Becoming an Insurance Claims Specialist: Salary & Job Description

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What are the pros and cons of an insurance claims specialist career? Get real job descriptions, career prospects and salary info to see if becoming an insurance claims specialist is right for you.
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Pros and Cons of Becoming an Insurance Claims Specialist

An insurance claims specialist, sometimes referred to as insurance claims examiner, is typically responsible for handling, fulfilling and resolving insurance claims in a particular establishment. Below is a list of pros and cons to help you decide if a career as an insurance claims specialist is right for you.

Pros of Becoming an Insurance Claims Specialist
Able to work in nearly any geographical area across the country*
Can work in a variety of industries (health care, automobile, home or life insurance)*
Above-average hourly wage (median wage of $29.91 per hour in 2014)*
Can have a wide variety of educational backgrounds (medical, legal, business or engineering)*

Cons of Becoming an Insurance Claims Specialist
Slower-than-average growth (expected increase of 3% between 2012 and 2022)*
High competition is expected between 2012 and 2022*
Licensing is required for some positions*
Can be required to deal with stressful situations**

Sources: *The U.S. Bureau of Labor Statistics, **O*NET OnLine.

Essential Career Information

Salary and Career Outlook

An insurance claims specialist made a median hourly wage of over $29.91 in 2014. However, the top 90% of claims specialists made about $44.00 per hour, and the lower 10% made around $18.00 per hour in the same year. The large variance in wages can be attributed to the variety in duties and responsibilities as well as years of experience in the field.

The field is expected to grow 3% between 2012 and 2022, which is slower than the national average of all occupations. Insurance claims specialists in the automotive industry should face particularly slow growth in the same decade period. However, better opportunities are expected in health care fields, where patients make insurance claims more frequently than in other industries.

Job Description and Duties

An insurance claims specialist is responsible for investigating damage or injuries, researching reports, interviewing claimants and witnesses, preparing reports, processing payments and gathering evidence and other information surrounding insurance claims. They review insurance claims and determine appropriate payments or negotiate settlements with claimants when applicable. Sometimes, insurance claims specialists are be required to testify about their findings in court.

What Are the Requirements?

Educational Requirements

Many insurance claims specialist positions only require a high school degree or equivalent G.E.D. in addition to relevant experience in the field. Working in positions such as insurance claims clerk, billing and coding worker, customer service representative or other similar occupations can be considered relevant career experience. Other employers look for candidates with appropriate state licensure, which varies by state. Some advanced positions also require a bachelor's degree in an insurance, business or job-related field.

What Do Employers Look for in Insurance Claims Specialists?

Employers typically look for specialists who are able to work with integrity, pay attention to detail, communicate effectively and use computer technology proficiently. While some employers require licensure or a postsecondary degree, most look for previous experience in a relevant position. The following job postings were found in April 2012:

  • A health care clinic in Washington needs an insurance claims specialist with medical billing and coding experience who is extremely organized.
  • An insurance company in New York City requires an insurance claims specialist who carries state licensure and is able to complete claims from start to finish.
  • In San Diego, a medical facility needs a specialist who is familiar with electronic insurance claim software and medical coding.

How to Get Ahead in the Field

Most employers prefer candidates who have relevant experience because there are no universal educational requirements. In order to gain experience in the field, you may benefit from beginning your career in the insurance field as an insurance claims clerk. Some employers might require appropriate state licensure, so you should verify state law requirements regarding insurance examiners and pursue the licensing options that can make you an appealing candidate to the greatest number of employers.

Develop Related Skills

In addition to gaining experience, you would benefit from developing relevant career skills. Employers often look for candidates who are well organized and have good communication skills. The following skills can benefit you in your pursuit of a career as an insurance claims specialists:

  • Able to work with little supervision
  • Proficient with Microsoft Word and Excel
  • Experienced in account management
  • Able to fulfill and complete various insurance claims scenarios
  • Be extremely detail-oriented

Alternative Career Choices

If you decide that you don't want to pursue a career as an insurance claims specialist, you might consider becoming a building inspector. They examine buildings and structures to ensure local laws are in compliance with existing state and national laws. A high school degree plus on-the-job training is typically the minimum required education for these careers. The field is projected to grow at an average pace between the years of 2010 and 2020, which is faster than insurance claims specialists in the same decade. In 2011, building inspectors made a median hourly wage of over $25.00.

Another similar career to an insurance claims specialist is an insurance underwriter. They determine whether an insurance company is able to insure a person, building or event. A bachelor's degree is normally required for these positions, and some positions might require certification. In 2011, these professionals made a median hourly wage of over $29.00; however, between 2010 and 2020, insurance underwriter positions are expected to increase at a pace that is slower than the national average of all occupations.

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