Claims Clerk Job Description for Resume

Updated on: June 4, 2018

Position Overview

A claims clerk performs many basic and complex activities related to handling claims within an insurance company.

They obtain information from the insured to settle claims with insurance carriers.

Position Requirements

Typically, a high school diploma or a GED equivalent is sufficient to work as a claims clerk. If you have had some experience in this regard, you will be welcomed with open arms. The work of a claims clerk can be easy or difficult, depending on what type of work you are performing then.

You may be asked to perform something as simple as organizing claims, or as complicated as determining claims coverage for different cases. To work at this position, you have to be exceptionally talented in handling a wide variety of tasks at the same time and have it in you to remain organized at all times.

Working with details, and handling records management work is something that you will be expected to perform each day. In addition to this, it will be your duty to make sure that you understand insurance rating systems, and how they work within the organization where you are working.

Some examples of job duties particular to the position of a claims clerk are provided below for reference purposes:

Job Description for Claims Clerk Resume

• Prepare insurance claim forms and correlating documents, and review them for completeness and accuracy.
• Enter claims information into the system, and check them to ensure that they are accurate.
• Open, sort, scan, and complete initial indexing information, and create and organize and ship out claim kits to new accounts.
• Match proper claim numbers on unidentified correspondence by using various automated systems.
• Type a variety of materials, including letters, benefit notices, and memos for medical appointments, and attorneys.
• Perform a wide range of control operator functions, and handle file retrieving activities.
• Contact insureds or other involved individuals to obtain any information that may be missing.
• Prepare and review insurance claim forms, and related documents to ensure completeness and accuracy of information.
• Provide limited instructions on how to proceed with claims, and provide referrals for repair or replacement.
• Post information to claim files, and compile data to ensure that all claim files are completed promptly.
• Review insurance policies to determine the coverage, and transmit claims for payments.
• Calculate the amount of each claim, and ensure that insurance rating systems are properly adhered to.