Insurance Processor Job Description
Insurance processor
provides assistance to insurance professionals by performing miscellaneous functions such as photocopying, faxing, scanning, word processing, and filing.
Insurance Processor Duties & Responsibilities
To write an effective insurance processor job description, begin by listing detailed duties, responsibilities and expectations. We have included insurance processor job description templates that you can modify and use.
Sample responsibilities for this position include:
Infrequently testifies in depositions, hearings and trials
Adjudication of all types of medical claims based on contractual policies and procedures
Edit and error resolution
Responsible for maintaining acceptable levels of inventory and age
Ensures claim quality by verifying accuracy of eligibility, pricing and benefits being applied to claims
Identifies opportunities for quality improvement or efficiencies
Will be required to manually calculate pricing correctly
Routing claims to other areas with clear and concise documentation of issue or request
Responsible for reading, interpreting and responding to member and provider correspondence
Will be responsible for coordinating benefits with other carriers
Insurance Processor Qualifications
Qualifications for a job description may include education, certification, and experience.
Education for Insurance Processor
Typically a job would require a certain level of education.
Employers hiring for the insurance processor job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Associates, Business, Education, Medical, Technical, Finance, Teaching, Continuing Education, General Education, Graduate
Skills for Insurance Processor
Desired skills for insurance processor include:
Emailing and faxing
MS Word and Excel
Coding terminology
Insurance/reimbursement practices
Medical terminology
Medical conditions/terminology and insurance products
Microsoft Office
Outlook Exchange
Proficient in Internet Explorer
Specifically Excel
Desired experience for insurance processor includes:
Obtain insurance documents from various claim systems and add them to our processing system
Respond to teammates regarding requests for documents and information and provide what it needed
Identify various types of claims documents, such as police reports, estimates, damage photos and others then add these to our system
Read through computer notes to look for specific information needed by our triage team
Prepare files for demand by searching for damage documentation and then ensuring all financial information is accurate
Update files in the client system and our own system using generated lists which provide the task to be processed
Insurance Processor Examples
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Insurance Processor Job Description
Job Description Example
Our company is growing rapidly and is looking for an insurance processor. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for insurance processor
- Assist the team leader by helping to train new employees
- Maintain positive work environment by acting and communicating in a manner so that you get along with customers, clients, co-workers and management
- Process payment requests for deductibles, co-pays
- Answer inbound calls and make outbound calls, at times in Spanish
- Maintain and update on-line policyholder information
- Compile licensing information for new agents and brokers
- Reviews and corrects pricing errors
- Demonstrates full competency/mastery in own area of work
- Provides timely and accurate resolution of bill issues and adjustments regarding contracts and pricing
- Participates in PPO review workflow projects
Qualifications for insurance processor
- Must be able to work at computer station for long periods of time
- Minimum of two (2) years administrative experience and/or customer service experience in commercial insurance preferred
- Knowledge of basic business processes, workflow and systems
- Ability and accuracy in analyzing/summarizing detailed information
- Quality and customer service advocate
- Customer/Quality focus
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Insurance Processor Job Description
Job Description Example
Our company is growing rapidly and is looking to fill the role of insurance processor. 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 insurance processor
- Under the direction of the Team Leader and Personal Lines Marketing/Processor Manager, the New Business Policy Processor position will support the sales staff by uploading policy data from personal lines insurance applications to partner carriers’ proprietary systems the agency management system
- This role is also responsible for downloads, system audits within their area of expertise and other assigned projects
- Resolves low complexity and routine upload and download discrepancies with minimal direction
- Refers complex problems and client inquiries to the Team Leader or Marketing/Processor manager for resolution
- Monitor, organize, and distribute daily work to team members
- Demonstrate effective time management and organizational skills and ability to prioritize work to meet deadlines and complete tasks efficiently
- Document, implement, and communicate all program/processing changes to team members
- Position requires hands on responsibilities and will be required to perform any and all functions that would part of their direct report responsibilities
- Responsible for day-to-day adherence to processing standards and efforts made toward process improvement
- Communicate in a professional and consistent positive manner to motivate and direct associates
Qualifications for insurance processor
- Ability to operate multiple types of complex imaging equipment
