Description:
Obtain information from insured or designated persons for purpose of settling claim with insurance carrier.
Tasks
- Review insurance policy to determine coverage.
- Prepare insurance claim forms and related documents and review them for completeness.
- Provide customer service, such as limited instructions on proceeding with claims or referrals to auto repair facilities or local contractors.
- Organize and work with detailed office or warehouse records, using computers to enter, access, search and retrieve data.
- Post or attach information to claim file.
- Pay small claims.
- Transmit claims for payment or further investigation.
- Contact insured or other involved persons to obtain missing information.
- Calculate amount of claim.
- Apply insurance rating systems.
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.
- Clerical
- Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and other office procedures and 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.
- Mathematics
- Knowledge of arithmetic, algebra, geometry, calculus, statistics, and their applications.
- Computers and Electronics
- Knowledge of circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming.
- Education and Training
- Knowledge of principles and methods for curriculum and training design, teaching and instruction for individuals and groups, and the measurement of training effects.
- Administration and Management
- Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources.
- Economics and Accounting
- Knowledge of economic and accounting principles and practices, the financial markets, banking and the analysis and reporting of financial data.
- Law and Government
- Knowledge of laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the democratic political process.
- Personnel and Human Resources
- Knowledge of principles and procedures for personnel recruitment, selection, training, compensation and benefits, labor relations and negotiation, and personnel information systems.
Skills
- Reading Comprehension
- Understanding written sentences and paragraphs in work related documents.
- 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.
- Service Orientation
- Actively looking for ways to help people.
- Speaking
- Talking to others to convey information effectively.
- Writing
- Communicating effectively in writing as appropriate for the needs of the audience.
- Learning Strategies
- Selecting and using training/instructional methods and procedures appropriate for the situation when learning or teaching new things.
- Social Perceptiveness
- Being aware of others' reactions and understanding why they react as they do.
- Critical Thinking
- Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
- Active Learning
- Understanding the implications of new information for both current and future problem-solving and decision-making.
- Time Management
- Managing one's own time and the time of others.
Abilities
- Written Comprehension
- The ability to read and understand information and ideas presented in writing.
- Speech Recognition
- The ability to identify and understand the speech of another person.
- Oral Expression
- The ability to communicate information and ideas in speaking so others will understand.
- Oral Comprehension
- The ability to listen to and understand information and ideas presented through spoken words and sentences.
- Speech Clarity
- The ability to speak clearly so others can understand you.
- Near Vision
- The ability to see details at close range (within a few feet of the observer).
- Written Expression
- The ability to communicate information and ideas in writing so others will understand.
- 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).
- Deductive Reasoning
- The ability to apply general rules to specific problems to produce answers that make sense.
- Selective Attention
- The ability to concentrate on a task over a period of time without being distracted.
Work Activities
- 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.
- 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.
- Interacting With Computers
- Using computers and computer systems (including hardware and software) to program, write software, set up functions, enter data, or process information.
- Establishing and Maintaining Interpersonal Relationships
- Developing constructive and cooperative working relationships with others, and maintaining them over time.
- Communicating with Supervisors, Peers, or Subordinates
- Providing information to supervisors, co-workers, and subordinates by telephone, in written form, e-mail, or in person.
- Organizing, Planning, and Prioritizing Work
- Developing specific goals and plans to prioritize, organize, and accomplish your work.
- Documenting/Recording Information
- Entering, transcribing, recording, storing, or maintaining information in written or electronic/magnetic form.
- Performing Administrative Activities
- Performing day-to-day administrative tasks such as maintaining information files and processing paperwork.
- Identifying Objects, Actions, and Events
- Identifying information by categorizing, estimating, recognizing differences or similarities, and detecting changes in circumstances or events.
Work Context
- Telephone
- How often do you have telephone conversations in this job?
- Letters and Memos
- How often does the job require written letters and memos?
- Spend Time Sitting
- How much does this job require sitting?
- Face-to-Face Discussions
- How often do you have to have face-to-face discussions with individuals or teams in this job?
- Importance of Being Exact or Accurate
- How important is being very exact or highly accurate in performing this job?
- Contact With Others
- How much does this job require the worker to be in contact with others (face-to-face, by telephone, or otherwise) in order to perform it?
