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Insurance Claims and Policy Processing Clerks - 43-9041.00

The occupation code you requested, 43-9041.01 (Insurance Claims Clerks), is no longer in use. In the future, please use 43-9041.00 (Insurance Claims and Policy Processing Clerks) instead.

O*NET-SOC Description

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.

Sample of Reported Job Titles

  • Claims Adjudicator
  • Claims Analyst
  • Claims Clerk
  • Claims Customer Service Representative (Claims CSR)
  • Claims Processor
  • Claims Representative (Claims Rep)
  • Claims Technician (Claims Tech)
  • Insurance Analyst
  • Policy Analyst
  • Underwriting Assistant

SOC Occupation Groups

Related Occupations

Tasks

  • Apply insurance rating systems.
  • Calculate amount of claim.
  • Calculate premiums, refunds, commissions, adjustments, or new reserve requirements, using insurance rate standards.
  • Check computations of interest accrued, premiums due, and settlement surrender on loan values.
  • Collect initial premiums and issue receipts.
  • Compare information from application to criteria for policy reinstatement, and approve reinstatement when criteria are met.
  • Compose business correspondence for supervisors, managers, and professionals.
  • Contact insured or other involved persons to obtain missing information.
  • Correspond with insured or agent to obtain information or to inform them of account status or changes.
  • Enter insurance- and claims-related information into database systems.
  • Examine letters from policyholders or agents, original insurance applications, and other company documents to determine if changes are needed and effects of changes.
  • Interview clients and take their calls to provide customer service and obtain information on claims.
  • Modify, update, or process existing policies and claims to reflect any change in beneficiary, amount of coverage, or type of insurance.
  • Notify insurance agent and accounting department of policy cancellation.
  • Obtain computer printout of policy cancellations, or retrieve cancellation cards from file.
  • Organize or work with detailed office or warehouse records, maintaining files for each policyholder, including policies that are to be reinstated or cancelled.
  • Organize or work with detailed office or warehouse records, using computers to enter, access, search or retrieve data.
  • Pay small claims.
  • Post or attach information to claim file.
  • Prepare insurance claim forms or related documents, and review them for completeness.
  • 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.
  • Review and verify data, such as age, name, address, and principal sum and value of property, on insurance applications and policies.
  • Review insurance policy to determine coverage.
  • Transcribe data to worksheets, and enter data into computer for use in preparing documents and adjusting accounts.
  • Transmit claims for payment or further investigation.

Detailed Work Activities

  • Answer telephones to direct calls or provide information.
  • Calculate costs of goods or services.
  • Calculate financial data.
  • Check data for recording errors.
  • Code data or other information.
  • Collect deposits, payments or fees.
  • Compile data or documentation.
  • Discuss account status or activity with customers or patrons.
  • Enter information into databases or software programs.
  • Execute sales or other financial transactions.
  • Explain regulations, policies, or procedures.
  • Interview employees, customers, or others to collect information.
  • Maintain financial or account records.
  • Maintain operational records.
  • Obtain personal or financial information about customers or applicants.
  • Prepare business correspondence.
  • Prepare documentation for contracts, transactions, or regulatory compliance.
  • Provide information to coworkers.
  • Provide notifications to customers or patrons.
  • Review customer insurance information.
  • Send information, materials or documentation.
  • Verify accuracy of financial or transactional data.

Military Crosswalk Titles

  • Household Goods Officer (Navy - Commissioned or Warrant Officer)
  • Pay Clerk (Navy - Enlisted)
  • Personnel Clerk (Navy - Enlisted)

Apprenticeship Crosswalk Titles

  • General Insurance Associate

DOT Crosswalk Titles

  • Cancellation Clerk
  • Claims Clerk I
  • Claims Clerk II
  • Insurance Checker
  • Policy-Change Clerk
  • Reviewer
  • Revival Clerk
  • Special-Certificate Dictator