Under the background of universal medical insurance, the relationship between public hospitals and medical insurance is increasingly close, and medical insurance management is becoming more and more important in public hospital management. As the main force of medical insurance work, medical insurance practitioners in hospitals play an increasingly important role. This paper conducts a questionnaire survey and interviews with 27 medical insurance practitioners in 15 public hospitals above Level II in Fuzhou to analyze the current situation of medical insurance practitioners in hospitals and the new challenges in medical insurance work, with a view to establishing a capable high-quality hospital medical insurance management team that meets the needs of the time and provides better medical insurance services for hospitals and the society.