Claims Processing Clerk, Sr. jobs in the United States

Claims Processing Clerk, Sr. receives and inputs new healthcare claims, processes payments, conducts billing research, and responds to telephone inquires. Evaluates claims and administers payment, denies, or returns claims according to policy provisions and organizational guidelines. Being a Claims Processing Clerk, Sr. produces routine and ad hoc reports. Requires a high school diploma. Additionally, Claims Processing Clerk, Sr. typically reports to a supervisor. The Claims Processing Clerk, Sr. works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. To be a Claims Processing Clerk, Sr. typically requires 3-5 years of related experience. (Copyright 2024 Salary.com)

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Casualty Claims Processing Clerk
  • MMG Insurance
  • Presque Isle, ME FULL_TIME
  • MMG INSURANCE COMPANY

    Job Description

    Job Title:              Claims Processing Clerk

    Department:         Casualty Claims

    Reports To:          Manager

    FLSA Status:       Non-Exempt        

    SUMMARY

    Supports Claims staff by performing clerical functions such as indexing, keying payments and notices; updating and maintaining loss notices, and related documentation.

    ESSENTIAL DUTIES AND RESPONSIBILITIES

    • Calls or writes insureds, agents or other involved persons for missing information and posts or attaches information to claims' files or other related or similar files.
    • Reviews insurance claim forms and related documents to verify completion.
    • Reviews insurance policies to verify basic coverage information.
    • Keys authorized claims' payments.
    • Processes towing claims, agency drafts; keys and routes Claims’ Reports to Underwriting (CRUs).
    •  Keys and/or types transcriptions of recorded text.
    • Files documents in paper files, organizing, updating and maintaining overall central filing system.
    • Maintains resource materials (i.e., Property/Casualty Loss Research Bureau; Maine, New Hampshire and Vermont Insurance Law, Regulations and Related Laws, etc.) by inserting updates on a weekly basis.
    • Codes and keys losses.
    • Reviews drafts to verify completion.
    • Faxes, photocopies, retrieves, separates, sorts, matches and distributes mail within Imaging system.
    • Obtains information from various sources at the request of adjusters.
    • Sends and receives Customer Surveys.
    • Maintains spreadsheets with data results.
    • Travels to fulfill educational requirements. (May include overnight stays.)
    • Other duties may be assigned.

    SUPERVISORY RESPONSIBILITIES

    This job has no supervisory responsibilities.

    QUALIFICATIONS 

    To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

    EDUCATION and/or EXPERIENCE

    Associate's degree; or equivalent combination of education and experience.

    LANGUAGE SKILLS

    Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings; Writes clearly and informatively; Edits work for spelling and grammar; Able to read and to interpret written information.

    MATHEMATICAL SKILLS

    Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions and decimals.  Ability to compute rate, ratio and percent.

    REASONING ABILITY

    Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem-solving situations; Uses reason even when dealing with emotional topics.

    COMPUTER SKILLS

    To perform this job successfully, an individual should have knowledge of Office Productivity software such as Spreadsheet, Word Processing, and Communication software, and claims-related processing software.

    CERTIFICATES, LICENSES, REGISTRATIONS

    The Company may require the employee to acquire, within a reasonable period of time as established by the Company, adjusters’ licenses in all states in which the Company does business.

    The Company may expect the employee to acquire the Associate in Insurance Claims (AIC) designation sponsored by the Insurance Institute of America.

    The Company may expect the employee to take other courses it deems appropriate to the employee's duties and responsibilities.

    OTHER SKILLS AND ABILITIES

    • Possesses above-average telephone skills.
    • Possesses good interpersonal, relationship skills.
    • Must possess good typing, keyboarding, word processing speed and accuracy.
    • Possesses familiarity with one or more Dictaphone machines and possesses good transcription skills.  
    • Customer Service – Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to request for service and assistance; Meets commitments.
    • Professionalism – Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
    • Demonstrates the ability to consistently maintain a positive attitude.
    • Works cooperatively and productively with employees.

    OTHER QUALIFICATIONS

    Teamwork – Balances team and individual responsibilities; Exhibits objectivity and openness to others’ views; Gives and welcomes feedback; Contributes to building a positive team spirit.

