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Claims Processor Job Description Template
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Claims Processor Job Description Template

Job Description Template

Claims Processor Job Description Template

March 2, 2023

Claims Processor Job Description Template

You will never have to waste time looking for new team members again! Our mission is to help you accelerate and enjoy the hiring process by providing you with the necessary resources and guidance throughout. If you seek a Claims Processor to hire, the primary thing you need is this FREE Claims Processor Job Description Template!

Familiarize yourself with the most essential skills, responsibilities, and requirements of a Claims Processor – they will help you distinguish the perfect candidate for your business!

This job description can be completely customized according to your special standards or demands.

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What is a Claims Processor?

Claims Processors are responsible for handling, reviewing, and processing insurance claims from clients.

They determine if submitted claims are accurate and eligible for financial compensation and coverage.

Claims Processors communicate with clients to collect and verify their information, determine the validity of claims, calculate amounts of compensation, coverage limits, and exclusions, and correct claims mistakes and discrepancies.

They also provide guidance and assistance to clients, address their complaints and inquiries, and schedule appointments.

Related Job Titles for Claims Processor

The Top Claims Processor Skills

Skill Why it's important
Communication The Claims Processor position requires strong verbal and written communication. Effective communication is essential for successful collaboration with coworkers, as well as building relationships and providing the necessary information, assistance, support, and explanations to clients. Claims Processors must answer questions accurately and convey important information.
Attention To Detail Claims Processors must be detail-oriented to ensure the accuracy of their work. Since their job involves handling a lot of paperwork and confidential information, they must be able to review, spot, and correct any error or discrepancy in terms of names, amounts, or dates. Attention to detail helps them be precise and responsible.
Mathematical Skills Solid mathematical skills are crucial for Claims Processors. They must be skilled in basic mathematical operations and calculations since their job entails managing and handling strict financial details. They would use calculations and estimations to determine damages, money compensations, coverage, etc.
Problem-Solving The ability to identify and resolve problems in the workplace is primary for Claims Processors. Problem-solving helps Claims Processors address and find solutions to complex issues and problems as quickly as possible. Claims Processors can speed up problem-solving processes by communicating with others and seeking advice.
Organization Excellent organizational skills are a must for Claims Processors. This skill is essential because Claims Processors handle and maintain huge amounts of paperwork and files daily. The organization helps them keep track of documentation and client information and find files, reports, or forms quickly.

Claims Processor Job Description Template (Free)

Our company is looking for an organized and detail-oriented Claims Processor. In this position, you will be responsible for processing, reviewing, and verifying insurance claims and applications. Your job will be to determine if they are correct, accurate, and eligible for compensation and coverage. You will communicate with clients to collect their information and prepare and maintain claim submissions and records in paper and digital forms.

Additionally, you will perform administrative duties, such as answering phones and scheduling appointments and provide assistance and guidance to clients regarding claims forms. You will also discover and resolve mistakes and discrepancies in documentation and process payments to clients.

As a Claims Processor, you should have outstanding verbal and written communication, problem-solving, attention to detail, organization, computer, and mathematical skills.

Claims Processor Duties & Responsibilities:

  • Process and review insurance claims and applications to determine if they are eligible
  • Communicate with clients to gather and verify pertinent information about their claims
  • Assess damages and calculate amounts of compensation, coverage limits, exclusions, etc
  • Determine the validity of claims based on policy provisions and state and federal laws
  • Record, prepare, and maintain claims forms, reports, submissions, and other documentation in database systems and paper forms
  • Ensure the necessary insurance paperwork is complete and accurate
  • Provide guidance and assistance to clients by answering questions, helping them file claims, etc
  • Perform administrative tasks, such as answering phone calls and emails and scheduling appointments
  • Identify and resolve mistakes and discrepancies in claims, such as incorrect dates, names, amounts, etc
  • Apply insurance rating systems to clients’ insurance policies and process payments
  • Notify insurance agents or other responsible parties of policy cancellations and other changes

Claims Processor Requirements:

  • Bachelor’s degree in economics, finance, accounting, business, or a related field
  • Experience as a Claims Processor or a similar position in the insurance industry
  • Solid knowledge of the insurance industry, practices, laws, and regulations
  • Strong computer literacy (MS Office)
  • Great mathematical and numerical skills
  • Excellent administrative and organizational skills
  • Outstanding verbal and written communication
  • Effective problem-solving
  • Keen attention to detail

Accounting Specialist Interview Questrions

Sample Interview Questions for a Claims Processor

Once you gather up all the received applications, you can use these sample interview questions for Claims Processor.

Personal
  1. What adjectives describe you the best?
  2. What attracted you to work in the insurance field?
  3. Is there any bad habit that you would like to change in the future?
Human Resources
  1. Could you tell us about your first employment as a Claims Processor?
  2. What makes you more suitable and qualified for this position than other applicants?
  3. Do you have any questions about the company or job so far?
Management
  1. How do you remain organized as a Claims Processor?
  2. How would you rate your multitasking skills?
  3. What do you find the most challenging part of being a Claims Processor?
Technical Skills and Knowledge
  1. How familiar are you with state and federal laws and regulations regarding the insurance industry?
  2. What is your typical process of assessing and reviewing a claim?
  3. What would you do if you had a claim that you don’t know how to process?

What are the Educational Requirements for a Claims Processor?

A Bachelor’s degree in finance, economics, business, accounting, or a related field is a typical requirement for Claims Processors.

A small number of employers would hire candidates with a high school diploma or GED if they possessed a relevant set of skills and basic knowledge and then provide on-the-job training.

On certain occasions, candidates with previous working experience would also receive on-the-job training to learn about the company’s policies, computer systems, and ways how to handle clients.

How Much to Pay a Claims Processor when Hiring

Claims Processors earn between $23,500 and $47,000 per year.

The median annual salary is $36,341.

Hourly wages range from $12 to $23.

The median hourly wage is $17.

Percentile 10% 25% 50%
(Median)		 75% 90%
Hourly Wage $12 $15 $17 $19 $23
Annual Wage $23,500 $31,000 $36,341 $39,500 $47,000

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Frequently Asked Questions about Claims Processor

 

What do Claims Processors do?

Claims Processors process, review, and verify insurance claims and determine if they are eligible for compensation and coverage.

They calculate amounts of compensation, collect information from clients, maintain claims forms and records, and provide assistance and guidance to clients.

In what type of insurance companies can Claims Processors work?

There are different insurance companies that provide employment for Claims Processors, such as:

Who do Claims Processors report to?

Claims Processors usually report to the Claims Manager.

What are the crucial skills for Claims Processors?

Claims Processors must have exceptional verbal and written communication, computer literacy, attention to detail, organization, problem-solving, and mathematical skills.

Similar Job Descriptions as Claims Processor

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