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Insurance Claims and Policy Processing Clerks

Insurance Claims and Policy Processing Clerks

Overview
Job Zone Two: Some Preparation Needed
Experience

Some previous work-related skill, knowledge, or experience is usually needed. For example, a teller would benefit from experience working directly with the public.

Education

These occupations usually require a high school diploma.

Job Training

Employees in these occupations need anywhere from a few months to one year of working with experienced employees. A recognized apprenticeship program may be associated with these occupations.

Examples

These occupations often involve using your knowledge and skills to help others. Examples include orderlies, counter and rental clerks, customer service representatives, security guards, upholsterers, and tellers.

Process new insurance policies, modifications to existing policies, and claims forms. Obtain information from policyholders to verify the accuracy and completeness of information on claims forms, applications and related documents, and company records. Update existing policies and company records to reflect changes requested by policyholders and insurance company representatives.

Salary Salary

Salary at 10th Percentile: $29K
Salary at 25th Percentile: $35K
Median Salary: $42K
Salary at 75th Percentile: $52K
Salary at 90th Percentile: $64K

Demand
Career Demand by State Career Demand by State Legend
Core Tasks

Prepare insurance claim forms or related documents, and review them for completeness.

Pay small claims.

Calculate amount of claim.

Post or attach information to claim file.

Transmit claims for payment or further investigation.

Contact insured or other involved persons to obtain missing information.

Review insurance policy to determine coverage.

Organize or work with detailed office or warehouse records, using computers to enter, access, search or retrieve data.

Process and record new insurance policies and claims.

Process, prepare, and submit business or government forms, such as submitting applications for coverage to insurance carriers.

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

Correspond with insured or agent to obtain information or to inform them of account status or changes.

Review and verify data, such as age, name, address, and principal sum and value of property, on insurance applications and policies.

Compare information from application to criteria for policy reinstatement, and approve reinstatement when criteria are met.

Examine letters from policyholders or agents, original insurance applications, and other company documents to determine if changes are needed and effects of changes.

Collect initial premiums and issue receipts.

Transcribe data to worksheets, and enter data into computer for use in preparing documents and adjusting accounts.

Check computations of interest accrued, premiums due, and settlement surrender on loan values.

Interview clients and take their calls to provide customer service and obtain information on claims.

Obtain computer printout of policy cancellations, or retrieve cancellation cards from file.

Compose business correspondence for supervisors, managers, and professionals.

Notify insurance agent and accounting department of policy cancellation.

Apply insurance rating systems.

Technology Skills
Technology
Example
Hot Technology
Accounting software
Billing software
Data base user interface and query software
Microsoft Access
Document management software
InSystems Calligo Enterprise
Electronic mail software
Microsoft Outlook
Financial analysis software
Insurance rating software
Instant messaging software
GroupMe
Internet browser software
Web browser software
Medical software
Medical condition coding software
Office suite software
Microsoft Office
Presentation software
Microsoft PowerPoint
Spreadsheet software
Microsoft Excel
Word processing software
Microsoft Word
Tools Used
Tool
Example
Computer Equipment and Accessories
Desktop computers
Office machines and their supplies and accessories
10-key calculators
Top 10 Knowledge Required
Customer and Personal Service
88%
Importance

Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.

Clerical
78%
Importance

Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and other office procedures and terminology.

English Language
73%
Importance

Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.

Computers and Electronics
60%
Importance

Knowledge of circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming.

Mathematics
57%
Importance

Knowledge of arithmetic, algebra, geometry, calculus, statistics, and their applications.

Administration and Management
51%
Importance

Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources.

Communications and Media
45%
Importance

Knowledge of media production, communication, and dissemination techniques and methods. This includes alternative ways to inform and entertain via written, oral, and visual media.

Production and Processing
45%
Importance

Knowledge of raw materials, production processes, quality control, costs, and other techniques for maximizing the effective manufacture and distribution of goods.

Law and Government
43%
Importance

Knowledge of laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the democratic political process.

Economics and Accounting
41%
Importance

Knowledge of economic and accounting principles and practices, the financial markets, banking and the analysis and reporting of financial data.

Top 10 Skills
Active Listening
75%
Importance

Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.

Reading Comprehension
72%
Importance

Understanding written sentences and paragraphs in work related documents.

Speaking
72%
Importance

Talking to others to convey information effectively.

Critical Thinking
67%
Importance

Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.

Writing
65%
Importance

Communicating effectively in writing as appropriate for the needs of the audience.

Service Orientation
60%
Importance

Actively looking for ways to help people.

Judgment and Decision Making
59%
Importance

Considering the relative costs and benefits of potential actions to choose the most appropriate one.

Time Management
59%
Importance

Managing one's own time and the time of others.

Active Learning
57%
Importance

Understanding the implications of new information for both current and future problem-solving and decision-making.

Complex Problem Solving
57%
Importance

Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.

Top 10 Abilities
Written Comprehension
79%
Importance

The ability to read and understand information and ideas presented in writing.

Oral Comprehension
78%
Importance

The ability to listen to and understand information and ideas presented through spoken words and sentences.

Oral Expression
78%
Importance

The ability to communicate information and ideas in speaking so others will understand.

Speech Recognition
73%
Importance

The ability to identify and understand the speech of another person.

Near Vision
72%
Importance

The ability to see details at close range (within a few feet of the observer).

Speech Clarity
72%
Importance

The ability to speak clearly so others can understand you.

Written Expression
70%
Importance

The ability to communicate information and ideas in writing so others will understand.

