About Medical Insurance Careers

A career in the medical insurance field can be both rewarding and lucrative. There are many facets to the medical insurance industry, from sales to underwriting to risk management and utilization review. The industry is constantly evolving to meet customer needs and can offer an exciting, fast-paced career path. Opportunities exist in both the group and individual health insurance sectors. Most medical insurance careers don't even require a college degree.

Function

The function of medical insurance is to transfer the potential risk of having to pay enormous medical bills from the patient to the insurance company in exchange for monthly premium payments. Since medical costs continue to rise, cost containment is a key function of the medical insurance industry. To that end, much effort goes into the pre-insurance process; whether it is "field" underwriting on the part of the health insurance sales professional, formal underwriting at the insurance company after an insurance application has been received or claims management when a doctor or hospital files an insurance claim on behalf of a covered patient. Insurance companies take advantage of discounts offered for quick claim turnaround times, so a medical insurance claims department is always a busy place to work.

Types

The types of medical insurance careers available fall into three distinct categories: sales and marketing, underwriting and claims management and utilization review. Job seekers with a medical background such as registered nurses also have career opportunities in the pre-authorization departments of medical insurance companies.

Medical insurance sales are generally handled by independent agents appointed by the medical insurance company. Most offer both group and individual medical insurance policies. Insurance sales professionals meet with potential clients, determine their needs and budgets and recommend the appropriate coverage to the potential client. During the individual medical insurance application process, the insurance sales professional must ask a host of medical history questions to determine whether or not the prospective client represents an acceptable risk to the insurance company. The insurance sales professional is paid a commission upon approval of the policy and continues to receive a small commission on the policy for as long as the policy is in force.

Underwriters analyze the prospective client's application in greater detail. They will access the applicant's Medical Information Bureau (MIB) to find out if there are any undisclosed medical conditions. Underwriters eventually approve or deny a policy and assist in the pricing of the policy once approved.

Risk management personnel strive to keep the insurance company's balance sheet healthy. They analyze the various expenses involved in patient claims and try to determine where costs can be eliminated. They also analyze the most consistent areas of financial loss to the company and make adjustments to insurance policies accordingly.

Considerations

People with a knack for sales or numbers are good candidates for a medical insurance career. Employees transitioning from other facets of the medical field also make excellent candidates. When beginning a career in medical insurance sales, it is important to remember that it is a long-term career and that, while the money may not be great at first, the residual income builds up considerably over time.

Potential

The potential for a successful career in the medical insurance field is almost unlimited if one is willing to work hard and has a talent for details. Many top insurance executives started out in sales or underwriting. Hard work and tenacity in the medical insurance field can provide a lifetime of financial security.

Expert Insight

In the medical insurance sales field, it is generally a good idea for an agent to concentrate on large group insurance policy sales. Underwriting is much simpler, and the income security is much better than it is in individual medical insurance sales.

Resources

• Insurance Sales Jobs