Insurance Claims and Policy Processing Clerks
43-9041.00
Updated 2024

Process new insurance policies, modifications to existing policies, and claims forms. Obtain information from policyholders to verify the accuracy and completeness of information on claims forms, applications and related documents, and company records. Update existing policies and company records to reflect changes requested by policyholders and insurance company representatives.

Sample of reported job titles: Claims Adjudicator, Claims Analyst, Claims Clerk, Claims Customer Service Representative (Claims CSR), Claims Processor, Claims Representative (Claims Rep), Claims Technician (Claims Tech), Insurance Analyst, Policy Analyst, Underwriting Assistant

Occupation-Specific Information

Tasks

  • Prepare insurance claim forms or related documents, and review them for completeness.
  • Calculate amount of claim.
  • Post or attach information to claim file.
  • Transmit claims for payment or further investigation.
  • Contact insured or other involved persons to obtain missing information.
  • Review insurance policy to determine coverage.
  • Process and record new insurance policies and claims.
  • Organize or work with detailed office or warehouse records, using computers to enter, access, search or retrieve data.
  • Provide customer service, such as limited instructions on proceeding with claims or referrals to auto repair facilities or local contractors.
  • Correspond with insured or agent to obtain information or to inform them of account status or changes.
  • Review and verify data, such as age, name, address, and principal sum and value of property, on insurance applications and policies.
  • Compare information from application to criteria for policy reinstatement, and approve reinstatement when criteria are met.
  • Examine letters from policyholders or agents, original insurance applications, and other company documents to determine if changes are needed and effects of changes.
  • Transcribe data to worksheets, and enter data into computer for use in preparing documents and adjusting accounts.
  • Notify insurance agent and accounting department of policy cancellation.
  • Pay small claims.
  • Process, prepare, and submit business or government forms, such as submitting applications for coverage to insurance carriers.
  • Collect initial premiums and issue receipts.
  • Interview clients and take their calls to provide customer service and obtain information on claims.
  • Obtain computer printout of policy cancellations, or retrieve cancellation cards from file.
  • Compose business correspondence for supervisors, managers, and professionals.
  • Calculate premiums, refunds, commissions, adjustments, or new reserve requirements, using insurance rate standards.
  • Enter insurance- and claims-related information into database systems.
  • Modify, update, or process existing policies and claims to reflect any change in beneficiary, amount of coverage, or type of insurance.
  • Organize or work with detailed office or warehouse records, maintaining files for each policyholder, including policies that are to be reinstated or cancelled.
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Technology Skills

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In demand
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Occupational Requirements

Work Activities

  • Working with Computers — Using computers and computer systems (including hardware and software) to program, write software, set up functions, enter data, or process information.
  • Getting Information — Observing, receiving, and otherwise obtaining information from all relevant sources.
  • Processing Information — Compiling, coding, categorizing, calculating, tabulating, auditing, or verifying information or data.
  • Communicating with Supervisors, Peers, or Subordinates — Providing information to supervisors, co-workers, and subordinates by telephone, in written form, e-mail, or in person.
  • Documenting/Recording Information — Entering, transcribing, recording, storing, or maintaining information in written or electronic/magnetic form.
  • Evaluating Information to Determine Compliance with Standards — Using relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards.
  • Communicating with People Outside the Organization — Communicating with people outside the organization, representing the organization to customers, the public, government, and other external sources. This information can be exchanged in person, in writing, or by telephone or e-mail.
  • Establishing and Maintaining Interpersonal Relationships — Developing constructive and cooperative working relationships with others, and maintaining them over time.
  • Making Decisions and Solving Problems — Analyzing information and evaluating results to choose the best solution and solve problems.
  • Updating and Using Relevant Knowledge — Keeping up-to-date technically and applying new knowledge to your job.
  • Performing Administrative Activities — Performing day-to-day administrative tasks such as maintaining information files and processing paperwork.
  • Organizing, Planning, and Prioritizing Work — Developing specific goals and plans to prioritize, organize, and accomplish your work.
  • Identifying Objects, Actions, and Events — Identifying information by categorizing, estimating, recognizing differences or similarities, and detecting changes in circumstances or events.
  • Interpreting the Meaning of Information for Others — Translating or explaining what information means and how it can be used.
  • Monitoring Processes, Materials, or Surroundings — Monitoring and reviewing information from materials, events, or the environment, to detect or assess problems.
  • Analyzing Data or Information — Identifying the underlying principles, reasons, or facts of information by breaking down information or data into separate parts.

Detailed Work Activities

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Work Context

Experience Requirements

Job Zone

Title
Job Zone Two: Some Preparation Needed
Education
These occupations usually require a high school diploma.
Related Experience
Some previous work-related skill, knowledge, or experience is usually needed. For example, a teller would benefit from experience working directly with the public.
Job Training
Employees in these occupations need anywhere from a few months to one year of working with experienced employees. A recognized apprenticeship program may be associated with these occupations.
Job Zone Examples
These occupations often involve using your knowledge and skills to help others. Examples include orderlies, counter and rental clerks, customer service representatives, security guards, upholsterers, tellers, and dental laboratory technicians.
SVP Range
(4.0 to < 6.0)

Training & Credentials

State training
Local training
Certifications
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State licenses

Apprenticeship Opportunities

Example apprenticeship titles for this occupation:

  • General Insurance Associate

Specific title(s) listed above are vetted by industry and approved by the U.S. Department of Labor for use in a Registered Apprenticeship Program.