Information Ordering
67%
Importance

The ability to arrange things or actions in a certain order or pattern according to a specific rule or set of rules (e.g., patterns of numbers, letters, words, pictures, mathematical operations).

Deductive Reasoning
65%
Importance

The ability to apply general rules to specific problems to produce answers that make sense.

Problem Sensitivity
63%
Importance

The ability to tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem.

Top 10 Work Activities
Interacting With Computers
90%
Importance

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

Getting Information
85%
Importance

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

Communicating with Supervisors, Peers, or Subordinates
82%
Importance

Providing information to supervisors, co-workers, and subordinates by telephone, in written form, e-mail, or in person.

Processing Information
82%
Importance

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

Documenting/Recording Information
81%
Importance

Entering, transcribing, recording, storing, or maintaining information in written or electronic/magnetic form.

Evaluating Information to Determine Compliance with Standards
81%
Importance

Using relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards.

Communicating with Persons Outside Organization
76%
Importance

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.

Establishing and Maintaining Interpersonal Relationships
75%
Importance

Developing constructive and cooperative working relationships with others, and maintaining them over time.

Making Decisions and Solving Problems
74%
Importance

Analyzing information and evaluating results to choose the best solution and solve problems.

Updating and Using Relevant Knowledge
73%
Importance

Keeping up-to-date technically and applying new knowledge to your job.

Detailed Work Activities

Check data for recording errors.

Prepare documentation for contracts, transactions, or regulatory compliance.

Calculate costs of goods or services.

Compile data or documentation.

Send information, materials or documentation.

Discuss account status or activity with customers or patrons.

Review customer insurance information.

Maintain operational records.

Enter information into databases or software programs.

Explain regulations, policies, or procedures.

Provide notifications to customers or patrons.

Verify accuracy of financial or transactional data.

Provide information to coworkers.

Execute sales or other financial transactions.

Collect deposits, payments or fees.

Interview employees, customers, or others to collect information.

Answer telephones to direct calls or provide information.

Obtain personal or financial information about customers or applicants.

Prepare business correspondence.

Code data or other information.

Calculate financial data.

Maintain financial or account records.

Majors
Major
Business Operations Support and Assistant Services
Interests
Conventional
98%
Importance

Conventional occupations frequently involve following set procedures and routines. These occupations can include working with data and details more than with ideas. Usually there is a clear line of authority to follow.

Enterprising
65%
Importance

Enterprising occupations frequently involve starting up and carrying out projects. These occupations can involve leading people and making many decisions. Sometimes they require risk taking and often deal with business.

Social
39%
Importance

Social occupations frequently involve working with, communicating with, and teaching people. These occupations often involve helping or providing service to others.

Investigative
27%
Importance

Investigative occupations frequently involve working with ideas, and require an extensive amount of thinking. These occupations can involve searching for facts and figuring out problems mentally.

Artistic
15%
Importance

Artistic occupations frequently involve working with forms, designs and patterns. They often require self-expression and the work can be done without following a clear set of rules.

Realistic
15%
Importance

Realistic occupations frequently involve work activities that include practical, hands-on problems and solutions. They often deal with plants, animals, and real-world materials like wood, tools, and machinery. Many of the occupations require working outside, and do not involve a lot of paperwork or working closely with others.

Top 10 Work Styles
Attention to Detail
96%
Importance

Job requires being careful about detail and thorough in completing work tasks.

Integrity
93%
Importance

Job requires being honest and ethical.

Dependability
91%
Importance

Job requires being reliable, responsible, and dependable, and fulfilling obligations.

Cooperation
86%
Importance

Job requires being pleasant with others on the job and displaying a good-natured, cooperative attitude.

Self Control
84%
Importance

Job requires maintaining composure, keeping emotions in check, controlling anger, and avoiding aggressive behavior, even in very difficult situations.

Independence
81%
Importance

Job requires developing one's own ways of doing things, guiding oneself with little or no supervision, and depending on oneself to get things done.

Initiative
80%
Importance

Job requires a willingness to take on responsibilities and challenges.

Stress Tolerance
80%
Importance

Job requires accepting criticism and dealing calmly and effectively with high stress situations.

Concern for Others
79%
Importance

Job requires being sensitive to others' needs and feelings and being understanding and helpful on the job.

Achievement/Effort
77%
Importance

Job requires establishing and maintaining personally challenging achievement goals and exerting effort toward mastering tasks.

Work Values
Relationships
67%
Importance

Occupations that satisfy this work value allow employees to provide service to others and work with co-workers in a friendly non-competitive environment. Corresponding needs are Co-workers, Moral Values and Social Service.

Support
65%
Importance

Occupations that satisfy this work value offer supportive management that stands behind employees. Corresponding needs are Company Policies, Supervision: Human Relations and Supervision: Technical.

Independence
48%
Importance

Occupations that satisfy this work value allow employees to work on their own and make decisions. Corresponding needs are Creativity, Responsibility and Autonomy.

Achievement
43%
Importance

Occupations that satisfy this work value are results oriented and allow employees to use their strongest abilities, giving them a feeling of accomplishment. Corresponding needs are Ability Utilization and Achievement.

Working Conditions
43%
Importance

Occupations that satisfy this work value offer job security and good working conditions. Corresponding needs are Activity, Compensation, Independence, Security, Variety and Working Conditions.

Recognition
34%
Importance

Occupations that satisfy this work value offer advancement, potential for leadership, and are often considered prestigious. Corresponding needs are Advancement, Authority, Recognition and Social Status.