Medical Billing and Coding as a Career | Career Training | The Salter School
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Health Claims Specialist: Career Description

What Health Claims Specialists Do

Health claims specialists are responsible for processing health insurance claims to ensure that health care providers get paid for their services. To prepare the claims, they use computer software that is specialized to the industry in order to code the patient diagnoses and treatments. As a health claims specialist, you will be expected to be accurate and detail-oriented as you keep track of insurance claim forms, payments made, and payments that are outstanding. Health claims specialists provide an important service to both patients and doctors by helping to ensure that insurance and payment details are in order.

Where Health Claims Specialists Work

Health claims specialists can work in any facility where medical insurance is accepted. Your job could be in one of the following places:

  • Private medical office
  • Hospital
  • Outpatient facility
  • Diagnostic center
  • Urgent care center
  • Nursing or long-term care center
  • Surgical center
  • Dental office
  • Specialists’ office
  • Insurance company
  • HMO (Health Maintenance Organization)
  • PPO (Preferred Provider Organization)
  • Medical billing agency
  • Governmental agency

The Professional Environment

The professional environment for health claims specialists is typically an office setting. You will be expected to spend a good deal of your time on the computer and the telephone, working with patients and insurance companies to handle claims and payments.

Occupational Outlook

The job outlook for health claims specialists is very good. According to the U.S. Department of Labor’s Occupational Outlook Handbook, employment of medical records and health information technicians is expected to increase by 15 percent from 2014 to 2024. This rate is much faster than the average for all occupations.

Part of the reason for the increased demand is the aging population. The handbook explains, “An aging population will need more medical tests, treatments, and procedures. This will also mean more claims for reimbursement from private and public insurance.”

The job outlook is particularly strong for health information specialists who have skills in technology and computer software. Many medical offices are converting to electronic health records (EHR) systems, which is expected to lead to an increased demand for technology-proficient health information professionals. The handbook states,  “As EHR systems continue to become more common, technicians with computer skills will be needed to use them.”

Because of these and other trends, the job outlook for health claims specialists is very good, especially for those specialists who have certification, computer skills, and on-the-job experience.

Salary and Wage Trends for Health Claims Specialists

What can you expect to earn as a health claims specialist? A good place to learn more about wage and salary trends is the U.S. Department of Labor’s Occupational Outlook Handbook.  In this handbook, you can find the annual median wage for medical records technicians. Please note that salaries across the country can vary because of factors such as where you live, your level of experience, your skill set, and the type of medical facility where you work.

Earning a certification is one way that you can improve your job opportunities and job security. In addition, as you gain more experience and perform well in your job, you can expect your income to increase.

Getting Certified as a Professional Coder

Getting certified can jump-start your career! At the Salter School, we strongly recommend to our graduates that they sit for the Certified Professional Coder exam offered by the American Academy of Professional Coders. We also suggest the Certified Electronic Health Records Specialists certification, offered through the National Healthcareer Association.

Certification shows potential employers that you are competent in the skills needed for the job. Health claims specialists with certification typically have better job opportunities and more job stability.

In most of our locations, certification exams are held at an off-campus location, and are not covered in your tuition. Remember, once you are certified, you will be entering the job market with a strong resume, proven skills, and a stronger sense of confidence. It’s worth the effort!

Still Trying to Decide?

Still trying to decide which program is right for you? At Salter, we offer numerous career-focused programs that may interest you. Take your time and review our list of programs.  We want your new career to begin with us.