Recruiter's Glossary

Examples: CPT Codes • Medicaid • Underwriting

Coinsurance

Term from Health Insurance industry explained for recruiters

Coinsurance is a common term in health insurance that refers to the percentage of medical costs that a patient must pay after meeting their deductible, while the insurance company pays the rest. For example, with 80/20 coinsurance, the insurance company pays 80% of approved medical costs, and the patient pays 20%. This is different from copayments (flat fees) and is an important concept for professionals working in healthcare insurance processing, billing, and customer service roles.

Examples in Resumes

Processed claims and explained Coinsurance policies to over 200 clients monthly

Trained new staff on Coinsurance calculations and benefit explanations

Developed educational materials about Coinsurance and other insurance terms for customer service teams

Typical job title: "Insurance Claims Specialists"

Also try searching for:

Benefits Coordinator Claims Processor Insurance Specialist Healthcare Benefits Administrator Insurance Claims Analyst Medical Billing Specialist Insurance Customer Service Representative

Where to Find Insurance Claims Specialists

Professional Organizations

Job Boards

Online Resources

Example Interview Questions

Senior Level Questions

Q: How would you handle a complex situation where a client disputes their coinsurance calculation?

Expected Answer: A senior specialist should explain the process of reviewing the claim, verifying the contract terms, checking for correct provider network status, and walking through the calculation with the client step by step. They should also mention escalation procedures and documentation requirements.

Q: Describe how you would implement changes to coinsurance policies across multiple insurance plans.

Expected Answer: Should discuss project management approach, including staff training, updating documentation, client communication strategy, and ensuring compliance with state regulations while maintaining clear records of all changes.

Mid Level Questions

Q: What factors affect coinsurance calculations?

Expected Answer: Should mention network status of providers, plan-specific percentages, deductible status, out-of-pocket maximums, and any special provisions in the insurance policy.

Q: How do you explain coinsurance to a confused client?

Expected Answer: Should demonstrate ability to break down complex terms into simple language, use real examples, and show patience in walking clients through their specific situation step by step.

Junior Level Questions

Q: What is the difference between coinsurance and copayment?

Expected Answer: Should explain that coinsurance is a percentage split of costs between insurer and patient, while copayments are fixed dollar amounts paid for specific services.

Q: Calculate the patient responsibility in a simple coinsurance scenario.

Expected Answer: Should be able to calculate a basic 80/20 split on a medical bill after the deductible has been met, showing their work clearly.