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Career Details

43-9041.00 - 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.


Key Facts
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Bright Outlook
Career Details
Green Job
Career Details
Current Employment
285,400
Estimate
Forecasted Employment
303,100
Estimate
Change in Employment
+17,700
Estimate
Change in Employment %
+6.2%
Estimate
Tasks
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Tasks
The tasks listed below can be performed to prepare you for a career in this field.
Core
  • 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 to 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.
Generic
  • 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.
Supplemental
  • 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.
All data sourced from US Department of Labor, Employment & Training Administration O*Net Database.
Knowledge
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Knowledge

The items listed below are organized into sections that contain knowledge useful for pursuing a career in this field. Each section also contains a "Percentage of Importance" statistic that shows how relevant an item is to the occupation.
 Customer and Personal Service
  • 87%
    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.
 Clerical
  • 78%
    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.
 English Language
  • 73%
    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
  • 60%
    Knowledge of circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming.
 Mathematics
  • 57%
    Knowledge of arithmetic, algebra, geometry, calculus, statistics, and their applications.
 Administration and Management
  • 51%
    Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources.
All data sourced from US Department of Labor, Employment & Training Administration O*Net Database.
Tools
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Tools
The tools listed below include machines, equipment, tools, and software that is useful for individuals who are interested in this career.
 Computers
  • Desktop computers
  • Personal computers
All data sourced from US Department of Labor, Employment & Training Administration O*Net Database.
Technology
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Technology
The technologies listed below include machines, equipment, tools, and software that is useful for individuals who are interested in this career.
 Finance accounting and enterprise resource planning ERP software
  • Account management software
  • Billing software
  • Insurance rating software
 Data management and query software
  • Alpha Software Alpha Five
  • Automated information system software
  • Claim processing system software
  • Data entry softwareHOT
  • Database software
  • IBM Check Processing Control System CPSC
  • Microsoft AccessHOT
  • Policy issuance system software
  • St. Paul Travelers e-CARMA
 Information exchange software
  • GroupMe
  • IBM Lotus Notes
  • Microsoft OutlookHOT
  • Novell GroupWise
 Industry specific software
  • Healthcare common procedure coding system HCPCSHOT
  • Medical condition coding softwareHOT
  • Medical procedure coding software
 Content management software
  • InSystems Calligo Enterprise
 Content authoring and editing software
  • Microsoft ExcelHOT
  • Microsoft PowerPointHOT
  • Microsoft WordHOT
  • Spreadsheet software
  • Word processing software
 Network applications software
  • Microsoft Internet Explorer
  • Web browser software
All data sourced from US Department of Labor, Employment & Training Administration O*Net Database.
Certifications
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Certifications
FastForward at Virginia's Community Colleges is a short-term training program for high-demand industries, like healthcare, information technology, and skilled trades and infrastructure, helping Virginians get the jobs and salaries they need. Our goal is to get you trained, help you earn your certification, and get you into a career that can support you and your family. Explore the latest training program offerings by visiting FastForward
The certifications listed below are useful to pursue if you are interested in a career in this field.
 Core
All data sourced from US Department of Labor, Employment & Training Administration O*Net Database.
Licensing
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Licensing
The licensing information below is organized into sections and is useful for pursuing if you are interested in a career in this field.
No specific licensing information is listed for this occupation in the area you have selected.
All data sourced from US Department of Labor, Employment & Training Administration O*Net Database.
Related Programs
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Programs related to this career, offered by participating institution(s), are listed below.

Clicking on the Degree programs in the list below will take you away from the Careers page.
INSTITUTION
PROGRAMS
Bridgewater College
Eastern Shore Community College
Paul D. Camp Community College
Randolph-Macon College
Southside Virginia Community College
Tidewater Community College
Wytheville Community College