Career Profile: Medical Claims Examiner
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.
- echocardiography
- vascular technology
- neurosonology
- obstetrics and gynecology
- ophthalmology
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 |
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(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 |
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| Arizona |
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(Phoenix) - Medical Insurance Billing/Coding, Medical Assisting |
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(Phoenix, Tempe) - Medical Billing Medical Coding, Medical Office Administration, Medical Transcription, Pharmacy Technician |
|
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(Phoenix, Tempe*) - Dental Assistant, Hospital Unit Coordinator, Massage Therapy, Medical Assistant, Medical Billing & Coding, Pharmacy Technician, Practical Technologist in Radiology, Surgical Technologist |
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| California |
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| |
(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 |
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(Orange County) - Medical Assisting, Medical Insurance Billing, Medical Office Administration |
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(Salinas) - Medical Administrative Assistant, Medical Assisting, Medical Biller/Coder |
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(Santa Rosa) - Medical Assisting, Billing/ Coding |
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(Sacramento) - Dental Assistant, Massage Therapy, Medical Assistant, Medical Billing & Coding, Pharmacy Technician |
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| Institute for Business and Technology |
(Santa Clara) - Lab Assistant, EKG Technician/Phleb, Massage Therapy, Medical Assistant, Medical Biller/Coder/Office Specialist |
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| Institute of Technology |
(Clovis, Modesto, Mather) - Medical Billing/Coding Specialist, Medical Office Administration, Medical Office Administration, Pharmacy Technician, Professional Medical Assistant |
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| National Career Education |
(Citrus Heights) - Lab Assistant, EKG Tech/Phlebotomist, Medical Assistant, Medical Biller/Coder/Office Assistant, Optical/Optometric Assistant |
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| National Institute of Technology |
(Long Beach) - Lab Assistant, EKG Tech/Phlebotomist, Medical Assistant, Medical Biller/Coder/Office Assistant, Optical/Optometric Assistant |
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(San Francisco, San Jose) - Medical Billing, Medical Coding, Medical Office Administration |
|
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(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 |
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| Colorado |
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(Colorado Springs*) - Medical Administrative Assistant, Medical Assisting, Medical Insurance Billing/Coding |
|
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(Aurora) - Medical Assistant, Medical Billing & Coding, X-ray Technician (Ltd. Scope) |
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| Institute for Business and Technology |
(Ft Collins) - Medical Administrative Assistant, Medical Assistant, Medical Insurance Billing/Coding |
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(Denver) - Medical Administrative Assistant, Medical Assisting, Medical Insurance Billing/Coding, Surgical Technologist |
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(Denver) - Medical Billing, Medical Coding, Medical Office Administration, Medical Transcription, Pharmacy Technician |
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| Flordia |
|
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(Jacksonville) - Dental Assistant, Medical Assistant, Medical Billing and Insurance Coding |
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| Edutech Centers |
(Riverview, Clearwater) - Medical Assistant, Medical Insurance Billing & Coding Specialist, Medical Transcription |
|
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(Hialeah, Lauderdale, Miami, Pembroke, West Palm Beach) - Massage Therapy Technician, Medical Assistant Technician, Medical Coding and Billing Specialist, Medical Office Administrator |
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| Florida Career Institute |
(Mulberry) - Medical Assistant, Medical Insurance Coding Specialist |
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| 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 |
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(Orlando) - Dental Assistant, Massage Therapy, Medical Assistant, Medical Billing & Coding, Pharmacy Technician, X-ray Technician (Ltd. Scope) |
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(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 |
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(Ft. 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 |
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(Ft.Myers, Tampa) - Medical Assistant, Medical Insurance Billing & Coding Specialist, Medical Transcription |
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| Technical Career Institute |
(Miami) -Medical Assistant, Medical Insurance, Medical Office Administrator, Medical Secretary, Pharmacy Technician |
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(Orlando, Tampa) - Medical Billing, Medical Coding, Medical Office Administration, Medical Transcription, Pharmacy Technician |
|
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(Pensacola) -Medical Assistant - diploma, Medical Billing and Coding - diploma, Pharmacy Technician, Practical Nursing - diploma |
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| Georgia |
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| ACT Advanced Career Training |
(Atlanta, Riverdale) - Dental Assistant, Massage Therapy, Medical Assistant, Medical Billing and Insurance Coding |
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| Career Education Institute |
(Marietta, Norcross) - Massage Therapy, Medical Administrative Assistant, Medical Assistant, Medical Coding & Billing |
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(Marietta, Norcross) - Massage Therapy, Medical Administrative Assistant, Medical Assistant, Medical Coding & Billing |
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(Marietta) - Massage Therapy,Medical Assistant, Medical Billing & Coding, Pharmacy Technician |
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(Atlanta) - Certificate - Medical Assistant, Certificate - Medical Billing and Coding Specialist, Certificate -, Cardiovascular Technology, Certificate - Diagnostic Medical Sonography |
