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.
SOC: 43-9041.00
Common Job Titles
Claims Processor
Claims Representative (Claims Rep)
Claims Technician (Claims Tech)
Underwriting Assistant
What You'll Need to Succeed
AI-generated
Key competencies for this occupation at a glance
KnowledgeEvaluate insurance claims forms and policy applications for accuracy and completeness using company standards and regulatory requirements, working independently in an office environment.
Developing
KnowledgeApply insurance policy provisions and claims processing procedures when reviewing policyholder requests and updating existing policies in claims management systems.
Developing
KnowledgeAnalyze policyholder information and supporting documentation to determine eligibility and compliance with insurance regulations and company guidelines.
Developing
KnowledgeInterpret medical coding systems and billing procedures when processing healthcare claims using HCPCS and diagnosis coding software.
Developing
Hands-onOperate claims processing and policy management software systems to document, record, and update policyholder information following established protocols.
Developing
Hands-onExecute data entry and database updates in insurance management systems using Microsoft Office applications and specialized claim processing software with accuracy under time constraints.
Developing
MindsetEngage with policyholders to gather information and clarify documentation requirements, demonstrating active listening and service orientation during verbal and written communications.
Developing
MindsetRespond to policyholder inquiries and concerns regarding claims status and policy modifications, maintaining professionalism and customer focus in high-volume service environments.
Developing
KnowledgeOrganize multiple claims and policy processing tasks, prioritizing workload to meet processing deadlines and service level agreements.
Developing
MindsetParticipate in interdepartmental communication and coordination, collaborating with supervisors, insurance representatives, and other clerks to resolve discrepancies and process exceptions.
Developing
Wage Data According to the Bureau of Labor Statistics
Annual wage data for Insurance Claims and Policy Processing Clerks (2024)
Estimated Total Employment (U.S.)
229,070
Wage Distribution by Percentile
Line chart of annual wages by percentile. U.S. is the solid line. 10th percentile: U.S. $36,900. 25th percentile: U.S. $41,600. 50th percentile: U.S. $48,450. 75th percentile: U.S. $59,500. 90th percentile: U.S. $73,100. Use the left and right arrow keys to move between percentiles.
U.S.
Metric
U.S.
10% of workers earn the following or less
$36,900
10% of workers earn the following or more
$73,100
Workers on average earn
$51,980
+ indicates wage is at or above the BLS reporting cap ($239,200/year)
Skills & Requirements
Key competencies for this occupation, ranked by importance
Customer and Personal Service4.2/5
Administrative3.9/5
English Language3.6/5
Computers and Electronics3.0/5
Mathematics2.9/5
Skills & Requirements: Knowledge
Tools & Technology
Equipment and software commonly used in this occupation
