Transcript Claims Examiners - City University of New York

Group: Business 1
We are going to presented 3 careers in
Business such as:
 Claims Examiners
 Accounting
 Top Executives
Claims Examiners
Task & Responsibilities


Claims examiners usually specialize in group
or individual insurance plans and in hospital,
dental, or prescriptions drug claims.
Examiners are provided with guides that
supply information on the average period of
disability, the expected treatments, and the
average hospital stay, for patients with the
various illnesses for which a claim may be
submitted.
Task & Responsibilities



Review health-related claims to see whether
costs are reasonable based on the diagnosis.
Check claim applications for completeness
and accuracy, interview medial specialists,
and consult policy files to verify the
information reported in a claim.
Examiners will either authorize the
appropriate payment or refer the claim to an
investigator for a more through review.
Skill



Examiners must be able to
communicate effectively with others
Examiners need to be familiar with
insurance policy
Knowledge of computer applications is
extremely important.
Experience

No specific experience needed
Values

Licensing requirements for these
workers are vary by State. Some States
have very few requirements, while
others require the completion of pre
licensing education or a satisfactory
score on a licensing exam.
Personality type



Conventional
Social
Investigative
Education



Although many in these occupations do
not have a college degree, most
companies prefer to hire college
graduates.
No specific college major is
recommended.
Must be familiar with new medical
procedures and prescription drugs.
Additional



Knowledge of computer applications
College education
Conventional
What is needed

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Continuing educations are very
important for examiners because new
Federal and State laws and court
decisions frequently affect how claims
are handled.
Need to be more sociable.
Learn effective communication skills.
Obtain a state required license.
Internship


Internship in a health insurance
company to gain more knowledge in the
filed of claims examiner such as:
evaluating claims, authorizing payments
Contacting hospitals for documentations
and learn to consul policy files for
information.
Why this field interests you



Employment of claims examiners is
expected to grow about as fast as the
average for all occupations
Stable jobs
Have experience, have confident in the
field of claims examiner
Work Cited


http://stats.bls.gov/oco/print/ocos125.h
tm
http://books.mongabay.com/labor/traini
ng/125.thml
Accounting
Accountant’s Job Description
 Analyze Financial Information
 Prepare Financial Reports
 Maintain records of assets, liabilities,
profit and loss, tax liability, and other
financial activities within an
organization.
Accountant’s Tasks
 Analyze business
operation, trends,
costs, revenues,
financial commitments,
and obligations, to
project future revenue
and expenses or to
provide advice.
 Compute taxes owed
and prepare tax
returns, ensuring
compliance with
payment, reporting and
other tax requirements.
 Establish tables of
accounts, and assign
entries to proper
accounts.
 Maintain and examine
the records of
government agencies.
 Provide internal or
external auditing
services for businesses
or individuals.
 Develop, implement,
modify, and document
record keeping and
accounting systems,
making use of current
computer technology.
Accountant’s Responsibilities
 Advice clients on financial
matters
 Analyze Budgets
 Analyze Financial Data
 Compile data for Financial
Reports
 Compute Tax
Requirements to be successful
 Bachelor’s Degree in Accounting or a
related field.
 Accounting and auditing positions in
the federal government.
 Master’s degree in Accounting
 Have previous experience in
accounting or auditing
 Internship programs in business or
accounting firms.
Accounting: Skills and Talents
Skill
Audit Accounting
Tax & Financial
Management
Accounting
People skills
Medium
Medium
Medium
Sales skills
Medium
Medium
Low
Communication skills
Medium
Medium
High
Analytical skills
High
Very High
High
Ability to synthesize
Medium
Low
High
Creative ability
Low
Medium
Medium
Initiative
Medium
Medium
Medium
Computer skills
High
High
Very High
Work hours
40-70/week
40-70/week
40-50/week
Experiences
 Accounts payable
 Accounts
receivable
 Purchase orders
 General ledger and
customer service.
 Bank reconciliation
 Working in the
office environment
 On job training
 Fixed assets
 Inventory control
 Office management
 Payroll data entry
Educational Background
 4 years of college (Bachelor in Accounting)
or 24 hours semester in
Accounting/Auditing.
 Practical knowledge of computer and their
applications
 Passed the CPA (Certified Public
Accountant)
 2 years experience in accounting.
 Knowledge and skills in business
management, information technology, and
interpersonal relationships
Type of Internship
 Accounting
 Finance
 Government Field
 Business Administration
Why Accounting is interesting?
 Future is Bright
 The future of
accounting is bright
according to the
Bureau of Labor
Statistics which
projects a 34%
increase in job
openings by the year
2005. Demand is
especially high in the
tax and health care
areas.
 Managerial
Accounting
Ideas Taking Off
 Now firms are
focusing on activitybased management,
process-view analysis,
constraint checking
and business process
analysis as well.
 Skill
 Image of
Requirements
Accountants
Becoming
Improving
Broader
 Too many people
associate accountants
with death, tax and bad
news and question our
integrity because of the
big audit failures that
major accounting firms
have failed to catch.
 There is high demand
for individuals who
can go beyond
technical skills and
display good
interpersonal abilities,
legal knowledge sales
abilities and foreign
language skills.
Sources
 http://www.careers-inaccounting.com/acskill.htm
 http://www.careers-inaccounting.com/acfacts.htm
 http://www.taxhelpdirectory.com/acc
ounting1/accountinginternship/
TOP EXECUTIVES
Found in every
industry
-Legislators (Govt.)
-Chief executives
-Top level Manager
-General Manager
What it take to be one
Lot of
Responsibility
High Work load
Long Working
hours also some
time on the
weekends.
Attending Lot of
conferences
Task and responsibilities
Setting the
corporation’s goals
and policies.
Performance of
finance, property
management,
market.
Training
Administrative
service, computer
information
Sales, purchasing,
transportation and
legal services
responsibilities
Education
Bachelor’s or
higher degree in
Business
administration or
liberal arts
If a person want to
go in educational
department they
must have
doctorate in the
field in which they
originally taught or
also master
degree.
Skills
Top executives
must have highly
developed
personal skills and
communication
skills.
Must be able to
analyze large
amount of data
quickly
Leader ship skills.
Must be able to
work in groups
Computer skills
Decision maker
Also Multiple
Languages
Values
Must be Inspirational
Honest
Insight
Complete Thinker
Pragmatists (Positive),
Who understand the
dollar value of time.
Internship
Skill that I would
like to improve
through internship
Work in a group
Communicational
Skills
Planning
Leadership skills
Why I Choose this career
Authority
Prestige
High Pay
Also I want to have
my own business
so it better to be in
that position.
Conclusion
 As a group, we are interested in
Business because we believe that it
would give us a better future.
However, it is all come back to
ourselves whether we want to be a
successful person or not. Keep think
positive and going up to reach your
goals.
Group
Members
 Abdul
Latif
 Young
Kang
 Shu Chen
 Ruth
Martha
 Aamar
Ahmad