement - Associate, Medical Assistant - diploma, Medical Billing and Coding - diploma, Medical Office Management - Associate, Orthopaedic Technology - Associate, Pharmacy Technician, Surgical Technology - Associate

Arizona
Everest College (Phoenix) - Medical Insurance Billing/Coding, Medical Assisting
TechSkills  (Phoenix, Tempe) - Medical Billing
Medical Coding, Medical Office Administration, Medical Transcription, Pharmacy Technician
The Bryman School  (Phoenix, Tempe*) - Dental Assistant, Hospital Unit Coordinator, Massage Therapy, Medical Assistant, Medical Billing & Coding, Pharmacy Technician, Practical Technologist in Radiology, Surgical Technologist

California
Everest College (El Monte, Alhambra, City of Industry, Gardena, Hayward, Los Angeles, Lynnwood, Reseda, San Bernardino, San Francisco, San Jose, Torrance, Wilshire) - Medical Administrative Assistant, Medical Assisting, Medical Insurance Billing/Coding, Pharmacy Technician
Career Networks Institute (Orange County) - Medical Assisting, Medical Insurance Billing, Medical Office Administration
Central Coast College (Salinas) - Medical Administrative Assistant, Medical Assisting, Medical Biller/Coder
Empire College (Santa Rosa) - Medical Assisting, Billing/ Coding
High Tech Institute (Sacramento) - Dental Assistant, Massage Therapy, Medical Assistant, Medical Billing & Coding, Pharmacy Technician
Institute for Business and Technology (Santa Clara) - Lab Assistant, EKG Technician/Phleb, Massage Therapy, Medical Assistant, Medical Biller/Coder/Office Specialist
Institute of Technology  (Clovis, Modesto, Mather) - Medical Billing/Coding Specialist, Medical Office Administration, Medical Office Administration, Pharmacy Technician, Professional Medical Assistant
National Career Education (Citrus Heights) - Lab Assistant, EKG Tech/Phlebotomist, Medical Assistant, Medical Biller/Coder/Office Assistant, Optical/Optometric Assistant
National Institute of Technology (Long Beach) - Lab Assistant, EKG Tech/Phlebotomist, Medical Assistant, Medical Biller/Coder/Office Assistant, Optical/Optometric Assistant
TechSkills  (San Francisco, San Jose) - Medical Billing, Medical Coding, Medical Office Administration
Medical Transcription, Pharmacy Technician
UEI (Chula Vista, El Monte, Huntington Park, Los Angeles, Ontario, San Bernardino San Diego,Van Nuys) - Dental Assistant, Massage Therapy, Medical Assistant, Medical Billing & Insurance Coding, Pharmacy Technician

Colorado
Everest College (Colorado Springs*) - Medical Administrative Assistant, Medical Assisting, Medical Insurance Billing/Coding
Anthem College (Aurora) - Medical Assistant, Medical Billing & Coding, X-ray Technician (Ltd. Scope)
Institute of Business and Medical Careers (Ft Collins) - Medical Administrative Assistant, Medical Assistant, Medical Insurance Billing/Coding
Everest College (Denver) - Medical Administrative Assistant, Medical Assisting, Medical Insurance Billing/Coding, Surgical Technologist
TechSkills (Denver) - Medical Billing, Medical Coding, Medical Office Administration, Medical Transcription, Pharmacy Technician

