Exploring Health Insurance Professionals` Career and Role


ExploringHealth Insurance Professionals’ Career and Role

Exploring Health Insurance Professionals’ Career and Role

Healthinsurance specialist has a lot of responsibilities. Some of theseresponsibilities include the use of medical coding procedures toreview patients’ records. They are involved in the examination ofclaims and insurance verification of eligibility, as well as takingrecords of any charges incurred and other adjustments or payments.They are also responsible when it comes to detecting any form of codeerrors or handling any modifications required (AAPC, 2014). Thesespecialists are also involved with helping patients to obtain andunderstand their medical benefits. Finally, they are also concernedwith updating all forms of internal databases that are electronicallystored and organized, especially for patients’ records,registration forms, and billing details.

Health insurance specialists are presented with some careeropportunities, which lies in areas of medical billing. Jobopportunities lie within the medical health sector and are moreprevalent in the field of health insurance. Employers require thesespecialists to be well-acquainted with medical terminologies, dataentry, computer knowledge, email and the internet (APPC, 2014). Thehealth insurance industry needs these specialists to have verbal andoral skills. Those practitioners seeking to add credentials shouldenroll for certification programs. Health insurance experts shouldjoin in NCCT (National Center for Competency Testing) and the AAPC(American Academy of Professional Coders) to acquire professionalcertifications (AAPC, 2014). The NCCT gives coding and insurancespecialists certification while the NCCT offers certification examfor medical coding and terminology procedures.

My career plans will involve interests in health insurance withinterests in health information management, which also includeinformation technology. Information technology will help me throughthe demands of the job as a specialist. I am planning to bewell-informed in my line of specialty through guidance in the scopeof practice. The guidance will help in defining my profession,clarify my supervision requirements, and delineates myqualifications. By the end of this course, I expect to learn howinsurance policies are interpreted and coverage determined. I alsoexpect to find out more in terms of billing and coding, and how theyare used in the hospitals and medical laboratories.


American Academy of Professional Coders (2014). Health InsuranceSpecialist: Official CPC certification study guide. Retrievedfrom https://www.aapc.com/training/cpc-study-guide.aspx