Claims Clerk reviews insurance claim forms and supporting documents for completeness and accuracy and obtains missing information as necessary. Inputs claim information into system for processing. Being a Claims Clerk verifies coverage eligibility. Calculates settlement amounts according to guidelines. Additionally, Claims Clerk processes routine claim payments. Requires a high school diploma or equivalent. Typically reports to a supervisor. The Claims Clerk works under the close direction of senior personnel in the functional area. Possesses a moderate understanding of general aspects of the job. May require 0-1 year of general work experience. (Copyright 2024 Salary.com)
Description
Position Overview:
The Policy Services Specialist position will assist with the daily workflows for incoming bind requests, endorsements, cancellations, reinstatements, new or renewal issuance and general review of correspondence received within their authority level. When deemed necessary these responsibilities could also include aiding within Customer Care and/or Training and Development in addition to any general job duties listed below.
Job Responsibilities:
· Collect data needed and organize documents and/or reports within a file to prepare it for review by underwriting and/or non-authority companies
· Review submitted documents received for J&J’s file documentation to ensure there are no changes from the original submitted documents prior to processing
· Send binding, new or renewal issuance, endorsement, cancellation and/or reinstatement requests to Non-Authority carriers for processing
· Review applications, documents, reports, etc to ensure the underwriter has properly reviewed and approved for acceptance
· Process, by means of data entry, binding, new or renewal issuance, endorsement, cancellation and/or reinstatement requests for authority carrier in various issuance systems
· Send confirmation of binding documents, including invoices if applicable, to agents
Education and Work Experience:
Knowledge Skills & Abilities:
· Ability to type 30-50 WPM
· Ability to learn various issuance/rating systems and/or new tasks when necessary quickly, efficiently and accurately
· Ability to type accurately, organize and present information in a neat and effective manner
· Ability to manage multiple tasks and exercise good judgment while paying attention to details
· Ability to handle difficult customers with confidence
· Willingness to learn and ability to take initiative by self-motivation
· Knowledge and experience with Microsoft Office Suite (word, excel, PowerPoint, outlook)
Typical Physical Demands:
· Requires the ability to sit or stand for long periods of time, occasional stooping, and reaching
· May require lifting-up to 25 pounds
· Requires normal range of vision and hearing with or without accommodations
Career Path from level I to IV:
· Determined by; confidence level and comprehension within Knowledge Skills and Abilities and Job Responsibilities, self-motivation, completed education requirements, contributions to the team and/or tenure within the role.
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