What is the job of a medical insurance specialist

Medicare specialist is responsible for dealing with health insurance staff, health insurance specialist in medical institutions or medical equipment manufacturing companies is a common recruitment positions, practitioners need to have a college degree or above and related professional learning experience, familiar with commonly used office software, understanding of the national and local health insurance related regulations and policies, their job responsibilities include:

1, actively publicize the policies of health insurance, implementation of the system of health insurance documents. Implementation of the system of medical insurance documents;

2, familiar with the scope of application of medical insurance, to ensure that participants correctly use the medical insurance;

3, the relevant staff for medical insurance-related knowledge training;

4, dealing with the implementation of the medical insurance of the various departments in the implementation of the various problems, and timely contact with the relevant departments, to ensure that the work of medical insurance in a normal and orderly manner;

5, responsible for uploading and checking the data of medical insurance drugs and diagnosis and treatment catalogs, making medical insurance statements and submitting them to the social security center.

Legal Basis: Article 1 of the Decision of the State Council on the Establishment of a Basic Medical Insurance System for Urban Workers

The Tasks and Principles of Reform

The main task of the reform of the medical insurance system is the establishment of a basic medical insurance system for urban workers, that is, adapting to the socialist market economic system, and establishing a basic medical insurance system to protect workers in accordance with the affordability of the finance, enterprises and individuals. individual affordability, and to establish a social medical insurance system that safeguards the basic medical needs of workers.

The principles for the establishment of a basic medical insurance system for urban workers are: the level of basic medical insurance should be commensurate with the level of development of productive forces at the primary stage of socialism; all urban employers and their workers should participate in basic medical insurance, and it should be managed on a localized basis; the basic medical insurance premiums should be borne by the employers and the workers on both sides of the border; and the basic medical insurance fund should be a combination of a social coordinating system and an individual account. The basic medical insurance fund is a combination of social coordination and individual accounts.