Medical Reimbursement Claims Clerk
しんりょうほうしゅうせいきゅうじむいん
Industry & Occupation
Classification
Summary
Specialized professional in medical institutions responsible for clerical tasks related to medical reimbursement claims. Creates insurance claim data, reviews recepts, and performs duties using knowledge of medical insurance systems.
Description
Medical Reimbursement Claims Clerks handle claims processing for medical reimbursements at hospitals, clinics, and other medical institutions. They create, review, and correct recepts (medical reimbursement detail statements) for submission to insurers, using medical reimbursement computer processing systems and medical administration software to produce accurate claim data. They also continuously track institutional changes due to reimbursement revisions, collaborate with related departments to improve workflows and handle issues. This occupation requires high attention to detail and specialized knowledge.
Future Outlook
With the advancement of an aging society, demand for medical claims processing remains stable. As recept online processing and medical DX accelerate, the importance of IT skills increases, and amid the introduction of AI-powered automatic review systems, the role of personnel with specialized knowledge remains essential.
Personality Traits
Meticulous / Patient / Strong sense of responsibility / Team-oriented
Work Style
Clinic Work / Flexitime / Hospital Work / Part-time / Remote
Career Path
Medical Administration Staff → Reimbursement Claims Leader → Medical Administration Manager → Hospital Administration Department Manager → Medical Administration Consultant
Required Skills
Basic PC Operation / Electronic Medical Records Operation / Knowledge of Medical Insurance Systems / Recept Computer Operation
Recommended Skills
Basic Bookkeeping / Medical Administration Software Operation / Recept Check Support Tools / Reimbursement Revision対応
Aptitudes (Strengths Preferred)
| Item | Description |
|---|---|
| Attention to Detail & Accuracy | Small input errors can greatly impact reimbursement calculations. |
| Learning Agility & Knowledge Acquisition | Must flexibly adapt to reimbursement revisions and institutional changes. |
Aptitudes (Weaknesses Acceptable)
| Item | Description |
|---|---|
| Creativity & Ideation | Primarily routine tasks where accuracy is valued more than creativity. |
| Physical Stamina & Endurance | Mainly desk work, so significant physical stamina is not required. |
Related Qualifications
- Medical Clerk Certification
- Medical Reimbursement Claims Ability Certification Exam
- Medical Secretary Skills Certification
Aliases
- Medical Claims Clerk
- Recept Claims Clerk
Related Jobs
- Accounting Clerk
- Dispensing Clerk
- Hospital Clerk
- Medical Clerk