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WAHM > Stay at Home Mom Work Ideas > Selling a Service > Become a Medical Claims Processor

Start a Medical Claims Processing Business from Home  

What you will be doing.  Going to the doctor does not just involve a routine visit anymore.  Insurance forms have to be filed, processed, and paid.  Policies state what the insurance company will and will not pay for.  After it’s all said and done you could get a bill.  What’s more, for some doctors you need to fill out the claim forms yourself. 

As a medical claims processor it is your job to go through the red tape to get the claim processed by the insurance company.  You make sure that the forms are properly filled out and communicate with the insurance company to make sure that all the information they need to pay the claim, they have. 

How to start.  If you’ve always had an interest in the health industry but didn’t know where you’d fit in, this business could be for you.  In order to process claims, you need to know about the health insurance industry.  Claims can be tricky depending which insurance company you are filing the claim with.  Learn all you can about the process before you start. 

Starting costs.  A medical claims processor needs a computer with Internet access, a fax machine, a telephone (preferably with a headset), a copier, claims manuals, and a printer.  You can purchase manuals that talk about the insurance industry.  Manuals discussing specific company insurance policies need to be obtained from the insurance companies.  Plan to spend around $5,000 for the equipment and other necessary materials.   

Skills needed.  You need to be able to comply fully with the health insurance company policies.  If there are problems with the claim, talking with someone at the company can seem like an exercise in futility.  Good communication skills combined with patience go a long way to resolving the situation. 

Your knowledge of the health insurance industry is paramount.  Understanding health coding and medical terminology is a plus that can help you catch mistakes on claim forms.  An eye for detail is important. 

Marketing.  You will be working with doctor’s offices and hospitals to assist with the burden of processing the claims of their patients.  Advertise in the Yellow Pages and health care publications.  If you know anyone in the health care industry, ask for referrals. 

Start your own website.  A website will let others know about your skills with medical claims.  Local contacts will get your business started, but the Internet will expand your enterprise as far as you want to go.  Advertise on home business websites of all kinds.   

Medical claims processing is a service that is sorely needed.  You can feel good knowing that you are helping hundreds of people to get the services that they are entitled to under their insurance policies.

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