Florida
ACT- Advanced Career Training (Jacksonville) - Dental Assistant, Medical Assistant, Medical Billing and Insurance Coding
Edutech Centers (Riverview, Clearwater) - Medical Assistant, Medical Insurance Billing & Coding Specialist, Medical Transcription
Florida Career College (Hialeah, Lauderdale, Miami, Pembroke, West Palm Beach) - Massage Therapy Technician, Medical Assistant Technician, Medical Coding and Billing Specialist, Medical Office Administrator
Florida Career Institute (Mulberry) - Medical Assistant, Medical Insurance Coding Specialist
Everest University (Brandon, Jacksonville, Lakeland, Melbourne, Orlando, Orange Park, Pinellas, Pompano, Tampa) - Assisted Living Administrator, Medical Assisting, Medical Insurance, Billing/Coding, Pharmacy Technician, Surgical Technologist, Massage Therapy
High-Tech Institute (Orlando) - Dental Assistant, Massage Therapy, Medical Assistant, Medical Billing & Coding, Pharmacy Technician, X-ray Technician (Ltd. Scope)
Everest Institute (Fort Lauderdale, Hialeah, Kendall, Miami) - Medical Assisting, Surgical Technologist, Massage Therapy, Cardiovascular Technologist, Pharmacy Technician, Medical Insurance Billing/Coding, Cardiovascular Technologist, Massage Therapy, Medical Assisting, Medical Insurance Billing/Coding, Pharmacy Technician
Sanford Brown (Lauderdale, Jacksonville, Tampa) - Diploma - Medical Billing and Coding Specialist, Diploma - Medical Assistant, Diploma - Dental Assistant, Diploma - Surgical Technology, Diploma - Advanced Massage Therapy, Associate - Diagnostic Medical Sonography
Southwest Florida College (Ft.Myers, Tampa) - Medical Assistant, Medical Insurance Billing & Coding Specialist, Medical Transcription
Technical Career Institute (Miami) -Medical Assistant, Medical Insurance, Medical Office Administrator, Medical Secretary, Pharmacy Technician
TechSkills (Orlando, Tampa) - Medical Billing, Medical Coding, Medical Office Administration, Medical Transcription, Pharmacy Technician
Virginia College (Pensacola) -Medical Assistant - diploma, Medical Billing and Coding - diploma, Pharmacy Technician, Practical Nursing - diploma

Georgia
ACT Advanced Career Training (Atlanta, Riverdale) - Dental Assistant, Massage Therapy, Medical Assistant, Medical Billing and Insurance Coding
Career Education Institute (Marietta, Norcross) - Massage Therapy, Medical Administrative Assistant, Medical Assistant, Medical Coding & Billing
Everest Institute (Atlanta, Dekalb, Jonesboro, Marietta, Norcross) - Medical Insurance Billing/Coding, Medical Assisting, Massage Therapy, Dialysis Technician
High Tech Institute (Marietta) - Massage Therapy,Medical Assistant, Medical Billing & Coding, Pharmacy Technician
Sanford Brown Institute (Atlanta) - Certificate - Medical Assistant, Certificate - Medical Billing and Coding Specialist, Certificate -, Cardiovascular Technology, Certificate - Diagnostic Medical Sonography
Westwood College (Atlanta) - Diploma - Medical Assisting, Diploma - Medical Insurance Coding and Billing

Illinois
Westwood College (O'Hare, River Oaks) - Diploma - Medical Assisting, Diploma - Medical Insurance Coding and Billing

Indiana
Kaplan College (Hammond, Merrillville) - Clinical Massage Therapy, Medical Assistant, Medical Coding & Billing, Medical Office Administration, Therapeutic Massage & Bodywork

Kansas
TechSkills (Kansas City) - Medical Billing, Medical Coding, Medical, Office Administration, Medical Transcription, Pharmacy Technician

Kentucky
ATA Career Education (Louisville) - Dental Assisting, Medical Coding
Daymar College (Louisville, Newport, Owensboro) - Dental Assisting, Medical Coding
Southwestern College (Florence) - Medical Administrative, Assistant (Associate Degree), Medical Assistant, Medical Billing and Coding, Phlebotomy (Certificate)

Louisiana
American Commercial College (Shreveport) - Medical Assisting, Medical Office Specialist, Medical Records Transcriptionist
Remington College (Baton Rouge, Lafayette) - Medical Assisting, Medical Insurance and Coding, Pharmacy Technician, Medical Assisting, Medical Insurance and Coding
Maine
Northeast Technical Institute (Hermon, Scarborough*) - Certified Clinical Medical Assistant, Health Information Management, Medical Coding and Billing, Medical Office Assistant, Medical Transcription
Pharmacy Technician
Seacost Career School  (Sanford) - Medical Assistant
Medical Billing Specialist

