Insurance Reimbursement Specialist

Insurance Reimbursement Specialist: Job Responsibilities

In order to manage the billing/reimbursement process, Insurance Reimbursement Specialists are typically responsible for the following tasks: 

• Identifying methods of payment for patients 
• Correlating insurance coverage with services to be provided 
• Managing financial and medical records 
• Medical coding 
• Review records, coding and billing practices to ensure compliance 
• Preparation and review of insurance claims 
• Submit insurance claims to insurance carriers 
• Follow up on unpaid claims 
• Invoice preparation 

Common Employment Settings for Insurance Reimbursement Specialists 

Insurance Reimbursement Specialists work in a wide variety of employment settings throughout the medical and insurance industries. Among the most common of these are: 

• State, Local and private acute-care hospitals 
• Physicians’ offices 
• Companies that provide administrative and support services to medical professionals and health care facilities 
• Nursing homes 
• Skilled nursing facilities 
• Rehabilitation hospitals 
• Insurance companies 
• Medical software firms 
• Medical/insurance consulting firms 

Insurance Reimbursement Specialists: Career Outlook 

The Bureau of Labor Statistics (BLS) Occupational Outlook Handbook does not provide information specifically for Insurance Reimbursement Specialist positions. Rather, they group these administrative professionals in the Medical Records and Health Information Technicians category. According to BLS, employment of medical records specialists is projected to grow 8 percent from 2022 to 2032, faster than the average for all occupations.  

About 15,000 openings for medical records specialists are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.  

An increasing share of the population is entering older age groups, which typically require more medical services. In addition, there is a growing prevalence of heart disease, diabetes, and other chronic conditions. As a result, more medical records specialists will be needed to translate patient information and services delivered into standardized codes to be used for insurance reimbursement and other purposes. 

It is important to note that while this information can offer readers a general idea of the career potential of various occupations, job market data from the US Bureau of Labor Statistics Occupational Handbook is intended to provide insight on occupational opportunities. That data is not to be construed as a guarantee of salary or job title. Neither BLS nor Bryant & Stratton College can guarantee employment in this or any other occupational field. 

Additional Training/Requirements to Become an Insurance Reimbursement Specialist 

To be hired as an Insurance Reimbursement Specialist, many employers will require that you hold certain professional certifications. Earning professional certifications generally means meeting certain educational and work experience standards set by the certifying organization and passing an exam administered by that organization. 

Many employers, especially in health care environments, will require that Insurance Reimbursement Specialists undergo background checks and, in many cases, drug screening tests. In many areas, these screenings are required by state health care regulations for any employee who works in a clinical setting, like hospitals, nursing homes or medical practices. Often, employers will require that newly hired Insurance Reimbursement specialists undergo a period of on the job training as a condition of continued employment. Typically, this training is designed to ensure that employees are well-versed in the policies, procedures and practices of their specific employment setting. 

For more insights into preparing for a career as an Insurance Reimbursement Specialist or in the health care field in general, please visit the health care degree section of the Bryant & Stratton College blog. There, we provide resources and insights you need to begin planning and building a satisfying and successful career.