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(Atlanta) - Diploma - Medical Assisting, Diploma - Medical Insurance Coding and Billing |
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| Illinois |
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(O'Hare, River Oaks) - Diploma - Medical Assisting, Diploma - Medical Insurance Coding and Billing |
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| Indiana |
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(Hammond, Merrillville) - Clinical Massage Therapy, Medical Assistant, Medical Coding & Billing, Medical Office Administration, Therapeutic Massage & Bodywork |
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| Kansas |
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(Kansas City) - Medical Billing, Medical Coding, Medical, Office Administration, Medical Transcription, Pharmacy Technician |
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| Kentucky |
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| ATA Career Education |
(Louisville) - Dental Assisting, Medical Coding |
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| Daymar College |
(Louisville, Newport, Owensboro) - Dental Assisting, Medical Coding |
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(Florence) - Medical Administrative, Assistant (Associate Degree), Medical Assistant, Medical Billing and Coding, Phlebotomy (Certificate) |
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| Louisiana |
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| American Commercial College |
(Shreveport) - Medical Assisting, Medical Office Specialist, Medical Records Transcriptionist |
|
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(Baton Rouge, Lafayette) - Medical Assisting, Medical Insurance and Coding, Pharmacy Technician, Medical Assisting, Medical Insurance and Coding |
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| Maine |
|
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(Hermon, Scarborough*) - Certified Clinical Medical Assistant, Health Information Management, Medical Coding and Billing, Medical Office Assistant, Medical Transcription
Pharmacy Technician |
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| Seacoast Career School |
(Sanford) - Medical Assistant
Medical Billing Specialist |
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| Massachusetts |
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| Career Education Institute |
( Lowell, Somerville) - Massage Therapy, Medical Administrative Assistant, Medical Assistant, Medical Coding & Billing, Pharmacy Technician |
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(Braintree, Cambridge, Framingham, Woburn) - Medical Assisting, Medical Coding, Medical Coding & Billing, Healthcare Professional, Medical Administrative Assistant |
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(Haverhill) - Certified Clinical Medical Assistant, Health Information Management, Medical Coding and Billing, Medical Office Assistant, Medical Transcription |
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| Michigan |
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| National Institute of Technology* |
(Detroit, Dearborn, Southfield) - Medical Assisting, Medical Insurance Billing and Coding, Medical Administrative Assistant |
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| |
(Grand Rapids, Kalamazoo) - Medical Administrative Assistant, Medical Assistant, Medical Insurance Billing/Coding |
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| Minnesota |
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(Eagan) - Medical Assisting, Medical Insurance Billing/Coding |
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| Duluth Business University |
(Duluth) - Billing and Coding Specialist, Medical Assistant, Medical Office Specialist |
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(Minneapolis) - Medical Assistant, Medical Billing & Coding |
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(Minneapolis) - Medical Billing, Medical Coding, Medical Office Administration |
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| Mississippi |
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(Jackson) - Medical Assistant, Medical Billing & Coding: Medical Reimbursement, Medical Coding, Medical Office Administration and Assisting |
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| Missouri |
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(St. Louis) - Medical Insurance Billing/Coding, Medical Assisting |
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(Fenton, St. Charles, Hazelwood) - Healthcare Administration, Medical Assistant, Medical Coding and Billing |
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(Springfield) - Medical Assisting, Medical Insurance Billing/Coding, Medical Office Assistant, Medical Transcription |
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(St. Louis) - Medical Billing and Coding, Medical Transcription, Medical Office Administration |
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| Nevada Schools |
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(Las Vegas) - Medical Assistant, Medical Insurance Coder
and Biller |
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(Las Vegas) - Medical Assistant, Medical Billing &
Coding |
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(Henderson, Las Vegas) - Administrative Medical Assistant, Medical
Assistant, Medical Insurance Billing/Coding |
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(Formerly Ultrasound Diagnostic School) (Iselin)
- Medical Assistant, Coding & Billing |
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| New Jersey Schools |
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| ATI
Training Institute |
(Edison)
- Medical Billing & Coding |
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(Marlton, Wayne, West Long Beach) - Medical Billing, Coding, & Office
Administration |
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| ProTrain,
Inc. |
(Portland)
- Administrative Medical Assistant, Medical Assistant,
Medical Insurance Billing/Coding |
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(Formerly Ultrasound Diagnostic School) (Iselin)
- Medical Assistant, Coding & Billing |
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| New York Schools |
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| Hunter
Business School |
(Levittown)
- Medical Assistant, Medical Billing, Medical Office
Administration |
|
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(Binghamton, Poughkeepsie)
- Medical Administrative Assistant, Medical Assistant,
Medical Billing & Coding Specialist, Medical Transcription
Specialist |
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(Rochester)
- Medical Assisting, Medical Insurance Billing &