Massachusetts
Career Education Institute ( Lowell, Somerville) - Massage Therapy, Medical Administrative Assistant, Medical Assistant, Medical Coding & Billing, Pharmacy Technician
Clark University CCI (Braintree, Cambridge, Framingham, Woburn) - Medical Assisting, Medical Coding, Medical Coding & Billing, Healthcare Professional, Medical Administrative Assistant
Northeast Technical Institute (Haverhill) - Certified Clinical Medical Assistant, Health Information Management, Medical Coding and Billing, Medical Office Assistant, Medical Transcription

Michigan
National Institute of Technology* (Detroit, Dearborn, Southfield) - Medical Assisting, Medical Insurance Billing and Coding, Medical Administrative Assistant
Everest Institute* (Grand Rapids, Kalamazoo) - Medical Administrative Assistant, Medical Assistant, Medical Insurance Billing/Coding
Minnesota
Everest Institute (Eagan) - Medical Assisting, Medical Insurance Billing/Coding
Duluth Business University (Duluth) - Billing and Coding Specialist, Medical Assistant, Medical Office Specialist
High-Tech Institute (Minneapolis) - Medical Assistant, Medical Billing & Coding
TechSkills (Minneapolis) - Medical Billing, Medical Coding, Medical Office Administration

Mississippi
Virginia College (Jackson) - Medical Assistant, Medical Billing & Coding: Medical Reimbursement, Medical Coding, Medical Office Administration and Assisting

Missouri
Everest College (St. Louis) - Medical Insurance Billing/Coding, Medical Assisting
Sanford-Brown College* (Fenton, St. Charles, Hazelwood) - Healthcare Administration, Medical Assistant, Medical Coding and Billing
Everest College (Springfield) - Medical Assisting, Medical Insurance Billing/Coding, Medical Office Assistant, Medical Transcription
TechSkills (St. Louis) - Medical Billing and Coding, Medical Transcription, Medical Office Administration

Nevada
Heritage College (Las Vegas) - Medical Assistant, Medical Insurance Coder and Biller
High-Tech Institute (Las Vegas) - Medical Assistant, Medical Billing & Coding
Las Vegas College (Henderson, Las Vegas) - Administrative Medical Assistant, Medical Assistant, Medical Insurance Billing/Coding
TechSkills (Las Vegas) - Medical Billing, Medical Coding, Medical Office Administration, Medical Transcription

New Jersey
ATI Training Institute (Edison) - Medical Billing & Coding
CDM Institute * (Marlton, Wayne, West Long Beach) - Medical Billing, Coding, & Office Administration
ProTrain, Inc. (Oakhurst) - Medical Billing & Coding
Sanford-Brown Institute (Formerly Ultrasound Diagnostic School) (Iselin) - Medical Assistant, Coding & Billing

New York
Hunter Business School (Levittown) - Medical Assistant, Medical Billing, Medical Office Administration
Ridley-Lowell Business & Technical Institute* (Binghamton, Poughkeepsie) - Medical Administrative Assistant, Medical Assistant, Medical Billing & Coding Specialist, Medical Transcription Specialist
Everest Institute (Rochester) - Medical Assisting, Medical Insurance Billing & Coding, Administration Information Processing (Medical)
Sanford-Brown Institute* (Formerly Ultrasound Diagnostic Schools) (Garden City, New York, White Plains) - Medical Assistant, Coding & Billing

North Carolina
TechSkills* (Charlotte, Greensboro, Raleigh) - Medical Billing and Coding, Medical Transcription, Medical Office Administration

North Dakota
Rasmussen College (Bismark, Fargo) - Medical Coding, Medical Office, Medical Transcriptionist

Ohio
Akron Institute (Cuyahoga Falls) - Medical Assistant, Medical Biller/Administrator
Everest College (Gahanna) - Medical Assisting, Medical Insurance Billing/Coding
Remington College * (Cleveland, Cleveland West) - Medical Assisting, Medical Insurance and Coding
Sanford Brown College (Cleveland) - Medical Assistant, Medical Billing and Coding Specialist
Southwestern College* (Dayton, Franklin, Tri-County, Vine Street) - Medical Administrative Assistant, Medical Assitant, Medical Billing & Coding
TechSkills* (Cincinnati, Cleveland, Columbus) - Medical Billing and Coding, Medical Transcription, Medical Office Administration

