Certificate in Claims Examiner
Program
ONLINE - Claims examiner is one of the fastest growing professions in the insurance and healthcare industries today. The Claims Examiner Certificate meets the educational needs of individuals entering the field of claims examination, while also providing professional development for current examiners who desire a formal education program for career enhancement.
In the Claims Examiner Certificate, you will learn that acting as an intermediary with the public is one of the most important roles of this profession. Claims examiners perform a wide variety of functions in dealing with insurance claims such as initiating the claims process, interpreting and explaining policy and regulations, and resolving billing disputes. They perform claims assessments to determine a customer's insurance coverage and the appropriate payment amount to the claimant. In all cases, the primary function of the claims examiner is to adjudicate claims to determine their validity, negotiate settlements, and authorize payments.
The Claims Examiner Certificate consists of five required totaling 60 hours of online instruction. Claims Examiner Certificate graduates will receive 6.0 Continuing Education Units (CEUs), a nationally recognized unit used for professional development.
Program Objective
Graduates of the online certificate program will be able to understand:
- The role and functions of the Claims Examiner
- The insurance claims industry and types of claims
- Insurance terminology - Worker's Compensation
- Customer service techniques
- Time and project management in Claims Examination
- Fraudulent claims and insurance fraud laws
- Claims examination scenarios after completion of a simulated or "mock" claims examination
Who Should Attend
- Recent college graduates
- Retirees
- Insurance clerks (Workers Compensation/healthcare/auto)
- Claims Examiners - career development
- Medical and dental assistants
- Billing and accounting clerks
Eligibility
Students beginning the program are required to be proficient with Windows XP and be familiar with Microsoft Office applications, using the Internet and downloading forms from the web.
Students with a minimum of one year claims examiner experience may request to waive the Claims Examiner - Introduction to the Profession class. Students interested in waiving this class must submit a Petition for Course Waiver form and register for Course Waiver: Claims Examiner (Fee $55 - non refundable). The waiver form is available on our Web site at http://www.csufextension.org. Click on Information then Forms and click on the link for the Course Waiver Form. You may also call 714.278.4752 to obtain a form.
Contact Yvette Garcia, 657.278.7518,