Insurance Claims Clerks :: Job Description

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Insurance Claims Clerks

Careers / Insurance Claims Clerks

Summary Description


	Obtain information from insured or designated persons for purpose of settling claim with insurance carrier.

Sample Job Titles

1.	Call Center Representative

2.	Claim Processing Specialist

3.	Claim Representative

4.	Claim Service Representative

5.	Claim Taker

6.	Claim Technician

7.	Claims Adjudicator

8.	Claims Adjuster

9.	Claims Associate

10.	Claims Clerk

11.	Claims Coordinator

12.	Claims Customer Service Representative (Claims CSR)

13.	Claims Examiner

14.	Claims Processor

15.	Claims Representative

16.	Claims Service Representative

17.	Claims Sorter

18.	Claims Technician

19.	Insurance Claims Processor

20.	Insurance Customer Service Representative

21.	Insurance Specialist

22.	Medical Insurance Claims Processor

23.	Open Claims Representative

24.	Personal Lines Insurance Customer Service Representative (Personal Lines Insurance CSR)

25.	Service Advisor

26.	Underwriting Clerk

Job Tasks

	Enter claims information into database systems. Enter information into databases or software programs.

	Prepare insurance claim forms or related documents and review them for completeness. Check data for recording errors. Prepare documentation for contracts, transactions, or regulatory compliance.

	Pay small claims. Execute sales or other financial transactions.

	Calculate amount of claim. Calculate costs of goods or services.

	Post or attach information to claim file. Compile data or documentation.

	Transmit claims for payment or further investigation. Send information, materials or documentation.

	Contact insured or other involved persons to obtain missing information. Discuss account status or activity with customers or patrons.

	Review insurance policy to determine coverage. Review customer insurance information.

	Organize or work with detailed office or warehouse records, using computers to enter, access, search or retrieve data. Enter information into databases or software programs.

	Provide customer service, such as limited instructions on proceeding with claims or referrals to auto repair facilities or local contractors. Explain regulations, policies, or procedures.

	Apply insurance rating systems.

Work Activities

Importance	Work Activity

Interacting With Computers — Using computers and computer systems (including hardware and software) to program, write software, set up functions, enter data, or process information.

Evaluating Information to Determine Compliance with Standards — Using relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards.

Communicating with Supervisors, Peers, or Subordinates — Providing information to supervisors, co-workers, and subordinates by telephone, in written form, e-mail, or in person.

Documenting/Recording Information — Entering, transcribing, recording, storing, or maintaining information in written or electronic/magnetic form.

Getting Information — Observing, receiving, and otherwise obtaining information from all relevant sources.

Processing Information — Compiling, coding, categorizing, calculating, tabulating, auditing, or verifying information or data.

Identifying Objects, Actions, and Events — Identifying information by categorizing, estimating, recognizing differences or similarities, and detecting changes in circumstances or events.

Establishing and Maintaining Interpersonal Relationships — Developing constructive and cooperative working relationships with others, and maintaining them over time.

Updating and Using Relevant Knowledge — Keeping up-to-date technically and applying new knowledge to your job.

Interpreting the Meaning of Information for Others — Translating or explaining what information means and how it can be used.

Making Decisions and Solving Problems — Analyzing information and evaluating results to choose the best solution and solve problems.

Communicating with Persons Outside Organization — Communicating with people outside the organization, representing the organization to customers, the public, government, and other external sources. This information can be exchanged in person, in writing, or by telephone or e-mail.

Performing Administrative Activities — Performing day-to-day administrative tasks such as maintaining information files and processing paperwork.

Organizing, Planning, and Prioritizing Work — Developing specific goals and plans to prioritize, organize, and accomplish your work.

Monitor Processes, Materials, or Surroundings — Monitoring and reviewing information from materials, events, or the environment, to detect or assess problems.

Performing for or Working Directly with the Public — Performing for people or dealing directly with the public. This includes serving customers in restaurants and stores, and receiving clients or guests.

Resolving Conflicts and Negotiating with Others — Handling complaints, settling disputes, and resolving grievances and conflicts, or otherwise negotiating with others.

Assisting and Caring for Others — Providing personal assistance, medical attention, emotional support, or other personal care to others such as coworkers, customers, or patients.

Training and Teaching Others — Identifying the educational needs of others, developing formal educational or training programs or classes, and teaching or instructing others.

Analyzing Data or Information — Identifying the underlying principles, reasons, or facts of information by breaking down information or data into separate parts.

Developing and Building Teams — Encouraging and building mutual trust, respect, and cooperation among team members.

Coordinating the Work and Activities of Others — Getting members of a group to work together to accomplish tasks.

Judging the Qualities of Things, Services, or People — Assessing the value, importance, or quality of things or people.

Inspecting Equipment, Structures, or Material — Inspecting equipment, structures, or materials to identify the cause of errors or other problems or defects.

Provide Consultation and Advice to Others — Providing guidance and expert advice to management or other groups on technical, systems-, or process-related topics.

Developing Objectives and Strategies — Establishing long-range objectives and specifying the strategies and actions to achieve them.

Coaching and Developing Others — Identifying the developmental needs of others and coaching, mentoring, or otherwise helping others to improve their knowledge or skills.

Selling or Influencing Others — Convincing others to buy merchandise/goods or to otherwise change their minds or actions.

Nature of the Work


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Working Conditions


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