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Insurance Specialist: Job Description and Education Requirements

Insurance specialists require little formal education. Learn about the training, job duties and certification options to see if this is the right career for you.

A postsecondary certificate or associate's degree is required for a career as an insurance specialist. Professional certification is optional, but can verify medical insurance credentials and may increase job prospects for those entering this field.

 

Essential Information

Insurance specialists are experts in interpreting insurance policies and determining coverage. With specialized training in billing and coding, they may work in medical and government offices, hospitals, and laboratories. Prospective insurance specialists can prepare for the job by earning an associate's degree, though most skills are learned on the job.

Required Education

College coursework leading to certificate or associate's degree

Other Requirements

Professional certification (optional)

Projected Job Growth (2014-2024)*

13% for billing and processing clerks, 
15% for medical records and health information technicians

Median Salary (2015)*

$35,050 for billing and processing clerks, 
$37,110 for medical records and health information technicians

Source: *U.S. Bureau of Labor Statistics

 

Insurance Specialist Job Description

Insurance specialists are trained to decipher complicated insurance laws and policies. In a government capacity, insurance specialists may be responsible for ensuring that government programs, such as Medicare and Medicaid, comply with federal law, regulations, and contracts. Specialists may advise on issues related to eligibility and coverage, as well as monitor the compliance of government contractors.

Many insurance specialists are also employed in the health care industry. As such, they may deal with health insurance billing and payments including interpreting billing codes and processing claims. Specialists may also be expected to keep track of patient records and perform other functions integral to the running of a medical office.

 

Insurance Specialist Education Requirements

While many of the skills necessary to the profession may be learned on the job, prospective insurance specialists may want to consider specialized training in the field. In the health care arena, schools offer certificate and associate's degree programs for medical or health insurance specialists. These programs offer courses in medical coding, medical terminology, and health care law. Graduates may be qualified to earn Health Insurance Portability and Accountability Act (HIPAA) Certification, which shows a greater understanding of the federal statute, which governs privacy of patient medical information.

 

Certification

For those seeking additional credentials, there are certification programs available to highlight specific skills. For health insurance specialists, the National Center for Competency Testing (NCCT) and the American Academy of Professional Coders (AAPC) offer various certifications. The NCCT offers the Insurance and Coding Specialist certification. The certification exam for an NCCT credential tests knowledge of medical coding, procedures and terminology. The AAPC offers certifications that reveal expertise in medical coding such as the Certified Professional Coder and the Certified Interventional Radiology Cardiovascular Coder.

 

Salary Info and Job Outlook

According to the U.S. Bureau of Labor Statistics (BLS, www.bls.gov), medical records and health information technicians earned a median salary of $37,110 in May 2015, while billing and processing clerks earned a median of $35,050 a year. The employment of medical records and health information techs is projected by the BLS to increase by 15% between 2014 and 2024, just as billing and processing clerks should see job opportunities rise by about 13% during the same decade.

Insurance specialists analyze policies and determine the scope of a policy's coverage. They need to be familiar with insurance laws and policies. One common area of specialization is in health insurance, which is expected to have much faster than average job growth from 2014 to 2024.

 

The document Insurance Specialists - Insurance Business And Market, Principles of Insurance, B com | Principles of Insurance is a part of the B Com Course Principles of Insurance.
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FAQs on Insurance Specialists - Insurance Business And Market, Principles of Insurance, B com - Principles of Insurance

1. What is the role of insurance specialists in the insurance business and market?
Ans. Insurance specialists play a crucial role in the insurance business and market. They are professionals who have in-depth knowledge about insurance policies, coverage options, and risk management. They assist individuals and businesses in selecting the right insurance policies based on their specific needs and requirements. Insurance specialists also provide advice and guidance on claim procedures, policy renewals, and premium payments.
2. What are the principles of insurance that insurance specialists follow?
Ans. Insurance specialists adhere to certain principles of insurance to ensure fair and effective coverage for their clients. These principles include: 1. Principle of Utmost Good Faith: Insurance specialists expect both the insurer and the insured to disclose all relevant information honestly and accurately to avoid any misrepresentation. 2. Principle of Insurable Interest: Insurance specialists ensure that the insured has a valid financial interest in the subject matter of the insurance policy, such as property or life, to prevent fraudulent claims. 3. Principle of Indemnity: Insurance specialists aim to provide compensation to the insured in the event of a loss, ensuring that the insured is restored to the same financial position as before the loss occurred. 4. Principle of Contribution: Insurance specialists ensure that if the insured has multiple insurance policies covering the same risk, each insurer contributes proportionately to the claim settlement. 5. Principle of Subrogation: Insurance specialists have the right to subrogate the insured's rights and recover the amount paid for a claim from the responsible third party, if applicable.
3. What is the significance of a B Com degree in becoming an insurance specialist?
Ans. A B Com degree (Bachelor of Commerce) provides a comprehensive understanding of various aspects of business, including finance, accounting, economics, and marketing. This knowledge is essential for insurance specialists to analyze the financial aspects of insurance policies, assess risks, and offer suitable coverage options to clients. A B Com degree equips individuals with the necessary skills to evaluate insurance products, understand legal and regulatory frameworks, and effectively communicate with clients and insurance companies.
4. Can insurance specialists assist in navigating complex insurance policies for businesses?
Ans. Yes, insurance specialists are trained to navigate complex insurance policies for businesses. They have expertise in analyzing the unique risks faced by businesses and can recommend appropriate coverage options to mitigate those risks. Insurance specialists can help businesses understand the terms, conditions, and exclusions of insurance policies, ensuring that they have comprehensive coverage tailored to their specific industry and operations. Additionally, insurance specialists can assist businesses in managing multiple policies, ensuring they have adequate coverage across various areas such as property, liability, and employee benefits.
5. How can insurance specialists help individuals in the claims process?
Ans. Insurance specialists play a crucial role in assisting individuals during the claims process. They guide clients through the necessary steps, ensuring that all required documentation is submitted accurately and promptly. Insurance specialists act as advocates for their clients, liaising with insurance companies to negotiate fair claim settlements. They also provide valuable advice on claim procedures, helping individuals understand their rights and entitlements under the insurance policy. By leveraging their expertise, insurance specialists can expedite the claims process and ensure individuals receive the compensation they are entitled to.
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