Will “Medical Claims Processor” be Replaced By Robots? 🤔
Unknown Chance of Automation
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Process applications for, changes to, reinstatement of, and cancellation of insurance policies. Duties include reviewing insurance applications to ensure that all questions have been answered, compiling data on insurance policy changes, changing policy records to conform to insured party's specifications, compiling data on lapsed insurance policies to determine automatic reinstatement according to company policies, canceling insurance policies as requested by agents, and verifying the accuracy of insurance company records.
- The SOC (Standard Occupational Classification) code is 43-9041.02
☝️ Information based on the reference occupation “Insurance Policy Processing Clerks”.
Also Known As…
- Insurance Policy Processing Clerks
- Processing Clerk
- Premium Representative
- Insurance Analyst
- Field Secretary
- Customer Service Technician
- Associate Financial Representative
- Agency Service Representative
- Administrative Underwriter
- Account Manager
- Account Administrator
- Underwriting Assistant
- Special Certificate Dictator
- Service Representative
- Revival Clerk
- Reinsurance Clerk
- Rater Associate
- Premium Service Representative
- Policy Services Representative
- Policy Service Coordinator
- Policy Issue Clerk
- Policy Checker
- Policy Change Clerk
- Personal Lines Customer Service Representative
- Personal Lines Account Manager
- Medical Collector
- Insurance Processor
- Insurance Processing Clerk
- Insurance Examining Clerk
- Insurance Checker
- Insurance Biller
- Document Reviewer
- Document Processor
- Data Entry Operator
- Data Entry Clerk
- Customer Service Representative (CSR)
- Customer Service Representative
- Customer Service Agent
- Commercial Lines Assistant
- Commercial Customer Service Representative
- Claims Processor
- Claims Assistant
- Cancellation Clerk
- Agency Service Coordinator
Tasks for “Medical Claims Processor”
- Correspond with insured or agent to obtain information or inform them of account status or changes.
- Organize and work with detailed office or warehouse records, maintaining files for each policyholder, including policies that are to be reinstated or cancelled.
- Interview clients and take their calls to provide customer service and obtain information on claims.
- Check computations of interest accrued, premiums due, and settlement surrender on loan values.
- Collect initial premiums and issue receipts.
- Obtain computer printout of policy cancellations or retrieve cancellation cards from file.
- Calculate premiums, refunds, commissions, adjustments, and new reserve requirements, using insurance rate standards.
- Examine letters from policyholders or agents, original insurance applications, and other company documents to determine if changes are needed and effects of changes.
- Compare information from application to criteria for policy reinstatement and approve reinstatement when criteria are met.
- Notify insurance agent and accounting department of policy cancellation.
- Modify, update, and process existing policies and claims to reflect any change in beneficiary, amount of coverage, or type of insurance.
- Transcribe data to worksheets and enter data into computer for use in preparing documents and adjusting accounts.
- Compose business correspondence for supervisors, managers, and professionals.
- Process and record new insurance policies and claims.
- Review and verify data, such as age, name, address, and principal sum and value of property on insurance applications and policies.
- Process, prepare, and submit business or government forms, such as submitting applications for coverage to insurance carriers.
Related Technology & Tools
- Personal computers
- Desktop computers
- 10-key calculators
- Dictation machines
- Novell GroupWise
- Insurance rating software
- Database software
- IBM Lotus Notes
- Microsoft Access
- Healthcare common procedure coding system HCPCS
- Microsoft Internet Explorer
- InSystems Calligo Enterprise
- Medical procedure coding software
- Web browser software
- Policy issuance system software
- Word processing software
- Account management software
- Spreadsheet software
- Microsoft Excel
- Microsoft Word
- Microsoft Outlook
- Microsoft PowerPoint
- Data entry software
- Medical condition coding software
- Microsoft Office