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TITLE: Insurance Claims Clerks
DEFINITION: Obtain information from insured or designated persons for purpose of settling claim with insurance carrier.
1. Contacts insured or other involved persons for missing information.
2. Prepares and reviews insurance-claim forms and related documents for completeness.
3. Reviews insurance policy to determine coverage.
4. Posts or attaches information to claim file.
5. Transmits claims for payment or further investigation.
6. Calculates amount of claim.
Knowledge elements are ranked by importance.
Knowledge of administrative and clerical procedures and systems such as word processing systems, filing and records management systems, stenography and transcription, forms design principles, and other office procedures and terminology
Knowledge of numbers, their operations, and interrelationships including arithmetic, algebra, geometry, calculus, statistics, and their applications
54 English Language
Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar
Knowledge of transmission, broadcasting, switching, control, and operation of telecommunications systems
50 Economics and Accounting
Knowledge of economic and accounting principles and practices, the financial markets, banking, and the analysis and reporting of financial data
50 Customer and Personal Service
Knowledge of principles and processes for providing customer and personal services including needs assessment techniques, quality service standards, alternative delivery systems, and customer satisfaction evaluation techniques
38 Law, Government and Jurisprudence
Knowledge of laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the democratic political process
33 Communications and Media
Knowledge of media production, communication, and dissemination techniques and methods including alternative ways to inform and entertain via written, oral, and visual media
29 Computers and Electronics
Knowledge of electric circuit boards, processors, chips, and computer hardware and software, including applications and programming
13 Public Safety and Security
Knowledge of weaponry, public safety, and security operations, rules, regulations, precautions, prevention, and the protection of people, data, and property
Knowledge of human behavior and performance, mental processes, psychological research methods, and the assessment and treatment of behavioral and affective disorders
13 Administration and Management
Knowledge of principles and processes involved in business and organizational planning, coordination, and execution. This includes strategic planning, resource allocation, manpower modeling, leadership techniques, and production methods
Knowledge of various methods for describing the location and distribution of land, sea, and air masses including their physical locations, relationships, and characteristics
8 Therapy and Counseling
Knowledge of information and techniques needed to rehabilitate physical and mental ailments and to provide career guidance including alternative treatments, rehabilitation equipment and its proper use, and methods to evaluate treatment effects
Knowledge of principles and methods for moving people or goods by air, rail, sea, or road, including their relative costs, advantages, and limitations
4 Sociology and Anthropology
Knowledge of group behavior and dynamics, societal trends and influences, cultures, their history, migrations, ethnicity, and origins
4 Personnel and Human Resources
Knowledge of policies and practices involved in personnel/human resource functions. This includes recruitment, selection, training, and promotion regulations and procedures; compensation and benefits packages; labor relations and negotiation strategies; and personnel information systems
4 Medicine and Dentistry
Knowledge of the information and techniques needed to diagnose and treat injuries, diseases, and deformities. This includes symptoms, treatment alternatives, drug properties and interactions, and preventive health-care measures
Skills elements are ranked by importance.
Talking to others to effectively convey information
71 Information Gathering
Knowing how to find information and identifying essential information
71 Active Listening
Listening to what other people are saying and asking questions as appropriate
67 Reading Comprehension
Understanding written sentences and paragraphs in work related documents
Using mathematics to solve problems
63 Information Organization
Finding ways to structure or classify multiple pieces of information
Communicating effectively with others in writing as indicated by the needs of the audience
46 Product Inspection
Inspecting and evaluating the quality of products
42 Problem Identification
Identifying the nature of problems
Assessing how well one is doing when learning or doing something
29 Solution Appraisal
Observing and evaluating the outcomes of a problem solution to identify lessons learned or redirect efforts
25 Social Perceptiveness
Being aware of others' reactions and understanding why they react the way they do
25 Active Learning
Working with new material or information to grasp its implications
21 Critical Thinking
Using logic and analysis to identify the strengths and weaknesses of different approaches
Reorganizing information to get a better approach to problems or tasks
17 Service Orientation
Actively looking for ways to help people
13 Identification of Key Causes
Identifying the things that must be changed to achieve a goal
13 Time Management
Managing one's own time and the time of others
Adjusting actions in relation to others' actions
Bringing others together and trying to reconcile differences
Determining what is causing an operating error and deciding what to do about it
8 Learning Strategies
Using multiple approaches when learning or teaching new things
8 Operation Monitoring
Watching gauges, dials, or other indicators to make sure a machine is working properly
8 Idea Generation
Generating a number of different approaches to problems
8 Operation and Control
Controlling operations of equipment or systems
8 Judgment and Decision Making
Weighing the relative costs and benefits of a potential action
4 Equipment Selection
Determining the kind of tools and equipment needed to do a job
4 Systems Evaluation
Looking at many indicators of system performance, taking into account their accuracy
4 Idea Evaluation
Evaluating the likely success of an idea in relation to the demands of the situation
4 Implementation Planning
Developing approaches for implementing an idea
Persuading others to approach things differently
Conducting tests to determine whether equipment, software, or procedures are operating as expected
4 Identifying Downstream Consequences
Determining the long-term outcomes of a change in operations
4 Systems Perception
Determining when important changes have occurred in a system or are likely to occur .
