Health Care Reimbursement: Duties & Job Market

If you know your HMO from your PPO, and your EPO from your POS, you may be an excellent candidate for the burgeoning field of health care reimbursement.

Duties of a health care reimbursement specialist
Health care reimbursement specialists handle all components of insurance claims processing. They also help control claim fraud, abusive practices, and unnecessary medical procedures.

Health care reimbursement specialists submit insurance claims; review and problem-solve returned, disputed, or rejected claims from Medicare and other third-party payers; and serve as a resource to patients as well as other health care professionals regarding insurance coverage and medical billing for specific procedures.

Where to find health care reimbursement specialist jobs
Health care reimbursement specialist jobs may be found in doctor's offices, insurance companies, consulting firms, nursing care facilities, outpatient care centers, medical billing companies, and hospitals.

Health care reimbursement specialist programs
Health care reimbursement specialist programs provide the skills necessary to enter the health insurance field in today's managed care environment. Courses may include coding procedures, computerized billing and practice management, insurance reimbursement and billing procedures, legal aspects of health care, medical terminology, and office procedures. Students learn about major medical third-party payers, including coverage offered, patient eligibility requirements, billing guidelines, and reimbursement methodologies.

Health care reimbursement specialist programs typically culminate in either a certificate or an associate degree, and prepare students for national professional certification exams such as those offered by the American Health Information Management Association and the American Academy of Professional Coders.

Demand for health care reimbursement specialist jobs
Changing federal and state regulations regarding reimbursement for health care services has fueled the demand for trained health care reimbursement specialists. According to the Bureau of Labor Statistics, employment in medical records technology is expected to grow at a faster rate than employment in other industries through 2016. Health care reimbursement specialists with a strong background in medical coding will be in especially high demand.

Make a difference in the increasingly complex world of managed care -- become a health care reimbursement specialist.

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