- Importance of Repeating Same Tasks
- How important is repeating the same physical activities (e.g., key entry) or mental activities (e.g., checking entries in a ledger) over and over, without stopping, to performing this job?
- Freedom to Make Decisions
- How much decision making freedom, without supervision, does the job offer?
- Electronic Mail
- How often do you use electronic mail in this job?
- Frequency of Decision Making
- How frequently is the worker required to make decisions that affect other people, the financial resources, and/or the image and reputation of the organization?
Interests
- Conventional
- Conventional occupations frequently involve following set procedures and routines. These occupations can include working with data and details more than with ideas. Usually there is a clear line of authority to follow.
- Enterprising
- Enterprising occupations frequently involve starting up and carrying out projects. These occupations can involve leading people and making many decisions. Sometimes they require risk taking and often deal with business.
- Social
- Social occupations frequently involve working with, communicating with, and teaching people. These occupations often involve helping or providing service to others.
- Investigative
- Investigative occupations frequently involve working with ideas, and require an extensive amount of thinking. These occupations can involve searching for facts and figuring out problems mentally.
- Realistic
- Realistic occupations frequently involve work activities that include practical, hands-on problems and solutions. They often deal with plants, animals, and real-world materials like wood, tools, and machinery. Many of the occupations require working outside, and do not involve a lot of paperwork or working closely with others.
- Artistic
- Artistic occupations frequently involve working with forms, designs and patterns. They often require self-expression and the work can be done without following a clear set of rules.
Work Style
- Dependability
- Job requires being reliable, responsible, and dependable, and fulfilling obligations.
- Attention to Detail
- Job requires being careful about detail and thorough in completing work tasks.
- Integrity
- Job requires being honest and ethical.
- Cooperation
- Job requires being pleasant with others on the job and displaying a good-natured, cooperative attitude.
- Adaptability/Flexibility
- Job requires being open to change (positive or negative) and to considerable variety in the workplace.
- Initiative
- Job requires a willingness to take on responsibilities and challenges.
- Stress Tolerance
- Job requires accepting criticism and dealing calmly and effectively with high stress situations.
- 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.
- Achievement/Effort
- Job requires establishing and maintaining personally challenging achievement goals and exerting effort toward mastering tasks.
Work Value
- 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.
- Working Conditions
- Occupations that satisfy this work value offer job security and good working conditions. Corresponding needs are Activity, Compensation, Independence, Security, Variety and Working Conditions.
- Achievement
- Occupations that satisfy this work value are results oriented and allow employees to use their strongest abilities, giving them a feeling of accomplishment. Corresponding needs are Ability Utilization and Achievement.
- Independence
- Occupations that satisfy this work value allow employs to work on their own and make decisions. Corresponding needs are Creativity, Responsibility and Autonomy.
- Recognition
- Occupations that satisfy this work value offer advancement, potential for leadership, and are often considered prestigious. Corresponding needs are Advancement, Authority, Recognition and Social Status.
Related Occupations
- Statement Clerks
- Billing, Cost, and Rate Clerks
- Procurement Clerks
- Credit Authorizers
- Credit Checkers
- New Accounts Clerks
- Receptionists and Information Clerks
- Insurance Policy Processing Clerks
- Office Clerks, General
Common Lay Titles
- Claim Processing Specialist
- Claim Taker
- Claims Adjudicator
- Claims Adjuster
- Claims Assistant
- Claims Clerk
- Claims Coordinator
- Claims Customer Service Representative (Claims CSR)
- Claims Examiner
- Claims Processor
- Claims Representative
- Claims Service Representative
- Claims Sorter
- Claims Technician
- Client Support Representative
- Commercial Lines Customer Service Representative (Commercial Lines CSR)
- Customer Service Representative (CSR)
- Health Insurance Claims Processor
- Insurance Claims Processor
- Insurance Customer Service Representative
- Insurance Specialist
- Medical Insurance Claims Processor
- Personal Lines Insurance Customer Service Representative (Personal Lines Insurance CSR)
- Service Specialist
- Staff Assistant
- Underwriting Clerk
- Workers' Compensation Claims Adjuster