Will “Medical Claims Processor” be Replaced By Robots? 🤔

Unknown Chance of Automation

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Job Description

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.

Job Details

The SOC (Standard Occupational Classification) code is 43-9041.02

☝️ Information based on the reference occupation “Insurance Policy Processing Clerks”.

Also Known As…

Tasks for “Medical Claims Processor”

Transcribe data to worksheets and enter data into computer for use in preparing documents and adjusting accounts.
Calculate premiums, refunds, commissions, adjustments, and new reserve requirements, using insurance rate standards.
Process, prepare, and submit business or government forms, such as submitting applications for coverage to insurance carriers.
Process and record new insurance policies and claims.
Correspond with insured or agent to obtain information or inform them of account status or changes.
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.
Interview clients and take their calls to provide customer service and obtain information on claims.
Notify insurance agent and accounting department of policy cancellation.
Review and verify data, such as age, name, address, and principal sum and value of property on insurance applications and policies.
Compose business correspondence for supervisors, managers, and professionals.
Compare information from application to criteria for policy reinstatement and approve reinstatement when criteria are met.
Organize and work with detailed office or warehouse records, maintaining files for each policyholder, including policies that are to be reinstated or cancelled.
Modify, update, and process existing policies and claims to reflect any change in beneficiary, amount of coverage, or type of insurance.
Examine letters from policyholders or agents, original insurance applications, and other company documents to determine if changes are needed and effects of changes.

Related Technology & Tools

Personal computers
Desktop computers
Dictation machines
10-key calculators

Spreadsheet software
Word processing software
Insurance rating software
Microsoft Office
Medical condition coding software
Healthcare common procedure coding system HCPCS
Medical procedure coding software
Data entry software
Web browser software
Microsoft Excel
InSystems Calligo Enterprise
Microsoft Internet Explorer
Account management software
Policy issuance system software
Microsoft Outlook
Microsoft Access
IBM Lotus Notes
Microsoft PowerPoint
Microsoft Word
Novell GroupWise
Database software