Coding, Administration Information Processing (Medical) |
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(Formerly Ultrasound Diagnostic Schools) (Garden City, New York, White Plains) - Medical Assistant, Coding & Billing |
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| North Carolina Schools |
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(Charlotte, Greensboro, Raleigh)
- Medical Billing and Coding, Medical Transcription,
Medical Office Administration |
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| North Dakota Schools |
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(Bismark, Fargo)
- Medical Coding, Medical Office, Medical Transcriptionist |
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| Ohio Schools |
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(Cuyahoga Falls) - Medical Assistant, Medical Biller/Administrator |
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(Gahanna)
- Medical Assisting, Medical Insurance Billing/Coding |
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(Cleveland, Cleveland West) - Medical Assisting, Medical Insurance and
Coding |
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(Cleveland)
- Medical Assistant, Medical Billing and Coding Specialist |
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(Dayton, Franklin, Tri-County, Vine Street) - Medical Administrative Assistant, Medical
Assitant, Medical Billing & Coding |
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(Cincinnati, Cleveland, Columbus)
- Medical Billing and Coding, Medical Transcription,
Medical Office Administration |
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(Cleveland)
- Medical Assistant, Medical Billing and Coding Specialist |
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| Oklahoma Schools |
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(Oklahoma City) - Medical Billing and Coding, Medical Transcription,
Medical Office Administration |
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| Oregon Schools |
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(Beaverton)
- Medical Assistant, Medical Billing & Coding |
|
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(Wilsonville)
- Healthcare Administration, Medical Assisting, Medical
Claims & Billing |
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| Western
Business College |
(Portland)
- Administrative Medical Assistant, Medical Assistant,
Medical Insurance Billing/Coding |
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| Pennsylvania Schools |
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| Career Training
Academy |
(Monroeville, New Kensington, Pittsburgh)
- Advanced Medical Coder/Biller, Medical Biller, Medical
Administrative Assistant |
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| |
(Allentown)
- Medical Billing, Coding, & Office Administration |
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| CLN |
(Altoona, Mechanicsburg)
- Medical Assistant, Medical Billing & Coding Specialist |
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| |
(Pittsburgh) - Medical Administrative Secretary, Medical Assistant, Medical Insurance Billing and Coding |
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| |
(Formerly Ultrasound Diagnostic School) (Philadelphia) - Medical Assistant, Coding & Billing |
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| Kaplan Career Institute |
(Harrisburg) - Medical Assisting, Billing and Coding Thompson Institute (Philadelphia) - Medical Assisting, Billing and Coding |
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| Tennessee Schools |
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(Memphis, Nashville)
- Medical Assistant, Medical Billing & Coding |
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| Texas Schools |
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| Academy
of Healthcare Professions* |
(Austin, Houston North Loop, Houston Southwest) - Medical Assistant, Medical Coding and
Billing Specialist |
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| CCI
Training Center* |
(Arlington, Dallas)
- Medical Billing and Coding, Medical Transcription |
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(Arlington/Mid-Cities, Dallas, Fort Worth) - Medical Assisting, Medical Insurance Billing
and Coding |
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(Irving)
- Medical Assistant, Medical Billing & Coding |
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| 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 |
|
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(Houston)
- Medical Assistant, Medical Billing |
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| |
(Dallas, Fort Worth, Houston)
- Medical Assistant, Medical Insurance and Coding |
|
| |
(Dallas, Houston)
- Medical Assistant, Coding & Billing |
|
| |
(Dallas, Fort Worth, Houston, San Antonio) - Medical Coding, Medical Billing, Medical
Office Administration, Medical Transcription |
|
| |
(Austin)
- Medical Assistant, Medical Assisting and Office Administration,
Medical Billing and Coding |
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| |
(Dallas, Fort Worth, Houston-Technology)
- Medical Assisting, Medical Insurance Coding &
Billing |
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| Utah Schools |
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(Salt Lake City) - Medical Assisting, Medical Insurance
Coding and Billing, Medical Administrative Assistant |
|
| |
(Salt Lake City) - Medical Coding, Medical Billing, Medical
Office Administration, Medical Transcription |
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| Virginia Schools |
|
| |
(Newport News, Chesepeake)
- Dental Assisting, Massage Therapy, Medical Administrative
Assistant, Medical Assisting, Medical Insurance Billing/Coding |
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| |
(McLean)
- Medical Insurance Billing and Coding, Medical Administrative
Assistant, Medical Assisting |
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| The
Anthem Institute |
(Arlington)
- Medical Assistant, Medical Billing & Coding |
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| Washington Schools |
|
| |
(Seattle)
- Medical Assistant, Medical Billing & Coding |
|
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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 |
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| Wisconsin Schools |
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(Madison, Milwaukee)
- Medical Coding, Medical Billing, Medical Office Administration,
Medical Transcription |
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* Program Availability Varies By Location and Often Changes. To get the most up-to-date information, use the links we provide to request additional information from a local campus representative.
