How do I Become a Medicare Consultant?

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  • Written By: A. Leverkuhn
  • Edited By: Andrew Jones
  • Last Modified Date: 21 November 2019
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Many of those involved in the health care field may look at changing careers and becoming a Medicare consultant. A Medicare consultant is a professional who focuses on aspects of Medicare medical billing, eligibility issues, or other aspects of dealing with the federal Medicare program for patients or providers. Medicare consultants specialize in this kind of government insurance, and help expedite Medicare claims and provide the support system that helps eligible patients use the Medicare entitlement program.

Individuals interested in Medicare consulting may not need a bachelor’s degree or specialized college degree. Instead, a Medicare consultant utilizes knowledge about medical billing and medical records as well as specific knowledge about Medicare reimbursement policy. On-the-job skills, in addition to education and specific Medicare certification programs, often form the basis for a Medicare consultant career.

As a practical way to become a Medicare consultant, working in a convalescent home or other group residential home for the aged or the disabled will help beginners build a knowledge of Medicare that they can use for a career as a Medicare consultant. Time spent in billing offices will help build knowledge of specific Medicare billing procedures. It’s not uncommon for health care workers to start in direct care positions, and move toward Medicare consulting as they gain skills and certifications.


Specific Medicare certifications are important for those who want to become a Medicare consultant. A group called the National Alliance of Medicare Set-Aside Professionals maintains a web site with more information on the kinds of certifications that individuals use as Medicare consultants. A Medicare Set-Aside Consultant-Certified (MSCC) exam is one certification choice that includes information on Medicare as a second payer, and is usually a useful addition to a resume for someone who wants to become a Medicare consultant.

In addition to these certifications, specific field skills can help Medicare consultants be informed about issues that patients face. Nurses, direct care staff, and even clerical staff in medical offices can have a better starting knowledge of the Medicare system and the common hurdles for different types of patients. These job-related skills can be useful to an employer who’s hiring a Medicare consultant for a specific billing position. For the best chance to become a Medicare consultant in a particular medical network, highlight your billing skills, and your knowledge of how the Medicare program works, and use what you have learned in a previous career to give employers what they need: informed, educated responses to issues with the Medicare system.


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Post 2

What is the best way to understand Medicare? Just from what I hear on the news, it sounds like the whole program is constantly changing.

I have no idea what Medicare Part A or B even means. We are not very far away from retirement, and I know I need to start educating myself about this.

If you live long enough, this is something that will affect everybody. I also think that the way the system is set up today will be much different a few years down the road.

I would like to find a local Medicare consultant who could help explain some of these things. I am wondering if some communities offer classes on something like this?

Post 1

If you are nearing the age where you are eligible for Medicare, you know how completely overwhelming it can be.

We have a close friend who worked as an office manager for years. When he retired he was looking for a way to fill some of his time, and help others.

After he went through the whole process of becoming eligible for Medicare he realized how many people were confused by the whole thing.

Since he is very knowledgeable with accounting, finances and numbers, this is something that was easier for him to grasp than most people.

Even though he didn't go through an official certification process to become a medicare consultant, he still volunteers in this capacity.

He works as a helping hand as people get started with this process. If he doesn't know the answers to their questions, he knows the right people to direct them to.

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