    Demonstrates an aptitude consistent with securing information, analyzing it, and making above-average decisions affecting the position's area of responsibility.

    Judgment – Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.

    PHYSICAL DEMANDS  

    The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

    While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear.  The employee is occasionally required to stand; walk; reach with hands and arms.      The employee must occasionally lift and/or move up to 10 pounds.  Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus.

    WORK ENVIRONMENT 

    The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

    While performing the duties of this job, the employee is occasionally exposed to outside weather conditions.  The noise level in the work environment is usually quiet.

     

  • 22 Days Ago

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Claims Processing Clerk
  • Praesum Healthcare
  • Worth, FL FULL_TIME
  • Praesum Healthcare: Position Title: Claims Processing Clerk Founded in 2003, Praesum Healthcare provides administrative services for healthcare providers in key geographical locations throughout the N...
  • 16 Days Ago

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Processing Clerk II
  • Clerk of the Circuit Court and County Comptroller
  • Sarasota, FL FULL_TIME
  • Join the Team We are seeking motivated candidates to perform a complete range of essential administrative duties for the Court Processing division. The ideal candidate requires diligence for analytica...
  • 13 Days Ago

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Document Processing Clerk I
  • Seminole County Clerk of the Circuit Court and...
  • Sanford, FL FULL_TIME
  • JOB Under the direction of the Document Processing Team Leader, the Deputy Clerk I is responsible for scanning documents into the system for input, verifying court documents, processing follow up work...
  • 1 Month Ago

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Associate Inventory Clerk - Claims Processing
  • Providence
  • Mission Hills, CA OTHER
  • DescriptionAssociate Inventory Clerk - Claims Processing$1,000 Hiring Bonus for eligible external candidates who meet all conditions for payment - this is in addition to the fantastic benefits and com...
  • 24 Days Ago

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Store Clerk
  • Trenton Processing
  • Trenton, IL FULL_TIME
  • About the Role: Trenton Processing is seeking a Store Clerk to join our team in Trenton, IL. As a Store Clerk, you will play a crucial role in providing excellent customer service and maintaining the ...
  • 19 Days Ago

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Judicial Law Clerk to Judge Michael P. Allen
  • U.S. Courts
  • Washington, DC
  • Summary The U.S. Court of Appeals for Veterans Claims has exclusive jurisdiction over decisions of the Board of Veterans...
  • 3/28/2024 12:00:00 AM

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Life Insurance Agent
  • Barnes Agency
  • Leesburg, VA
  • Job Title: Life Insurance Agent Company Overview: Join our dynamic and rapidly growing team at the Barnes Family Agency,...
  • 3/28/2024 12:00:00 AM

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Remote Insurance Agent
  • Dorr Agency
  • Great Falls, VA
  • Looking for your last career stop? Interested in an industry change? Seeking work-life balance? The Dorr Agency is seeki...
  • 3/28/2024 12:00:00 AM

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Sr. Manager, Sales Compensation Design (remote)
  • Quest Diagnostics
  • Chantilly, VA
  • Overview: The Senior Manager, Sales Compensation Design will work as an advisor to leaders to design pay plans that are ...
  • 3/28/2024 12:00:00 AM

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Senior Manager Government Affairs
  • Nissan Motor Co., Ltd.
  • Sterling, VA
  • Life at Nissan encompasses everything that inspires both the quality of our vehicles and the quality of our people. Comp...
  • 3/27/2024 12:00:00 AM

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Entry Level Insurance Sales Agent
  • Bankers Life
  • Chantilly, VA
  • Bankers Life® seeks professionals for a dynamic hybrid remote work environment. Start your insurance agent career and ea...
  • 3/27/2024 12:00:00 AM

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Director of Clinical Placement and Compliance
  • George Washington University
  • Ashburn, VA
  • I. JOB OVERVIEW Job Description Summary: The GW School of Nursing (GW Nursing) prepares nurse leaders, providers, and sc...
  • 3/25/2024 12:00:00 AM

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Director of Compliance
  • gategroup
  • Reston, VA
  • About us Gate Gourmet, a gategroup company, is the world's largest independent provider of catering and provisioning ser...
  • 3/24/2024 12:00:00 AM

Income Estimation for Claims Processing Clerk, Sr. jobs
$47,914 to $59,100