- Prior knowledge of Medical Insurance Practices and terms, including enrollment, claims processing, payment terms, benefits coordination
- Candidate will request loss run reports from agency, the report is then provided for the candidate to cross check with the reports that the company has, if there are no discrepancies then the loss report is filed accordingly, if there are discrepancies the candidate will identify the discrepancy and send it to the appropriate party
- Entering and keying in new policy submissions
- Reviews and processes applications, renewals and cancellations for agent/broker licenses
- Implements customary changes in insurance licensing requirements based on changes in laws, regulations, or company policies
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Insurance Processor Job Description
Job Description Example
Our innovative and growing company is looking for an insurance processor. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for insurance processor
- Teach, coach, and mentor others
- Demonstrates the technical knowledge to lead teams - knowledgeable of underwriting and rating instructions and guidelines
- Challenge team members to raise “the bar” on innovative and creative ways to improve processing on assigned programs
- Complete quarterly time studies on all processing items of programs assigned
- Make a strong, positive impact in meetings
- Updates membership files and documents records according to company policies and procedures
- Maintains quality customer service, with high attention to detail and accuracy
- Ensures legal compliance by following company policies and procedures, state and federal insurance regulations
- Ensure proper payments transactions are completed and issues refunds when required
- Reviews coverage plans, applications and membership files to ensure completeness and accuracy
Qualifications for insurance processor
- Typing/Keypunch
- Insurance or Financial background preferred
- Maintains databases and related background information and files for assigned states, operation, and/or distribution channel
- Updates and distributes licensing/appointment requirements and procedures manuals
- Advises employees, agents, and/or brokers with licensing by providing information on the licensing requirements and process, furnishing materials, and submitting forma and fees to state department of insurance and/or other regulatory agencies
- Assists in reviewing, analyzing and interpreting licensing laws and regulations
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Insurance Processor Job Description
Job Description Example
Our company is growing rapidly and is hiring for an insurance processor. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for insurance processor
- Individual will be responsible for providing clerical support to a team of 6 processors
- Insurance Claims Processors perform clerical duties, including data entry, filing paper documents, email, calendar management, and word processing
- Retrieves, prints, faxes, or mails supporting documentation to vendors or others as directed Provides back-up for any support functions in the office
- Coordinate and monitor daily inventory
- Training/developing/mentoring associates
- Ensure that assigned reports are completed timely and accurately
- Research and provide feedback of the root cause on processing and quality issues
- Customer Service-initial loss reports
- Reviewing and processing claims
- Reviewing the claims system to determine if a vendor needs to be scheduled to assist Adjusters with roof inspections
Qualifications for insurance processor
- Knowledge of EPS, EPDS, WGS, AniTa, FACETS systems a plus
- Medical Bill Reviewer certification required
- Minimum of two (2) years administrative experience and/or customer service experience in Private Client Group insurance preferred
- Minimum 5 GCSE's or equivalent at grades A to C
- Additional certification preferred – Certificate 1 (LOMA 280/291 and LOMA 290/291)
- Knowledge of basic business processes, workflow and systems considered a plus
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Insurance Processor Job Description
Job Description Example
Our company is growing rapidly and is searching for experienced candidates for the position of insurance processor. 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 insurance processor
- Receives documents, investigates, refers and coordinates appeals
- Review appeal document to determine member or providers request Ability to identify appeal type
- Review all files/cases sent to Part C Appeals reviewed to determine nature of the document, and routed to the proper work stream Initiates case files for each appeal
- Researches and assesses appeal
- Strictly Telephonic, no travel Unit is 24/7 operation
- Receptionist relief
- Reviews and processes routine applications, registrations, contracts, and/or appointments and maintenance requests consistent with approved standards and practices
- Assists in implementing customary changes in insurance licensing requirements based on changes in laws, regulations, or company policies
- Assists internal and external customers on the licensing requirements and registration process, furnishing materials, and submitting forms and fees to state department of insurance and/or other regulatory agencies
- Complies with routine licensing laws and regulations
Qualifications for insurance processor
- Basic knowledge of medical conditions considered a plus
- NextGen experience is a plus but not mandatory
- Personal Lines Insurance Experience is a MUST
- Personal Lines or Commercial Lines experience (Auto & Property Insurance) strongly preferred
- Need proficient excel & math skills, the ability to interpret and execute complex instructions accurately
- Some customer service experience and data processing experience preferred