Start your career and build your skillset. Visit Apprenticeship.gov to learn about opportunities related to this occupation.

Worker Requirements

Skills

  • Reading Comprehension — Understanding written sentences and paragraphs in work-related documents.
  • Time Management — Managing one's own time and the time of others.
  • Speaking — Talking to others to convey information effectively.
  • Active Listening — Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
  • Critical Thinking — Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.
  • Coordination — Adjusting actions in relation to others' actions.
  • Service Orientation — Actively looking for ways to help people.
  • Social Perceptiveness — Being aware of others' reactions and understanding why they react as they do.
  • Writing — Communicating effectively in writing as appropriate for the needs of the audience.
  • Complex Problem Solving — Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
  • Judgment and Decision Making — Considering the relative costs and benefits of potential actions to choose the most appropriate one.
  • Monitoring — Monitoring/Assessing performance of yourself, other individuals, or organizations to make improvements or take corrective action.

Knowledge

  • Customer and Personal Service — Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
  • Administrative — Knowledge of administrative and office procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and workplace terminology.
  • English Language — Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
  • Computers and Electronics — Knowledge of circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming.

Education

How much education does a new hire need to perform a job in this occupation? Respondents said:

  • 55%
     
    High school diploma or equivalent required
  • 21%
     
    Associate’s degree required
  • 9%
     
    Some college, no degree required

Worker Characteristics

Abilities

  • Oral Comprehension — The ability to listen to and understand information and ideas presented through spoken words and sentences.
  • Written Comprehension — The ability to read and understand information and ideas presented in writing.
  • Near Vision — The ability to see details at close range (within a few feet of the observer).
  • Oral Expression — The ability to communicate information and ideas in speaking so others will understand.
  • Speech Clarity — The ability to speak clearly so others can understand you.
  • Speech Recognition — The ability to identify and understand the speech of another person.
  • Deductive Reasoning — The ability to apply general rules to specific problems to produce answers that make sense.
  • Information Ordering — The ability to arrange things or actions in a certain order or pattern according to a specific rule or set of rules (e.g., patterns of numbers, letters, words, pictures, mathematical operations).
  • Written Expression — The ability to communicate information and ideas in writing so others will understand.
  • Problem Sensitivity — The ability to tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing that there is a problem.
  • Category Flexibility — The ability to generate or use different sets of rules for combining or grouping things in different ways.
  • Inductive Reasoning — The ability to combine pieces of information to form general rules or conclusions (includes finding a relationship among seemingly unrelated events).

Interests

Interest code: CE
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  • Conventional — Work involves following procedures and regulations to organize information or data, typically in a business setting. Conventional occupations are often associated with office work, accounting, mathematics/statistics, information technology, finance, or human resources.
  • Enterprising — Work involves managing, negotiating, marketing, or selling, typically in a business setting, or leading or advising people in political and legal situations. Enterprising occupations are often associated with business initiatives, sales, marketing/advertising, finance, management/administration, professional advising, public speaking, politics, or law.

Work Values

  • Relationships — Occupations that satisfy this work value allow employees to provide service to others and work with co-workers in a friendly non-competitive environment. Corresponding needs are Co-workers, Moral Values and Social Service.
  • Support — Occupations that satisfy this work value offer supportive management that stands behind employees. Corresponding needs are Company Policies, Supervision: Human Relations and Supervision: Technical.
  • Independence — Occupations that satisfy this work value allow employees to work on their own and make decisions. Corresponding needs are Creativity, Responsibility and Autonomy.

Work Styles

  • Attention to Detail — Job requires being careful about detail and thorough in completing work tasks.
  • Dependability — Job requires being reliable, responsible, and dependable, and fulfilling obligations.
  • Integrity — Job requires being honest and ethical.
  • Cooperation — Job requires being pleasant with others on the job and displaying a good-natured, cooperative attitude.
  • Self-Control — Job requires maintaining composure, keeping emotions in check, controlling anger, and avoiding aggressive behavior, even in very difficult situations.
  • Concern for Others — Job requires being sensitive to others' needs and feelings and being understanding and helpful on the job.
  • Independence — Job requires developing one's own ways of doing things, guiding oneself with little or no supervision, and depending on oneself to get things done.
  • Stress Tolerance — Job requires accepting criticism and dealing calmly and effectively with high-stress situations.
  • Initiative — Job requires a willingness to take on responsibilities and challenges.
  • Achievement/Effort — Job requires establishing and maintaining personally challenging achievement goals and exerting effort toward mastering tasks.
  • Adaptability/Flexibility — Job requires being open to change (positive or negative) and to considerable variety in the workplace.
  • Persistence — Job requires persistence in the face of obstacles.
  • Analytical Thinking — Job requires analyzing information and using logic to address work-related issues and problems.
  • Social Orientation — Job requires preferring to work with others rather than alone, and being personally connected with others on the job.

Workforce Characteristics

Wages & Employment Trends

Median wages (2023)
$22.55 hourly, $46,900 annual
State wages
Local wages
Employment (2023)
271,800 employees
Projected growth (2023-2033)
Decline (-1% or lower)
Projected job openings (2023-2033)
22,300
State trends
Top industries (2023)

Source: Bureau of Labor Statistics 2023 wage data and 2023-2033 employment projections . “Projected growth” represents the estimated change in total employment over the projections period (2023-2033). “Projected job openings” represent openings due to growth and replacement.

Job Openings on the Web

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More Information

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