Claims Clerk

What is a Claims Clerk?

Duties              

You will manage the following duties as a claims clerk:

• Complete clerical tasks such as opening, counting and sorting through incoming paper claims; answering telephones and taking messages as assigned by management.
• Assess and prepare insurance claim forms and other documents based on the case.
• Go through and organise office records, often using computer software to find and retrieve case-related data.
• Utilise insurance rating systems and calculate the amount of claim to be filed by an individual.
• Handle all claims with integrity and honesty to ensure that the person involved receives the correct insurance coverage they paid for.

Day In The Life

A claims clerk is vital to ensure that insurance companies run smoothly and settle disputes over denied claims efficiently. During the day, you will be conducting interviews with clients and compiling their paperwork to begin the settlements process. Interacting with a wide range of clients is a big part of your work, especially dealing with those that have had their claims denied or are not sure of how the claims filing process works.

You need to utilize a deep knowledge of the company’s insurance policies and the legal requirements for completing the claims. The process begins with collecting relevant information about a client with the intent of reviewing their insurance policy. The most frequent cases you will deal with are related to medical and auto claims.

In case the person’s claims are in line with the requirements, it is up to you to finish all necessary documentation and submit them for processing. The position of a claims clerk is pivotal as a mediator between the insurance company and a person filing for claims to come to terms. While some cases you handle will go smoothly, others can take more time.

Work Schedule

You can work around 35 to 40 hours per week as an insurance claims clerk. Office hours are between Monday and Friday. For the most part, the work schedule is regular, meaning you will have a set routine in a standard comfortable office environment. The job involves working with tight deadlines under pressure. If you are working at a contact center, this may vary due to shift work that falls on weekends and evenings. There may the rare chance that you have to travel to meet someone filing a claim with your company.

Growth Of The Job

According to the national data published by the U.S. Bureau of Labor Statistics (BLS), employment for insurance claims clerks is projected to remain strong through 2018. Opportunities for advancement will differ based on your educational qualifications, the location of the job and your experience. At large organizations, you will start off with an entry-level role that progresses to team leader, claims manager then claims director as your experience increases. With experience, you will also be given more responsibility in the form of complex cases, quality control functions and instructional training.

Continuing professional development via employers and other professional bodies is a great way to speed up career prospects in this field. You can branch off and specialize in certain focus areas by working with teams on environmental claims, fraud investigation and disease. Acquiring such knowledge can help you go into a different area of insurance expertise.

Typical Employers

Employers of claims clerks value candidates that have completed college coursework in subject areas like economics and business. You can find employment at leading insurance firms or insurance brokers, at organizations such as AmTrust Financial Services, UnitedHealth Group, Eklego Workforce Solutions, Republic Western Insurance Company, BCA Financial Services, Inc. and more.