Insurance Claims Clerk Job Description [Updated for 2025]

In an increasingly risk-aware society, the importance of insurance claims clerks is at an all-time high.

As life evolves, the demand for skilled individuals capable of processing, coordinating, and overseeing insurance claims continues to grow.

But let’s delve deeper: What is actually expected from an insurance claims clerk?

Whether you are:

• A job seeker trying to understand the core responsibilities of this role,
• A hiring manager outlining the perfect candidate,
• Or simply curious about the world of insurance claims processing,

You’ve come to the right place.

Today, we present a customizable insurance claims clerk job description template, designed for effortless posting on job boards or career sites.

Let’s dive right in.

Insurance Claims Clerk Duties and Responsibilities

Insurance Claims Clerks are responsible for processing insurance claims and ensuring that all necessary documentation is complete and accurate.

They work with insurance agents, clients, and other professionals to settle claims in a timely and efficient manner.

Their primary duties and responsibilities include:

• Reviewing insurance applications to ensure all necessary information is provided
• Processing new insurance claims notifications
• Collecting accurate information and documents to proceed with a claim
• Organizing and maintaining records of claims
• Coordinating with insurance agents and claimants to process claims
• Investigating potentially fraudulent claims by working with investigators and other specialists
• Ensuring fair settlement of all claims in a timely manner
• Communicating with insurers, claimants, and other parties to update them on claim status
• Assisting with the payment and closure of claims
• Performing data entry tasks related to claims processing and insurance programs

 

Insurance Claims Clerk Job Description Template

Job Brief

We are seeking an organized and detail-oriented insurance claims clerk to process claims and review insurance policies.

Your responsibilities will include registering new claims, maintaining claim files, and assisting policyholders throughout the claims process.

You should be familiar with insurance policies and claims processing and have excellent customer service skills.

 

Responsibilities

• Review insurance policies to determine coverage.
• Register new claims and maintain claim files.
• Review and process insurance claims.
• Communicate with policyholders about their claims.
• Prepare reports on claim status and resolution.
• Coordinate with insurance adjusters and other professionals to investigate claims.
• Ensure accurate and prompt claim processing.
• Maintain a high level of confidentiality with customer information.

 

Qualifications

• Proven experience as an insurance claims clerk or similar position.
• Knowledge of insurance policies and claims.
• Excellent customer service and communication skills.
• Attention to detail and organizational skills.
• Ability to handle confidential information.
• High school diploma or equivalent; further education in insurance or relevant field is a plus.

 

Benefits

• 401(k)
• Health insurance
• Dental insurance
• Retirement plan
• Paid time off
• Professional development opportunities

 

Additional Information

• Job Title: Insurance Claims Clerk
• Work Environment: This role is primarily office-based, with standard business hours. Occasional after-hours or weekend work may be required during peak times.
• Reporting Structure: Reports to the Claims Manager.
• Salary: Salary is based upon candidate experience and qualifications, as well as market and business considerations.
• Pay Range: $40,000 minimum to $60,000 maximum
• Location: [City, State] (specify the location or indicate if remote)
• Employment Type: Full-time
• Equal Opportunity Statement: We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
• Application Instructions: Please submit your resume and a cover letter outlining your qualifications and experience to [email address or application portal].

 

What Does an Insurance Claims Clerk Do?

Insurance Claims Clerks work in the insurance industry and are typically employed by insurance companies and agencies.

They may also work for third-party administrators that handle claims processing for multiple insurance companies.

Their primary role is to process insurance claims, ensuring that the paperwork is in order and that all necessary information has been received.

This may involve gathering additional information from claimants, witnesses, or healthcare professionals.

They review the insurance policy to check coverage details and determine if the claim is valid.

They coordinate with insurance adjusters, insurance representatives, or investigators as needed.

Insurance Claims Clerks also maintain records of claims and write reports that summarize the claim activity.

They communicate with claimants, informing them about the status of their claim and explaining the claims process.

In some cases, they may also be responsible for issuing payments, denying claims, or referring claimants to investigators.

Their role is crucial in ensuring that the claims process runs smoothly and efficiently, and that claimants receive fair and timely settlements.

 

Insurance Claims Clerk Qualifications and Skills

An Insurance Claims Clerk should have the skills and qualifications that align with your job description, such as:

• Good knowledge of insurance policies, practices and procedures to efficiently process claims and deal with claimants.
• Strong analytical and problem-solving skills to examine claims and validate their authenticity.
• Detail-oriented nature to ensure accurate processing and documentation of claims.
• Excellent customer service skills to deal with claimants professionally and empathetically, ensuring their satisfaction and loyalty to the company.
• Strong communication skills to communicate effectively with claimants, insurance agents and other professionals involved in the claims process.
• Organizational skills to manage multiple claims, keeping track of each claim’s status and ensuring that they are processed in a timely manner.
• Basic math skills for calculating claim amounts, settlements and deductibles.
• Ability to work under pressure in a fast-paced environment where they might have to deal with numerous claims and claimants at the same time.

