Health Claims Examiner Classes and Colleges

Health claims examiners review patient billing documentation for insurance carriers to determine the validity and cost effectiveness of treatments. You could complete a certificate or degree program in a related field, like medical billing or health information management, to prepare for this career. Review what you'll learn during health claims examiner training, and find out how you can qualify for certification. Schools offering Medical Billing Administrative Specialist degrees can also be found in these popular choices.

What You Need to Now

A background in medical billing and coding is often helpful for a career as a health claims examiner. Taking classes on these subjects as well as courses more specific to health information could prepare you to enter this career field.

Program Options Health Claims Examiner/Medical Biller Diploma, Associate of Science in Medical Billing and Coding, Associate of Science in Health Information Technology, Bachelor of Science in Health Information Administration
Classes Coding and diagnosis, reimbursement procedures, surgical procedure coding, claims production, medical terminology, pathophysiology, health records systems
Online Some programs may offer a portion or all of the coursework through distance learning

What Type of Degree Will I Need to Become a Health Claims Examiner?

Entry-level health claims examiner positions often require you to have at least a high school diploma. However, you may also wish to complete a certificate program related to health insurance examining or medical billing. You may also choose to pursue an Associate of Science or Bachelor of Science degree in health information management. Many certificate and degree programs are offered with online learning components. Schools offering these types of programs include:

  • Harrison College
  • Florida Technical College
  • University of West Florida
  • Wake Technical Community College
  • Dakota State University
  • Central Piedmont Community College
  • Clarkson College
  • Indiana University Northwest

What Skills Will I Need to Become a Health Claims Examiner?

While many of the skills necessary for medical billing and coding specialist positions apply to health claims examiners, you will need training in reviewing insurance policies and performing cost analysis. You should develop strong data entry, statistical analysis and general math skills as well as knowledge of healthcare laws and regulations.

What Classes Will I Take?

As an aspiring health claims examiner, you may want to enroll in courses providing you with extensive knowledge of coding, international classification of diseases (ICD) and current procedural terminology (CPT). You may obtain background knowledge in anatomy and physiology, as well as treatment costs and the expected duration of treatment.

Career-based coursework may focus on software technology used in the field that includes elements of database information collection and security. You may receive training in the utilization of medical and dental reference books as well as anatomical charts and models. Topics covered in training may also address procedures for interviewing physicians and examining information pertaining to billing and inpatient hospital stays.

Specific courses could include:

  • Medical software
  • Health records management
  • Reimbursement methods
  • Hospital billing systems
  • Medical law and ethics

What Certifications Can I Obtain?

The American Association of Professional Coders issues the Certified Professional Coder credential. An associate's degree program covering coding-specific coursework is recommended to prepare you for the certification exam. You may also choose to obtain the Registered Health Information Technician credential issued by the America Health Information Management Association (AHIMA). The AHIMA also issues the Certified Coding Associate (CCA) designation. You will only need to have completed a coding training program to be eligible for the CCA credential.

To continue researching, browse degree options below for course curriculum, prerequisites and financial aid information. Or, learn more about the subject by reading the related articles below:

  • 1. Degree Options:
The schools in the listing below are not free and may include sponsored content but are popular choices among our users. Tuition and costs will vary across programs and locations. Be sure to always request tuition information before starting a program.

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