Details for Insurance Claims and Policy Processing Clerks
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.
- 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.
- Process and record new insurance policies and claims.
- Organize or work with detailed office or warehouse records, using computers to enter, access, search or retrieve data.
- 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 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.
- Transcribe data to worksheets and enter data into computer for use in preparing documents and adjusting accounts.
- Notify insurance agent and accounting department of policy cancellation.
- Pay small claims.
- Process, prepare, and submit business or government forms, such as submitting applications for coverage to insurance carriers.
- Collect initial premiums and issue receipts.
- 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.
- Apply insurance rating systems.
- Calculate premiums, refunds, commissions, adjustments, or new reserve requirements, using insurance rate standards.
- Enter insurance and claims related information into database systems.
- Modify, update, or process existing policies and claims to reflect any change in beneficiary, amount of coverage, or type of insurance.
- Organize or work with detailed office or warehouse records, maintaining files for each policyholder, including policies that are to be reinstated or cancelled.
- Enterprising - 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.
- Conventional - 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.
Education, training, experience
- Education - These occupations usually require a high school diploma.
- 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.
- 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.
- English Language -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 -Knowledge of circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming.
- Clerical -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.
- Customer and Personal Service -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.