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Health/Medical Claims Examiner

A program that prepares individuals to perform specialized investigatory, analytical, evaluative, and consultative functions related to health/medical insurance operations and their regulation. Includes instruction in health and medical insurance processes and procedures, health insurance law and regulations, health care industry law, record-keeping, analytic and investigatory techniques, evaluation methods, field operations methods, office procedures, related software applications, oral and written communications skills, interviewing techniques, and professional standards and ethics.

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 develop 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

The skill set emphasized 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 Expression — Importance 4.1 / 5; level 4.5 / 7.
• Oral Comprehension — Importance 4.1 / 5; level 4.5 / 7.
• Inductive Reasoning — Importance 4 / 5; level 4.4 / 7.
• Deductive 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
Identifying Objects, Actions, and Events	4.5 / 7
Making Decisions and Solving Problems	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
Microsoft Access	Data base user interface and query software	—
AutoClaims Direct DirectLink	Document management software	—
Fair Isaac SmartAdvisor	Expert system software	—
CSC Fault Evaluator	Expert system software	—
ISO ClaimSearch	Expert system software	—
Automatic Data Processing Claims Manager & Dispatch	Document management software	—
Microsoft Word	Word processing software	—
Hyland OnBase Enterprise Content Management	Document management software	—
Claims processing administration and management software	Data base user interface and query software	—
Microsoft PowerPoint	Presentation software	—
Document management system software	Document management software	—
Property damage, bodily injury, and liability estimation software	Financial analysis software	—

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

Sample Job Titles

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

• Disability Specialist
• Claims Analyst
• Field Investigator
• Auto Claims Adjuster (Automotive Claims Adjuster)
• Claims Adjustor
• Insurance Auditor
• Property Damage Claims Adjustor
• Investigator
• Independent Insurance Agent
• Medical Claims Examiner
• Disability Examiner
• Insurance Examiner
• Adjuster
• Claims Service Adjustor
• Professional Liability Claims Specialist

What Can You Do With a Health/Medical Claims Examiner Degree?

Graduates with a degree in Health/Medical Claims Examiner commonly enter the following occupations:

Occupation	Job Growth	Median Salary	25th–75th Pctile
Claims Adjusters, Examiners, and Investigators	12.2%	$46,655	$36,455–$56,855

^{Job-growth = projected employment change for the parent occupation. Source: ONET / BLS Employment Projections.*}

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?

College Scorecard reports median earnings of Health/Medical Claims Examiner graduates 1, 4, and 5 years after completion. Wages typically rise 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?

Looking purely at 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	Annual Degrees Awarded
Health and Medical Administrative Services	90,166
Health/Health Care Administration/Management	28,347
Medical Insurance Specialist/Medical Biller	11,963
Health Information/Medical Records Technology/Technician	11,828
Medical Insurance Coding Specialist/Coder	10,171
Medical Administrative/Executive Assistant and Medical Secretary	7,771
Hospital and Health Care Facilities Administration/Management	3,494
Health and Medical Administrative Services, Other	3,168
Medical Office Management/Administration	2,900
Health Information/Medical Records Administration/Administrator	2,781
Medical/Health Management and Clinical Assistant/Specialist	1,195
Medical Reception/Receptionist	844

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.