Oklahoma
TechSkills (Oklahoma City) - Medical Billing and Coding, Medical Transcription, Medical Office Administration

Oregon
Anthem College (Beaverton) - Medical Assistant, Medical Billing & Coding
Health Career Institute (Wilsonville) - Healthcare Administration, Medical Assisting, Medical Claims & Billing
Western Business College (Portland) - Administrative Medical Assistant, Medical Assistant, Medical Insurance Billing/Coding

Pennsylvania
Career Training Academy™ * (Monroeville, New Kensington, Pittsburgh) - Advanced Medical Coder/Biller, Medical Biller, Medical Administrative Assistant
CDM Institute (Allentown) - Medical Billing, Coding, & Office Administration
CLN* (Altoona, Mechanicsburg) - Medical Assistant, Medical Billing & Coding Specialist
Everest Institute< a> (Pittsburgh) - Medical Administrative Secretary, Medical Assistant, Medical Insurance Billing and Coding
Sanford-Brown Institute (Formerly Ultrasound Diagnostic School) (Philadelphia) - Medical Assistant, Coding & Billing
Kaplan Career Institute (Harrisburg) - Medical Assisting, Billing and Coding Thompson Institute (Philadelphia) - Medical Assisting, Billing and Coding

Tennessee
High-Tech Institute (Memphis, Nashville) - Medical Assistant, Medical Billing & Coding

Texas
Academy of Healthcare Professions* (Austin, Houston North Loop, Houston Southwest) - Medical Assistant, Medical Coding and Billing Specialist
CCI Training Center* (Arlington, Dallas) - Medical Billing and Coding, Medical Transcription
Everest College * (Arlington/Mid-Cities, Dallas, Fort Worth) - Medical Assisting, Medical Insurance Billing and Coding
High-Tech Institute (Irving) - Medical Assistant, Medical Billing & Coding
National Institute of Technology * (Austin, Houston/Bissonnet, Houston/Galleria, Houston/Greenspoint, Houston/Hobby, San Antonio) - Medical Assistant, Medical Administrative Assistant, Medical Assisting, Medical Business and Clinical Specialist, Medical Insurance Billing & Coding
Pinnacle Career Center (Houston) - Medical Assistant, Medical Billing
Remington College* (Dallas, Fort Worth, Houston) - Medical Assistant, Medical Insurance and Coding
Sanford-Brown Institute* (Dallas, Houston) - Medical Assistant, Coding & Billing
TechSkills* (Dallas, Fort Worth, Houston, San Antonio) - Medical Coding, Medical Billing, Medical Office Administration, Medical Transcription
Virginia College (Austin) - Medical Assistant, Medical Assisting and Office Administration, Medical Billing and Coding
Westwood College* (Dallas, Fort Worth, Houston-Technology) - Medical Assisting, Medical Insurance Coding & Billing

Utah
Everest College (Salt Lake City) - Medical Assisting, Medical Insurance Coding and Billing, Medical Administrative Assistant
TechSkills* (Salt Lake City) - Medical Coding, Medical Billing, Medical Office Administration, Medical Transcription

Virginia
Everest Institute* (Newport News, Chesepeake) - Dental Assisting, Massage Therapy, Medical Administrative Assistant, Medical Assisting, Medical Insurance Billing/Coding
Everest College* (McLean) - Medical Insurance Billing and Coding, Medical Administrative Assistant, Medical Assisting
The Anthem Institute (Arlington) - Medical Assistant, Medical Billing & Coding

Washington
Anthem College (Seattle) - Medical Assistant, Medical Billing & Coding
Capstone Career College (Tacoma) - Medical Coding & Billing Specialist, Medical Transcription Specialist
Northwest Business College (Lynnwood) - Medical Billing and Coding, Medical Office Administration
Western Business College (Vancouver) - Administrative Medical Assistant, Medical Assistant, Medical Insurance Billing/Coding

Wisconsin
TechSkills* (Madison, Milwaukee) - Medical Coding, Medical Billing, Medical Office Administration, Medical Transcription