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How do I Become a Medicare Specialist?

By Vanessa Harvey
Updated May 17, 2024
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Your preparation to become a Medicare specialist can vary depending on the employer for which you choose to work. Among the qualifications you are advised to have are attention to detail, familiarity with using a Personal Computer (PC) and solid customer service skills, especially in dealing with senior citizens. Experience working in the medical insurance field as well as in medical coding also are highly desirable if you want to become a Medicare specialist. Although it would be to your advantage to learn as much about Medicare prior to applying for a position, most employers provide all of the training needed for you to become a Medicare specialist, also known as a Medicare consultant.

Medicare is a national medical insurance offered by the federal government of the United States to citizens who are at least 65 years of age and who have worked 10 years or approximately 40 quarters in the U.S. Persons younger than 65 might also be eligible for Medicare if they have received Social Security disability benefits for a period of two years, and some people who have been diagnosed with end stage renal disease (ESRD) might also qualify. These are some of the people whom you will serve if you become a Medicare specialist. If you work for an insurance company, your duties as a Medicare specialist could include reviewing, processing or investigating claims to help prevent Medicare fraud.

There is a national toll-free telephone number, 1-800-Medicare, that it is available for beneficiaries and their family members to call at any time for answers to their questions about benefits and coverage. This service is actually provided via a federal contract held by a private company that is responsible for recruiting and training those who will assist the beneficiaries. You can become a Medicare specialist by applying for a position with this service. Beneficiaries often have questions about eligibility requirements, supplemental insurance, premiums, deductibles, co-payments, coverage, fraud, choice of doctors and specialists and many other issues.

Answering such questions and educating beneficiaries on their options and rights can be stressful at times because you might have to speak with people who are terminally ill, severely depressed or mentally challenged. Patience, a desire to deliver high-quality customer service and the professionalism to represent the federal government to these people will be consistently required on the job. These skills and qualities are perhaps just as important to possess as the extensive knowledge base needed to become a Medicare specialist.

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Discussion Comments
By anon334960 — On May 16, 2013

This is a great field to get into. At 19, I got licensed and became an independent benefits consultant making over $6,000 a month.

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