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Health/Medical Claims Examiner

Types of Degrees Health/Medical Claims Examiner Majors Are Earning

Students pursuing Health/Medical Claims Examiner may pursue degrees at several award levels.

Award Level	Graduates
Certificate	5

What Health/Medical Claims Examiner Majors Need to Know

Programs in Health/Medical Claims Examiner emphasize a specific mix of knowledge, skills, and abilities — derived from O*NET surveys of workers in occupations that Health/Medical Claims Examiner graduates commonly enter.

Knowledge Areas

Coursework in Health/Medical Claims Examiner emphasizes the following knowledge areas:

• Customer and Personal Service — Importance 4.7 / 5; level 6.2 / 7.
• English Language — Importance 4.4 / 5; level 4.1 / 7.
• Administrative — Importance 3.8 / 5; level 5.1 / 7.
• Mathematics — Importance 3.7 / 5; level 3.8 / 7.
• Computers and Electronics — Importance 3.4 / 5; level 4.0 / 7.

^{Importance is rated 1–5; level is 1–7. Source: ONET Online — weighted across related occupations.*}

Skills

Skills built by a Health/Medical Claims Examiner program reflects the day-to-day work of related occupations:

• Reading Comprehension — Importance 4.1 / 5; level 4.5 / 7.
• Critical Thinking — Importance 4 / 5; level 4.2 / 7.
• Active Listening — Importance 4 / 5; level 4.2 / 7.
• Speaking — Importance 3.9 / 5; level 4 / 7.
• Judgment and Decision Making — Importance 3.8 / 5; level 3.8 / 7.

Abilities

Abilities most relevant to Health/Medical Claims Examiner careers — again drawn from O*NET surveys of related occupations:

• Written Comprehension — Importance 4.4 / 5; level 4.4 / 7.
• Oral Comprehension — Importance 4.1 / 5; level 4.5 / 7.
• Oral Expression — Importance 4.1 / 5; level 4.5 / 7.
• Deductive Reasoning — Importance 4 / 5; level 4.4 / 7.
• Inductive Reasoning — Importance 4 / 5; level 4.4 / 7.

Common Job Activities

Day-to-day, Health/Medical Claims Examiner graduates report doing:

Activity	Frequency / Importance
Working with Computers	4.7 / 7
Communicating with People Outside the Organization	4.6 / 7
Getting Information	4.6 / 7
Making Decisions and Solving Problems	4.5 / 7
Identifying Objects, Actions, and Events	4.5 / 7
Communicating with Supervisors, Peers, or Subordinates	4.4 / 7
Documenting/Recording Information	4.3 / 7
Resolving Conflicts and Negotiating with Others	4.3 / 7
Organizing, Planning, and Prioritizing Work	4.2 / 7
Analyzing Data or Information	4.1 / 7

Technology Skills Used on the Job

Most frequently-cited tools used by Health/Medical Claims Examiner professionals:

Tool / Software	Category	In-Demand
Insurance claims fraud detection software	Analytical or scientific software	—
CGI-AMS BureauLink Enterprise	Information retrieval or search software	—
Simsol for Adjusters	Financial analysis software	—
Tropics Claims Reserve Management	Data base user interface and query software	—
Microsoft Excel	Spreadsheet software	✓
Datanex ClaimTrac	Document management software	—
Computerized voice stress analyzer CVSA software	Interactive voice response software	—
Bridium Claims 3	Document management software	—
Healthcare common procedure coding system HCPCS	Medical software	—
BCCORP Burkitt W5	Document management software	—
Automatic Data Processing Estimating	Financial analysis software	—
CAD Zone Insurance	Computer aided design CAD software	—

^{Source: ONET Online technology skills, weighted across related occupations.*}

Sample Job Titles

Real job postings for Health/Medical Claims Examiner graduates include:

• Medical Claims Specialist
• Claims Representative
• Claims Investigator
• Insurance Auditor
• Independent Insurance Adjuster
• Litigation Claims Representative
• Fire Claims Adjuster
• Claims Approver
• Workers’ Compensation Claims Representative
• Claims Service Specialist
• Claims Specialist
• Property and Casualty Insurance Claims Examiner
• Field Property Claims Specialist
• Property Adjuster
• Insurance Adjuster

Education Typically Required

Across the occupations open to Health/Medical Claims Examiner graduates, the typical level of education actually held by current workers is distributed as:

Education Level	Share of Workers
Bachelor’s degree	55.8%
High school diploma or equivalent	13.1%
Associate’s degree (or other 2-year)	12.0%
Some college courses	11.9%
Doctoral degree	4.0%
Postsecondary certificate	2.6%
Master’s degree	0.6%

^{Source: ONET Online education / training / experience requirements.*}

Who Is Earning a Degree in Health/Medical Claims Examiner?

Gender Distribution

This field has a relatively balanced gender distribution: 40% women and 60% men among Health/Medical Claims Examiner graduates.

Gender	Graduates	Share
Women	2	40.0%
Men	3	60.0%

Racial-Ethnic Diversity

At the national level, the racial-ethnic distribution of Health/Medical Claims Examiner graduates is as follows:

Race / Ethnicity	Graduates	Share
White	5	100.0%

^{See minority definition below.}

How Much Do Health/Medical Claims Examiner Graduates Earn?

The U.S. Department of Education tracks median earnings of Health/Medical Claims Examiner graduates 1, 4, and 5 years after completion. Earnings tend to climb steadily as graduates gain experience and move into mid-career roles.

Years Out	Median Earnings
1 year	$36,041
4 years	$36,054
5 years	$40,847

By year 5 out, median earnings rise to $40,847 — roughly 13% above the 1-year mark.

^{Source: U.S. Department of Education College Scorecard, field-of-study earnings tracker.}

Is a Degree in Health/Medical Claims Examiner Worth It?

On the earnings side, the federal earnings tracker, Health/Medical Claims Examiner graduates earn a median of $36,054 four years after completion — about 5% below the national median for workers with only a high school diploma (~$38,000). On earnings alone, this program does not show an income premium over the baseline; non-financial outcomes (career interests, certification requirements, advancement potential) are typically the stronger argument for fields in this range.

^{ROI estimate compares the program’s 4-yr median earnings against the 2023 BLS CPS median earnings for high-school-only workers. Source: U.S. Department of Education College Scorecard + BLS Current Population Survey.}

Related Programs

You may also be interested in these closely related fields of study:

Program	CIP Code
Health and Medical Administrative Services	51.07
Clinical Research Coordinator	51.0719
Disease Registry Data Management	51.0721
Health and Medical Administrative Services, Other	51.0799
Health Information/Medical Records Administration/Administrator	51.0706
Health Information/Medical Records Technology/Technician	51.0707
Health Unit Coordinator/Ward Clerk	51.0703
Health Unit Manager/Ward Supervisor	51.0704
Health/Health Care Administration/Management	51.0701
Healthcare Information Privacy Assurance and Security	51.0723
Healthcare Innovation	51.0722
Hospital and Health Care Facilities Administration/Management	51.0702

References

The racial-ethnic minorities count is calculated by taking the total number of students and subtracting white students and international students. This number is then divided by the total number of students to obtain the racial-ethnic minorities percentage.

• College Factual
• National Center for Education Statistics (IPEDS)
• O*NET Online
• U.S. Bureau of Labor Statistics
• U.S. Department of Education College Scorecard

More about our data sources and methodologies.