Claims Clerk Job Description

Claims Clerk Job Description

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Claims clerk provides accurate claim system documentation and paperless file documentation as required by company claim manuals and procedures.

Claims Clerk Duties & Responsibilities

To write an effective claims clerk job description, begin by listing detailed duties, responsibilities and expectations. We have included claims clerk job description templates that you can modify and use.

Sample responsibilities for this position include:

Looking up and printing payment vouchers from the RAM Imaging system
Identifying payers and cross-walking those payers to the DOH listing of elected payers for the NY State Surcharge
Handling clerical and administrative issues, as needed
Claims processing includes bad debt, bankruptcy, bad address
Periodically reviews and removes files for destruction or transfer to central storage
Keeps supervisor informed verbally and in writing of activities and problems within assigned area of responsibility
Performs a variety of clerical duties such as answering telephones, taking messages, and sorting and filing mail and correspondences
Assists in maintaining office supplies and forms
Creates claim file by inputting initial loss report information into the Focus system
Verifying and monitoring incoming and outgoing mail

Claims Clerk Qualifications

Qualifications for a job description may include education, certification, and experience.

Education for Claims Clerk

Typically a job would require a certain level of education.

Employers hiring for the claims clerk job most commonly would prefer for their future employee to have a relevant degree such as High School and Collage Degree in General Education, Supervision, Education, Associates, Business Operations, Communication, Business, Legal, Paralegal Studies, Law

Skills for Claims Clerk

Desired skills for claims clerk include:

Computer operations and of claim file systems and procedures
Claim processing and of Claim policies and procedures
Computer entry and operations
Insurance office setting
Claims procedures and policies
MS Office
MS Word and MS Excel
Microsoft Office
Office equipment and operations
Basic bookkeeping and financial transactions

Desired experience for claims clerk includes:

Must be flexible with your working hours
Office experience an asset
Must be available to work 8am to 4pm (EST), Mon-Fri
Proficient knowledge, ability and skills in claims data base systems
Previous experience in a hospital or medical environment
Computer skills, including word processing (MS Word, Outlook, Excel, Adobe pro)

Claims Clerk Examples

1

Claims Clerk Job Description

Job Description Example
Our growing company is hiring for a claims clerk. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for claims clerk
  • Comparing identifying information and counts of claims from incoming mail
  • Sorting mail such as returned letters, adjustments, bills, orders, and payments
  • File documents according to supervisory direction
  • Enter or key information into a computer for the Claims function
  • Distribute documents to the appropriate personnel as required/needed
  • The Clerk may be requested to code or load information into the computer or other filing means
  • Answer phone calls from insureds or their representatives, agents, independent adjusters, contractors
  • Mail adjustments
  • Floor adjustments
  • Copy and collate any documents for distribution
Qualifications for claims clerk
  • High School diploma or equivalent supplemented by courses in typing and personal computer skills or the equivalent in related work experience
  • Education equivalent to graduation from high school supplemented by courses in typing and personal computer skills or the equivalent in related work experience
  • Recent experience analyzing complex medical claim information
  • Fax or mail information prepared by claims staff
  • Proficient with computer and Windows PC applications, which includes previous experience working with dual computer screens and multiple applications at a time
  • 6 months experience in a claims department a plus
2

Claims Clerk Job Description

Job Description Example
Our innovative and growing company is looking for a claims clerk. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for claims clerk
  • Identification of First Notices of Loss and priority legal documents ensure delivery to the appropriate claim handling unit
  • Research claim systems to ensure accurate and appropriate new loss registrations
  • Verify system policy existence or request policy documents as per instructions
  • Provide agents/producers/brokers with status
  • Answer customer service inquiries
  • Maintain logs, databases or spreadsheets as needed
  • Perform other job related duties as dictated by business needs, as determined by management
  • Creates claim file by inputting initial loss report information into the various data systems
  • Performs a variety of clerical duties such as answering telephones, taking messages, and sorting and filing mail and correspondence, and data entry
  • Adheres to federal and state regulatory and/or company plan requirements and established FMLA workflow procedures
Qualifications for claims clerk
  • High school degree or equivalent with at least one year related experience
  • Organization of work flow and data
  • Must be able to work in the United States without employer sponsorship
  • Comprehension of medical billing and coding methods
  • PC Skills, ability to build spreadsheets and format reports in Excel
  • Ability to follow up and meet deadlines
3