 

Insurance Claims Clerk Experience Requirements

The experience requirements for an Insurance Claims Clerk vary depending on the complexity of the role and the size of the insurance company.

However, entry-level positions typically require at least 1 to 2 years of experience in an administrative or clerical role, preferably within the insurance industry.

This experience can be gained through internships, part-time roles, or even relevant full-time jobs.

Individuals with more than 2 years of experience may have worked in roles such as Claims Assistant or Insurance Support Clerk, where they have gained specific knowledge about claims processing, insurance policies, and customer service.

Candidates with more than 5 years of experience are often well-versed in handling more complex claims and may have some supervisory or management experience.

They may have worked as Senior Claims Clerk or Claims Supervisor, which involves overseeing the work of other clerks, training new hires, and ensuring the team meets efficiency and accuracy goals.

Additionally, those with a strong background in legal, medical, or auto insurance claims may have an advantage, as these are often more complex areas that require a deeper understanding of specific laws, medical terminology, or vehicle repairs and evaluations.

Therefore, prior experience in these areas can be highly beneficial for an Insurance Claims Clerk position.

 

Insurance Claims Clerk Education and Training Requirements

Insurance Claims Clerks typically have a high school diploma or equivalent as the minimum education requirement.

Basic computer skills and familiarity with office software like Microsoft Office Suite are also essential for this role.

Some employers may require a bachelor’s degree in business administration, finance, or a related field, but this is not always the case.

A good understanding of insurance law and regulations can be beneficial.

Insurance Claims Clerks often have previous experience in administrative or clerical roles, and on-the-job training is typically provided to familiarize them with the specific procedures and software used in the insurance industry.

Certification is not required, but some Insurance Claims Clerks may choose to obtain certification from organizations like The Institutes or the Insurance Institute of America to enhance their professional credentials.

These certifications can demonstrate expertise in insurance principles, law, and ethical guidelines, which can increase job prospects and advancement opportunities.

Continuing education is important as insurance regulations and laws can change frequently.

 

Insurance Claims Clerk Salary Expectations

An Insurance Claims Clerk earns an average salary of $39,700 (USD) per year.

The actual salary can vary significantly based on the individual’s level of experience, the location of the job, and the size and nature of the employing company.

 

Insurance Claims Clerk Job Description FAQs

What skills does an Insurance Claims Clerk need?

Insurance Claims Clerks should possess strong communication and customer service skills, as they will often be interacting with policyholders during stressful situations.

They need to be detail-oriented and have strong organizational skills to handle multiple claims and paperwork simultaneously.

Additionally, they need to have a good understanding of insurance policies, terms, and conditions.

 

Do Insurance Claims Clerks need a degree?

While some employers may require an associate’s or bachelor’s degree in business administration or a related field, many positions just require a high school diploma or GED.

However, a background in insurance or experience in a similar role can be advantageous.

 

What should you look for in an Insurance Claims Clerk resume?

When reviewing an Insurance Claims Clerk’s resume, you should look for previous experience in insurance, customer service, or administrative roles.

Also, check for skills such as data entry, record keeping, and familiarity with insurance terms and procedures.

Software skills, especially in industry-specific programs, could also be valuable.

 

What qualities make a good Insurance Claims Clerk?

A good Insurance Claims Clerk is patient, empathetic, and able to interact professionally with clients even under stressful circumstances.

They are detail-oriented and organized, able to manage multiple claims at once without making errors.

They also have a strong understanding of insurance terms and policy details, enabling them to accurately process claims and provide correct information to policyholders.

 

What are the daily duties of an Insurance Claims Clerk?

On a typical day, an Insurance Claims Clerk reviews and processes new insurance claims notifications.

They collect accurate information to proceed with a claim and coordinate with insurance agents and investigators to get additional information.

They also handle any inquiries from policyholders related to their claims.

In addition, they also maintain organized records of all insurance claims.

 

Conclusion

And there you have it.

Today, we’ve delved deep into the essential aspects of being an insurance claims clerk.

Surprise, surprise?

It’s not just about processing claims.

It’s about creating a safety net for the unexpected, one claim at a time.

With our detailed insurance claims clerk job description template and practical examples, you’re ready to make your mark.

But why draw the line here?

Explore further with our job description generator. It’s your key to crafting precise job listings or refining your resume to sheer excellence.

Remember:

Each processed claim is a part of a bigger narrative.

Let’s shape that future. Together.

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