Medical Insurance Specialist
The Medical Insurance Specialist is a Level II (Complex Skills Certificate) certificate designed to provide entry-level skills for medical billing specialists. These individuals process the information necessary for reimbursement of health care services. The medical insurance biller is responsible for collection of preadmission/pretreatment insurance information through submission of claims to insurance carrier or patient. Verification of insurance coverage and determination of whether any predetermination, pre-certification, or second-opinion requirements exist is another important aspect of the job.
Training is provided in verification of insurance coverage, assignment of diagnostic and procedural codes, as well as both manual and computerized claim preparation. Review and follow-up procedures for the major carriers are included in addition to posting and balancing of accounts. The student will be able to recognize, evaluate, and interpret inconsistencies, discrepancies, and inaccuracies in the billing procedure. Physician billing as well as facility billing procedures are developed.
The Medical Insurance Specialist Certificate of Achievement requires a minimum of 48 credit hours which may be completed in two years by attending full time, or it may be extended following a part- time schedule. In either case, careful scheduling is required as not all technical courses are offered every semester. Students are encouraged to consult the Health Career Advisor in planning their class schedules.
Henry Ford Community College has developed a very successful Business Co-op experience that is required and available to Medical Insurance Specialist students during their last semester in the program. This allows the student to practice theory and skills learned during the program under direct supervision of billing and coding professionals within our clinical affiliates. Students will need to demonstrate critical thinking skills in the application of processing health insurance claims, performing computerized or electronic billing and data entry. It is important that students obtain experience as they move from one career to another in the health care field.
Medical Insurance Specialist is the second stage of the three step program option. The students may elect to stop-out at the end of any one of the three stages depending upon their career and educational objectives.
- Medical Receptionist, Level I Certificate, 16.5 credit hours
- Medical Insurance Specialist, Level II Certificate, 48 credit hours
- Medical Practice/Facility - Business Management Associate in Business degree, 70 credit hours
Again, interested students must work closely with the Health Career Advisor in order to develop their own individual educational plan. For additional information or an appointment, students should contact the Health Careers Office at 313-845-9877.
The employment outlook for medical insurance specialists is good, but very competitive especially for entry- level positions. Information about career placement is available through the College Placement Office which also assists students in finding employment.
All health care employers are now requiring Criminal Background Checks and Drug Screens of their new applicants. Students must complete Criminal Background Check and Drug Screen per Michigan Public Health Code 20713 for admission into the Medical Insurance Specialist program - see below.
Upon completion of the Medical Insurance Specialist program students are eligible to take the certification examination for Certified Medical Administrative Specialists (CMAS).
- This examination is offered through the American Medical Technologists (AMT).
- As a graduate of a CAAHEP accredited program (Commission on Accreditation of Health Education Programs) or ABHES accredited program. (American Bureau of Health Education Programs).
Students may also consider taking the Certified Medical Billing Insurance Examination (MBI) offered by the American Association of Professional Coders. These credentials are necessary for employment in administrative medical office duties.
- Admission to the program is based on upon satisfying the following admission requirements.
- A minimum high school grade-point average of C+ (2.5) or a minimum average score of 55 on the GED test, or a minimum college grade-point average of C (2.0) for both transfer students and Henry Ford Community College students.
- An ASSET/COMPASS score of 43/84 or successful completion of ENG 081
- An ASSET/COMPASS score of 39/39 for numerical skills or completion of MATH 074 or 101 with a grade of C or better
- Successful completion of BCA 101 with a grade of B or better, or typing proficiency of at least 30 words per minute.
Progression in the program is based upon the student meeting the following requirements:
- Adherence to the program requirements outlined in the MOA/MR/MIS Student Handbook.
- Achievement of a minimum grade of C or better in all MOA and required courses.
- Maintenance of an overall cumulative grade point average of 2.0 or better.
- All Medical Insurance Specialist program courses must be successfully completed within three consecutive calendar years.
HFCC continuously attempts to improve each program, and as a result courses and/or requirements may be modified. Curriculum, course content, and admission criteria are subject to change by action of the College faculty and administration.