Claims Clerk Job Description

Job Description Example
Our company is growing rapidly and is hiring for a claims clerk. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for claims clerk
  • This will include registering various claim types, update and maintain data within the claims systems
  • Utilize Apollo or Work View imaging system to manage claim documents
  • As instructed by Claims Operation Management support claim registration process with preparation and delivery of new claim acknowledgements
  • Verify accuracy of all clams coding prior to registration in the correct claim system
  • Obtain policy information from Underwriting and provide to claims technical staff
  • Telephonic or written response to provide requested information
  • Prepare claim file and comments package for attorney in preparation for litigation
  • Provide back up for critical, time sensitive deadlines
  • Maintain and strengthen claims processing and system knowledge through constant research and exploration of claims operating systems and associated data banks
  • Identify and develop process improvement opportunities
Qualifications for claims clerk
  • Must be able to proactively work within team structure providing assistance to team leader and claim handlers on task specific requests
  • Must be able to utilize PC systems in a paperless environment
  • Must exhibit good communication skills, both verbally and written, with customers in-house personnel, and claim file parties
  • Proven ability in planning, prioritizing, and organizing diverse workload
  • Works in Homeowner Subrogation Department, processes spreadsheets, creates reports
  • Two (2) years experience in healthcare preferred
4

Claims Clerk Job Description

Job Description Example
Our growing company is looking to fill the role of claims clerk. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for claims clerk
  • Processing claims payments for Consumer Electronics and Home Warranty claims
  • Perform work in multiple legacy applications SalesForce GLOW
  • Maintain detailed documentation and tracking of manual processes
  • Coordinate daily check handling and reconciliation
  • Provide support as needed for offsite team
  • Engage in and support project work
  • Must be detail oriented and able to coordinate multiple priorities
  • Work with team members in person, over the phone or computer to answer questions and
  • Contact payers for claims status, follow-up denials, or partial payments
  • Obtain payer requirements for timely adjudication of claims
Qualifications for claims clerk
  • Requires sound independent judgment and high level of accuracy
  • Must be able to use PC tools such as Microsoft Word, EXCEL, Share Point, PowerPoint, for communication, documentation and organizational purposes
  • 3 to 5 years of experience in a claims department preferred, related experience okay
  • Strong organizational skills and ability to multi task, with minimal supervision and must be able to exercise independent sound business judgement based on experience and policies and procedures
  • 1+ years of experience with basic clerical duties
  • Intermediate proficiency with Outlook and Word
5

Claims Clerk Job Description

Job Description Example
Our company is growing rapidly and is searching for experienced candidates for the position of claims clerk. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for claims clerk
  • Work assigned RBCO reports
  • Available to assist other PACs with questions or collection needs
  • Acts as liaison between staff and management
  • Processing and transacting freight claims that have incurred loss or damage
  • Reporting on claims and results
  • Review, sort, and mail letters
  • Type labels accurately and efficiently
  • Complete clerical functions in support of claim adjuster activity in claims offices
  • Pay claims related bills
  • Scan Documents using scanning equipment and ensure documents are attached to appropriate claim file
Qualifications for claims clerk
  • 1-3 years of claims payable experience
  • Operate well under pressure and meet deadlines
  • Shows effective problem solving, investigative and multi-tasking skills
  • Must be able to accurately file large volumes of documents alphabetically or numerically
  • Must have a working knowledge of personal computers and
  • Must have good human relation skills (the ability to work well with others and to be a team member)

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