The healthcare industry is one of the fastest-growing industries in the United States, and as such, it’s also one of the most competitive. It’s no surprise that job seekers are always looking for ways to stand out from the crowd. One way to do that is by getting health insurance entry level jobs!

Health insurance entry level jobs offer a wide range of options for people who want to work in the medical field. Health insurance companies need a variety of employees to handle different tasks. These can include billing, customer service, and marketing roles. With so many different positions available, it’s important for job seekers to know what they’re looking for before applying for any given position with a health insurance company.

If you’re interested in getting health insurance entry level jobs, there are several steps you should take:

• Research companies that offer health insurance entry level jobs
• Find out what kind of education or experience they require from candidates
• Create a resume that highlights your relevant skills and experience
• Send applications through email or snail mail (if needed)

Health Insurance Entry Level Jobs

Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance is risk among many individuals. By estimating the overall risk of health risk and health system expenses over the risk pool, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to provide the money to pay for the health care benefits specified in the insurance agreement.^[1] The benefit is administered by a central organization, such as a government agency, private business, or not-for-profit entity.

According to the Health Insurance Association of America, health insurance is defined as “coverage that provides for the payments of benefits as a result of sickness or injury. It includes insurance for losses from accident, medical expense, disability, or accidental death and dismemberment”.^[2]: 225

Contents

• 1Background
• 2Comparisons
  • 2.1Australia
  • 2.2Canada
  • 2.3China
  • 2.4Cyprus
  • 2.5France
  • 2.6Germany
  • 2.7Greece
  • 2.8India
  • 2.9Japan
  • 2.10Netherlands
  • 2.11New Zealand
  • 2.12Rwanda
  • 2.13Singapore
  • 2.14Switzerland
  • 2.15United Kingdom
  • 2.16United States
  • 2.17Russia
  • 2.18Taiwan
• 3See also
• 4References
• 5External links

Background[edit]

hideThis article has multiple issues. Please help improve it or discuss these issues on the talk page. (Learn how and when to remove these template messages)This section needs additional citations for verification. (June 2021)The examples and perspective in this section may not represent a worldwide view of the subject. (June 2021)

A health insurance policy is:

1. A contract between an insurance provider (e.g. an insurance company or a government) and an individual or his/her sponsor (that is an employer or a community organization). The contract can be renewable ( annually, monthly) or lifelong in the case of private insurance. It can also be mandatory for all citizens in the case of national plans. The type and amount of health care costs that will be covered by the health insurance provider are specified in writing, in a member contract or “Evidence of Coverage” booklet for private insurance, or in a national [health policy] for public insurance.
2. (US specific) In the U.S., there are two types of health insurance – tax payer-funded and private-funded.^[3] An example of a private-funded insurance plan is an employer-sponsored self-funded ERISA plan. The company generally advertises that they have one of the big insurance companies. However, in an ERISA case, that insurance company “doesn’t engage in the act of insurance”, they just administer it. Therefore, ERISA plans are not subject to state laws. ERISA plans are governed by federal law under the jurisdiction of the US Department of Labor (USDOL). The specific benefits or coverage details are found in the Summary Plan Description (SPD). An appeal must go through the insurance company, then to the Employer’s Plan Fiduciary. If still required, the Fiduciary’s decision can be brought to the USDOL to review for ERISA compliance, and then file a lawsuit in federal court.

The individual insured person’s obligations may take several forms:^{[citation needed]}

