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The Basics of Medical Claims Processing


So, you're interested in medical claims processing, but you're not quite sure what it is or how to get started. Let's take a look at what medical claims processing is, how to find jobs, and the skill set you'll need to be successful.

What Is Medical Claims Processing?

With any business, your primary focus should be on your area of specialization. Anything that distracts you from this purpose should be outsourced. In the case of doctors and other medical professions, the primary focus is the care of their patients. Due to this, many doctors do not have the skills or knowledge to get paid in a timely fashion.

This is where medical claims processing comes in. You, as a medical claim processor, work directly with a doctor's patients and his insurance companies to make sure that the doctor gets paid. This allows doctors to focus on the care of their patients, without having to worry about the hassle of accounting.

Skills Needed to Perform the Job

Not just anybody can be a medical claim processor. Here are a few skills that will be helpful in your new endeavor:

  • Knowledge of the health insurance industry
  • Good communication skills
  • Understanding health coding and medical terminology
  • Excellent attention to detail

If you've got experience in the medical field already, you've got a leg up. However, there is plenty of research material out there that can help you learn the skills you need.

How to Find Jobs and Advertise

The most important method of finding jobs and advertising in medical claims processing is networking. Word-of-mouth is an important aspect of the medical industry, and to get people talking about you, you need to make contacts. First off, start with everyone you know. Tell them about your new, exciting opportunity. Get them talking about it, and word will spread.

Then, talk to your doctor. Make him aware of your new medical claims processing business. He may know other doctors in need of your service. He might be able to give you names or pass your name around to his colleagues.

After that, check in with other doctors you know of: your dentist, your pharmacist and doctors of other family members, such as your husband or kids. Knowing as many people in the industry as you can will help you make new contacts. Any of them may also be able to provide you with methods to approach other doctors.

Lastly, don't ignore other professionals such as lawyers, accountants, real estate agents and insurance agents. Many of these professionals will have contacts in the medical field. If you ask the professionals that you work with, they may be able to provide you with some good information about who to talk to.

Word-of-mouth and networking will get you far, but don't ignore other forms of advertising as well. Here are some methods to consider:

  • Keep a collection of compliments from your clients to include in any promotional materials
  • Create a web site that reflects your skills
  • Publish ads in the Yellow Pages and health care publications
  • Put ads on web sites catering to home businesses

Medical claims processing is in high demand. Any WAHM with the right skills and know-how could make a good income in this field.

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