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Medical insurance
clerks, in conjunction with coding specialists and other billing
professionals, work to ensure that all medical procedures are properly
filed with the appropriate insurance agency. Insurance clerks obtain
information from policyholders to verify the accuracy and completeness of
information on claims forms, review related insurance documents provided
by the patient, as well as review medical records to verify all relevant
information. They are often called upon to read and review medical
documentation provided by physicians and other health care providers in
order to obtain detailed information regarding patients’ disease,
injuries, surgical operations, and other procedures. Medical insurance
clerks work extensively with private insurers, as well as federal agencies
such as Medicare and Medicaid, so they must remain current with all of the
rules and regulations that govern third party payment for medical
services. This usually requires a great deal of continuing education and
training to stay on top of these constantly changing guidelines. They also
produce reports used to improve patient care, control cost, and conduct
survey and research studies. Medical insurance clerks usually work under
the supervision of a billing supervisor or the health information
administrator.
Work Environment:
Medical insurance clerks work in hospitals,
clinics, surgery centers, dental offices, long-term care facilities,
insurance companies, home health care agencies, consulting firms, coding
and billing services, and government agencies.
High School Preparation:
Students interested in pursuing a career as
an insurance clerk should take high school courses in algebra, biology,
English, office procedures, typing, data processing, computer skills, and
health occupations/medical professions education.
College Requirements:
Medical insurance clerks should have a high
school diploma or the equivalent. An associate’s degree in health
information is recommended and is often two years in length. Training may
be available on-the-job as well as through continuing education classes
offered by state associations/organizations. There are currently no
required certifications for medical insurance clerks, but individuals
desiring to become a certified health information technician must pass
examinations offered by the American Health Information Management
Association (AHIMA).
For educational institutions in
Mississippi
offering this course of study
click here.
Career Outlook:
There is an
outstanding future for medical insurance clerks because of the increased
scrutiny over proper billing by third party payers. In an effort to
control costs, complete and accurate records are becoming a necessity in
order for hospitals and clinics to receive money from Medicare and
Medicaid. Because this field is constantly changing due to new state and
federal guidelines, insurance clerks that stay current with new laws
governing insurance payments will enjoy the best job security. As in most
other occupations, many openings will result from the need to replace
employees who transfer to other companies, retire, or stop working for
various other reasons.
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Salary:
Average Annual
Salary
$28,900
Salary Range
$19,700-$38,800
Professional Organizations:
American Health
Information Management Association
919 North Michigan
Avenue, Suite 1400
Chicago, IL
60611-1683
Phone: (312)
233-1100
Web:
www.ahima.org
Mississippi Health
Information Association
921 North Congress
Street
Jackson, MS
39202-2554
Phone: (601)
956-4105
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