Occupation

Insurance Claims and Policy Processing Clerks

Human Advantage 69%

Significant human skills needed

AI Automation Risk Moderate Risk
4.6 / 10

Some tasks in this role may be augmented by AI, but human oversight and interpersonal skills remain important.

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.

Also Known As: Agency Service Representative (Agency Service Rep), Auto Claims Rep (Automotive Claims Representative), Auto Liability Claims Rep (Automotive Liability Claims Representative), Billing and Insurance Coordinator, Bodily Injury Claims Representative (Bodily Injury Claims Rep), Cancellation Clerk, Claim Representative (Claims Rep), Claims Adjudicator +58 more

Video

Core Tasks

  1. Prepare insurance claim forms or related documents, and review them for completeness.
  2. Calculate amount of claim.
  3. Post or attach information to claim file.
  4. Transmit claims for payment or further investigation.
  5. Contact insured or other involved persons to obtain missing information.
  6. Review insurance policy to determine coverage.
  7. Process and record new insurance policies and claims.
  8. Organize or work with detailed office or warehouse records, using computers to enter, access, search or retrieve data.
  9. Provide customer service, such as limited instructions on proceeding with claims or referrals to auto repair facilities or local contractors.
  10. Correspond with insured or agent to obtain information or to inform them of account status or changes.
  11. Review and verify data, such as age, name, address, and principal sum and value of property, on insurance applications and policies.
  12. Compare information from application to criteria for policy reinstatement, and approve reinstatement when criteria are met.
  13. Examine letters from policyholders or agents, original insurance applications, and other company documents to determine if changes are needed and effects of changes.
  14. Transcribe data to worksheets, and enter data into computer for use in preparing documents and adjusting accounts.
  15. Notify insurance agent and accounting department of policy cancellation.

Supplemental Tasks (6)

  1. Pay small claims.
  2. Process, prepare, and submit business or government forms, such as submitting applications for coverage to insurance carriers.
  3. Collect initial premiums and issue receipts.
  4. Interview clients and take their calls to provide customer service and obtain information on claims.
  5. Obtain computer printout of policy cancellations, or retrieve cancellation cards from file.
  6. Compose business correspondence for supervisors, managers, and professionals.

Education & Training

Job Zone 2 Job Zone Two: Some Preparation Needed
Education: These occupations usually require a high school diploma.
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.
On-the-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.

Education Level Distribution

Percentage of workers in this occupation with each education level.

High School Diploma - or the equivalent (for example, GED)
55%
Associate's Degree (or other 2-year degree)
21%
Some College Courses
9%
Post-Secondary Certificate - awarded for training completed after high school (for example, in agriculture or natural resources, computer services, personal or culinary services, engineering technologies, healthcare, construction trades, mechanic and repair technologies, or precision production)
8%
Bachelor's Degree
7%
Less than a High School Diploma
0%

Technology & Tools

Hot Technologies

  • Microsoft Access
  • Microsoft Excel
  • Microsoft Office software
  • Microsoft Outlook
  • Microsoft PowerPoint
  • Microsoft Windows
  • Microsoft Word

Software (29)

  • Account management software
  • Alpha Software Alpha Five
  • Automated information system software
  • Billing software
  • Claim processing system software
  • Database software
  • GroupMe
  • Healthcare common procedure coding system HCPCS
  • IBM Check Processing Control System CPSC
  • IBM Lotus Notes
  • InSystems Calligo Enterprise
  • Insurance rating software
  • Medical condition coding software
  • Medical procedure coding software
  • MicroFocus GroupWise
  • Microsoft Internet Explorer
  • Policy issuance system software
  • Spreadsheet software
  • St. Paul Travelers e-CARMA
  • Web browser software
  • Word processing software
  • Xactware Xactimate

Tools & Equipment (4)

  • 10-key calculators
  • Desktop computers
  • Dictation machines
  • Personal computers

Where This Career Leads

Career progression organized by specialty track and experience level.

Insurance Advanced Manufacturing

Zone 2
Insurance Claims and Policy Processing Clerks You are here
Zone 5
Mathematicians 75% match

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