The health insurance field is a fast growing industry with a wide
variety of positions available. Depending on your skills and what type
of position you seek will determine which area of the health insurance
field that you should pursue. Take a look at your resume and define your
experience so that you know what you are best at and identify any
weaknesses you may have.
When interviewing for these types of positions, employers want to know where your strengths lie and where you may need coaching. They will look at you as a whole person, and be very in-depth. The best way to get your point across and be considered for a position is by being prepared. Often times, employers want real world examples and situations that you have experienced in the past. Normally, a company will conduct two interviews and for high level positions they may even have three interviews.
Listed below are six of the most common types of health insurance jobs that are available. Within these types is room for advancement in most cases, so take this as a look at the starting points for these areas. Consider the duties involved and the types of qualities that would be important for a person holding that type of position.
This person will most often be required to design, implement, and price insurance plans for outside companies. Previous medical or insurance experience is an absolute must for this type of upper level position. Be prepared to make presentations, host meetings, and work with clients in person and via the telephone, letters and email.
This position will require both people skills and technical skills. This person will be handling incoming phone calls and outgoing phone calls regarding insurance eligibility. Often, you will be required to also upkeep eligibility records, as well as issue letters stating when an insurance plan has ended and the participants are no longer eligible for services. This person will handle calls regarding eligible services under a participant’s plan and often times will also handle calls regarding who is eligible under a participant’s plan.
This position is normally very demanding, and is highly technical. This person will be processing claims for the insurance company as they are received from doctor’s offices, hospitals, specialists, and many other medical professionals. A person in this position should have good computer skills, and be capable of sitting for long periods of time. Also, there is not often much variety in the daily tasks for a claims processor, so you should be a person who can stay on task and be able to dedicate yourself to one task for long periods. Many insurance companies put a claims processor through several weeks of training in the technical specifics of the programs used by that company. Previous claims experience in any field is accepted, but previous experience with claims in a medical environment is preferred.
This type of position will vary by company. Many health insurance sales agents may also sell other types of insurance, so they may work for a company other than a major health insurance carrier like Blue Cross Blue Shield or Humana. This type of work requires a license for every state in which you wish to sell insurance, and often companies prefer to hire college graduates. If you have good job longevity or have a proven track record in sales, many companies will consider you even if you only have a high school diploma.
This position is the life blood of health insurance. As a call center representative, you are the first point of contact for patients and physicians. Working as a representative in a call center, you develop knowledge over a wide range of topics. You will know high level knowledge regarding eligibility, plan details and answer many different types of questions. This position requires professional phone etiquette and it is helpful if you also have a desire to help your fellow man. A call center representative is the person that is reached out too when patients and physicians need help or clarification.
Medical Billing and Coding is the other side of the health insurance field. These positions are held in doctor’s offices, hospitals, and with other medical professionals. The main responsibility of this position is to accurately assign ICD-9 and CPT codes for diseases, procedures, conditions and treatments so that the claim can be processed by the insurance company. You will be sending the coded claims to the insurance company, and then insure the accuracy of the claim and payments received for that claim. This position is mostly data entry, but it is significantly important. Without the coding and billing, medical professionals could not be paid by the insurance company. It is best to look at medical billing and coding professionals as translators that speak the insurance company’s special language.