Insurance claims processing clerks work with insurance agencies to assist with the paperwork in a claims department. They review claims forms and determine the accuracy of the information before submitting a claim. They work with computers and make phone calls to customers and businesses.
When you’re in the beginning stages of writing your insurance claims processing clerk job description, you’ll need to review common qualifications for this job. Most individuals in this role have at least a high school diploma. Some companies require their clerks to have a college degree in a related field.
Then, you’ll need to review some of the other essential skills for the job. Insurance claims processing clerks must be highly organized and efficient. They must also be able to meet deadlines and have excellent attention to detail. Take a look at the insurance claims processing clerk job description template below to get more ideas.
Insurance Claims Processing Clerk Job Summary
Looking for a challenging work environment where you can help patients access top-quality health care? Our organization is seeking a highly accurate and hard working insurance claims processing clerk to join our claims department. In this role, you would be working to get patients’ paperwork through our system more efficiently, and you would be checking for claim form completion and submitting forms for final approval to help patients get timely coverage for needed health treatments. You could make a difference in people’s lives by ensuring they get access to covered services and improving wait time for insurance coverage approval. As an insurance claims processing clerk, your top attention to detail and your organizational skills could make an impact on the lives of others.
- Check over insurance claims forms as they are submitted and review each section for accuracy and completeness
- Confirm that the patient and the treatment or prescription are covered parts of the insurance plan by researching the plan details using a computerized database or calling the physician’s office
- Submit each insurance claim after verification for final processing via an electronic submittal form system and review the reception of the claim with a final check
- Interpret the language in the overview of benefits summary explanation for the insurance policy and apply interpretation to the claims review process
- Update policy forms and claims information when insurance coverage changes have occurred and notify appropriate parties of the changes when necessary
- Maintain knowledge of all appropriate medical insurance coverage laws in the local, state and federal jurisdiction area when reviewing claims submissions
- Follow all required medical privacy laws when discussing private information about patients with physicians, healthcare managers or other staff members in the insurance agency
Job Skills & Qualifications
- High school diploma
- One to two years of experience working in claims processing
- Knowledge of the health insurance industry
- Experience working with a high-volume phone system
- Bachelor’s degree in finance, accounting or a related field
- Excellent customer service skills
- Proficiency in Microsoft Office
Finding the right person to hire for your insurance claims processing clerk job opening starts with a strong job description. Next, you’ll need to find an effective way of advertising your job listing online.
Potential candidates for the role may not necessarily be seeking your company out, so you have to essentially find them instead. That means other methods of advertising job postings, such as through industry web pages, on your company website or via your social media account, may not be as impactful to the average job searcher. Instead, you’ll need to take your insurance claims processing clerk job description to the masses by using a tool such as MightyRecruiter to post to free job boards. This way, you’ll be able to advertise though hundreds of avenues instantly.
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