What Does a Medical Insurance Claims Processor Do? : Dental & Other Insurance Questions



hi my name is Susan Combs and today we're gonna talk about what does a medical insurance claim processor do so a medical claim processor is somebody that typically works for a doctor's office they gather all the information from a patient that comes in gets their insurance information and then depending upon what services that we're done then they'll actually put in the claims with the insurance company so you can have somebody that's going to be an internal side on the doctor side but then you can also have somebody on the insurance side that's doing similar things so they're going to gather the information from the doctor's office because each procedure that you haven't done at the doctor's office and each diagnosis there's codes associated with it so there's a diagnosis code and there's a CPT code that corresponds with how the insurance companies are going to pay out claims so that the person on the doctor side is going to make sure that the doctor is getting paid exactly for the procedures that he's doing and the insurance company on their end is going to make sure that they're paying out the doctor properly and that they're not paying out any more money than they need to so that in a nutshell is what an insurance claims processor does you

2 Comments

  1. But it seems that this type of work has changed. the part I want to do is seeing whether or not it's payable. being on the insurance end. not the doctors end.

  2. This is the type of work I am looking for and the time of work I want to do while in school. But more of the investigative part of it. I want a job where I will stay throughout and this is the type of work that keeps me interested. I stayed at one company for 7 yrs. because I loved it.

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