• Premium: The amount the policy-holder or their sponsor (e.g. an employer) pays to the health plan to purchase health coverage. (US specific) According to the healthcare law, a premium is calculated using 5 specific factors regarding the insured person. These factors are age, location, tobacco use, individual vs. family enrollment, and which plan category the insured chooses.^[4] Under the Affordable Care Act, the government pays a tax credit to cover part of the premium for persons who purchase private insurance through the Insurance Marketplace.^{[5]: TS 4:03}
• Deductible: The amount that the insured must pay out-of-pocket before the health insurer pays its share. For example, policy-holders might have to pay a $7500 deductible per year, before any of their health care is covered by the health insurer. It may take several doctor’s visits or prescription refills before the insured person reaches the deductible and the insurance company starts to pay for care. Furthermore, most policies do not apply co-pays for doctor’s visits or prescriptions against your deductible.
• Co-payment: The amount that the insured person must pay out of pocket before the health insurer pays for a particular visit or service. For example, an insured person might pay a $45 co-payment for a doctor’s visit, or to obtain a prescription. A co-payment must be paid each time a particular service is obtained.
• Coinsurance: Instead of, or in addition to, paying a fixed amount up front (a co-payment), the co-insurance is a percentage of the total cost that an insured person may also pay. For example, the member might have to pay 20% of the cost of a surgery over and above a co-payment, while the insurance company pays the other 80%. If there is an upper limit on coinsurance, the policy-holder could end up owing very little, or a great deal, depending on the actual costs of the services they obtain.
• Exclusions: Not all services are covered. Billed items like use-and-throw, taxes, etc. are excluded from admissible claim. The insured are generally expected to pay the full cost of non-covered services out of their own pockets.
• Coverage limits: Some health insurance policies only pay for health care up to a certain dollar amount. The insured person may be expected to pay any charges in excess of the health plan’s maximum payment for a specific service. In addition, some insurance company schemes have annual or lifetime coverage maxima. In these cases, the health plan will stop payment when they reach the benefit maximum, and the policy-holder must pay all remaining costs.
• Out-of-pocket maximum: Similar to coverage limits, except that in this case, the insured person’s payment obligation ends when they reach the out-of-pocket maximum, and health insurance pays all further covered costs. Out-of-pocket maximum can be limited to a specific benefit category (such as prescription drugs) or can apply to all coverage provided during a specific benefit year.
• Capitation: An amount paid by an insurer to a health care provider, for which the provider agrees to treat all members of the insurer.
• In-Network Provider: (U.S. term) A health care provider on a list of providers preselected by the insurer. The insurer will offer discounted coinsurance or co-payments, or additional benefits, to a plan member to see an in-network provider. Generally, providers in network are providers who have a contract with the insurer to accept rates further discounted from the “usual and customary” charges the insurer pays to out-of-network providers.
• Out-of-Network Provider: A health care provider that has not contracted with the plan. If using an out-of-network provider, the patient may have to pay full cost of the benefits and services received from that provider. Even for emergency services, out-of-network providers may bill patients for some additional costs associated.
• Prior Authorization: A certification or authorization that an insurer provides prior to medical service occurring. Obtaining an authorization means that the insurer is obligated to pay for the service, assuming it matches what was authorized.^{[disputed – discuss]} Many smaller, routine services do not require authorization.^[6]
• Formulary: the list of drugs that an insurance plan agrees to cover.^[7]
• Explanation of Benefits: A document that may be sent by an insurer to a patient explaining what was covered for a medical service, and how payment amount and patient responsibility amount were determined.^[6] In the case of emergency room billing, patients are notified within 30 days post service. Patients are rarely notified of the cost of emergency room services in-person due to patient conditions and other logistics until receipt of this letter.^[8]

Prescription drug plans are a form of insurance offered through some health insurance plans. In the U.S., the patient usually pays a copayment and the prescription drug insurance part or all of the balance for drugs covered in the formulary of the plan.^{[5]: TS 2:21} Such plans are routinely part of national health insurance programs. For example, in the province of Quebec, Canada, prescription drug insurance is universally required as part of the public health insurance plan, but may be purchased and administered either through private or group plans, or through the public plan.^[9]

Some, if not most, health care providers in the United States will agree to bill the insurance company if patients are willing to sign an agreement that they will be responsible for the amount that the insurance company doesn’t pay. The insurance company pays out of network providers according to “reasonable and customary” charges, which may be less than the provider’s usual fee. The provider may also have a separate contract with the insurer to accept what amounts to a discounted rate or capitation to the provider’s standard charges. It generally costs the patient less to use an in-network provider.

Comparisons

See also: Health system

Health Expenditure per capita (in PPP-adjusted US$) among several OECD member nations. Data source: OECD’s iLibrary^[10]

The Commonwealth Fund, in its annual survey, “Mirror, Mirror on the Wall”, compares the performance of the health care systems in Australia, New Zealand, the United Kingdom, Germany, Canada and the U.S. Its 2007 study found that, although the U.S. system is the most expensive, it consistently under-performs compared to the other countries.^[11] One difference between the U.S. and the other countries in the study is that the U.S. is the only country without universal health insurance coverage.

Life Expectancy of the total population at birth among several OECD member nations. Data source: OECD’s iLibrary^[12]

The Commonwealth Fund completed its thirteenth annual health policy survey in 2010.^[13] A study of the survey “found significant differences in access, cost burdens, and problems with health insurance that are associated with insurance design”.^[13] Of the countries surveyed, the results indicated that people in the United States had more out-of-pocket expenses, more disputes with insurance companies than other countries, and more insurance payments denied; paperwork was also higher although Germany had similarly high levels of paperwork.^[1