health Insurance Claims Examiner Job Description

March 19, 20120 Comments

Health Insurance Claims Examiner Job Profile and Description

Why do people buy insurance…or more precisely health insurance? The answer is not that they get convinced by the seedy media advertisements, but because they know they can fall sick and that could mean significant financial loss. Health insurance cannot prevent people from falling sick, but at least give them some comfort by paying medical bills. As a health insurance claim examiner, you’d have to go around verifying the claims made by people and find out whether or not the claims are according to the guidelines and legitimate.

Health Insurance Claims Examiner Job Duties and Responsibilities

  • You’d have to know a thing or two about diseases, especially the ones that need major surgeries or are fatal.
  • An excellent eye for detail is very essential. You’d have to be able to differentiate between diseases that were there before the policy was done and those that weren’t.
  • Many unscrupulous customers resort to telling pharmacies and hospitals to make fat bills so they can charge a bomb from the insurance company. You should have an eye to detect that.

Health Insurance Claims Examiner Job Skills and Specifications

  • Basic skills would involve the ability to detect spots in bills.
  • A thorough understanding of what medical reports mean is essential because a lot depends on the medical reports.
  • Good communication skills

Health Insurance Claims Examiner Job Education and Qualifications

  • Most health insurance companies would accept a high school diploma, but a higher qualification could make matters better.
  • The study of biosciences could prove to be beneficial because unless you understand diseases you won’t be able to stop yourself from being taken for a ride.

Health Insurance Claims Examiner Analyst Salary

  • Salary could vary from organization to organization, but even a mediocre firm should offer around $3000 monthly.

Download health Insurance Claims Examiner Job Description in Word Format

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