Insurance Claims and Policy Processing Clerks
In the Insurance Claims and Policy Processing Clerks occupation, workers process new insurance policies, modifications to existing policies, and claims forms. A regular part of the work is to prepare insurance claim forms or related documents, and review them for completeness. Its interest code is CES. Conventional leads at 7.0 out of 7, so expect orderly work with data, records and clear procedures, with Enterprising next at 3.9. Plan on a few months to a year of learning on the job; O*NET labels this some preparation. Strength in time management, reading comprehension, and speaking helps most here. If you want orderly work with data, records and clear procedures, keep it on your list. If you need creative work with room for original expression, it may feel thin.
What they do
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.
Main tasks
- Prepare insurance claim forms or related documents, and review them for completeness.
- 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.
Skills
- Time Management
- Reading Comprehension
- Speaking
- Critical Thinking
- Active Listening
- Writing
Who this career fits
May suit you if
- You like clear rules and getting the details right.
- You like taking the lead and making the call.
- You want to start work after a short stretch of training.
- You are comfortable relying on time management and reading comprehension.
May not suit you if
- You get restless with routine, records and exact procedures.
- You need creative expression to be a big part of your day. Artistic rates 1.0 out of 7 here.
- You want a career built on years of advanced study.
Interest profile
O*NET rates each occupation from 1 to 7 on six interest types. The code CES takes the three highest, and Conventional comes first here.
Preparation
Some preparation. Most people start with a high school diploma, then learn from experienced coworkers over a few months to a year.
Most-reported requirement in the O*NET survey: High School Diploma or the equivalent (such as a GED). This reflects what workers reported most often and is not a legal minimum. Licensing rules can differ by state or industry, so confirm what applies where you plan to work.
Also called
- Claims Adjudicator
- Claims Analyst
- Claims Clerk
- Claims Customer Service Representative (Claims CSR)
- Claims Processor
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This page includes information from the O*NET 31.0 Database by the U.S. Department of Labor, Employment and Training Administration (USDOL/ETA). Used under the CC BY 4.0 license. O*NET® is a trademark of USDOL/ETA.