Abilities elements are ranked by importance.
83 Number Facility
The ability to add, subtract, multiply, or divide quickly and correctly
75 Written Comprehension
The ability to read and understand information and ideas presented in writing
71 Oral Comprehension
The ability to listen to and understand information and ideas presented through spoken words and sentences
71 Near Vision
The ability to see details of objects at a close range (within a few feet of the observer)
71 Information Ordering
The ability to correctly follow a given rule or set of rules in order to arrange things or actions in a certain order. The things or actions can include numbers, letters, words, pictures, procedures, sentences, and mathematical or logical operations.
67 Oral Expression
The ability to communicate information and ideas in speaking so others will understand
67 Speech Clarity
The ability to speak clearly so that it is understandable to a listener
58 Speech Recognition
The ability to identify and understand the speech of another person
58 Written Expression
The ability to communicate information and ideas in writing so others will understand
46 Perceptual Speed
The ability to quickly and accurately compare letters, numbers, objects, pictures, or patterns. The things to be compared may be presented at the same time or one after the other. This ability also includes comparing a presented object with a remembered object
46 Selective Attention
The ability to concentrate and not be distracted while performing a task over a period of time
46 Mathematical Reasoning
The ability to understand and organize a problem and then to select a mathematical method or formula to solve the problem
42 Wrist-Finger Speed
The ability to make fast, simple, repeated movements of the fingers, hands, and wrists
42 Inductive Reasoning
The ability to combine separate pieces of information, or specific answers to problems, to form general rules or conclusions. It includes coming up with a logical explanation for why a series of seemingly unrelated events occur together.
38 Deductive Reasoning
The ability to apply general rules to specific problems to come up with logical answers. It involves deciding if an answer makes sense.
The ability to remember information such as words, numbers, pictures, and procedures
29 Speed of Closure
The ability to quickly make sense of information that seems to be without meaning or organization. It involves quickly combining and organizing different pieces of information into a meaningful pattern
29 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 there is a problem.
21 Trunk Strength
The ability to use one's abdominal and lower back muscles to support part of the body repeatedly or continuously over time without "giving out" or fatiguing
21 Extent Flexibility
The ability to bend, stretch, twist, or reach out with the body, arms, and/or legs
17 Time Sharing
The ability to efficiently shift back and forth between two or more activities or sources of information (such as speech, sounds, touch, or other sources)
17 Flexibility of Closure
The ability to identify or detect a known pattern (a figure, object, word, or sound) that is hidden in other distracting material
17 Fluency of Ideas
The ability to come up with a number of ideas about a given topic. It concerns the number of ideas produced and not the quality, correctness, or creativity of the ideas.
17 Auditory Attention
The ability to focus on a single source of auditory (hearing) information in the presence of other distracting sounds
17 Finger Dexterity
The ability to make precisely coordinated movements of the fingers of one or both hands to grasp, manipulate, or assemble very small objects
17 Manual Dexterity
The ability to quickly make coordinated movements of one hand, a hand together with its arm, or two hands to grasp, manipulate, or assemble objects
17 Category Flexibility
The ability to produce many rules so that each rule tells how to group (or combine) a set of things in a different way.
13 Far Vision
The ability to see details at a distance
The ability to come up with unusual or clever ideas about a given topic or situation, or to develop creative ways to solve a problem
8 Response Orientation
The ability to choose quickly and correctly between two or more movements in response to two or more signals (lights, sounds, pictures, etc.). It includes the speed with which the correct response is started with the hand, foot, or other body parts
8 Spatial Orientation
The ability to know one's location in relation to the environment, or to know where other objects are in relation to one's self
8 Multilimb Coordination
The ability to coordinate movements of two or more limbs together (for example, two arms, two legs, or one leg and one arm) while sitting, standing, or lying down. It does not involve performing the activities while the body is in motion
8 Hearing Sensitivity
The ability to detect or tell the difference between sounds that vary over broad ranges of pitch and loudness
8 Control Precision
The ability to quickly and repeatedly make precise adjustments in moving the controls of a machine or vehicle to exact positions
8 Arm-Hand Steadiness
The ability to keep the hand and arm steady while making an arm movement or while holding the arm and hand in one position
The ability to exert one's self physically over long periods of time without getting winded or out of breath
4 Depth Perception
The ability to judge which of several objects is closer or farther away from the observer, or to judge the distance between an object and the observer
4 Night Vision
The ability to see under low light conditions
4 Visual Color Discrimination
The ability to match or detect differences between colors, including shades of color and brightness
4 Gross Body Coordination
The ability to coordinate the movement of the arms, legs, and torso together in activities where the whole body is in motion
4 Speed of Limb Movement
The ability to quickly move the arms or legs
4 Reaction Time
The ability to quickly respond (with the hand, finger, or foot) to one signal (sound, light, picture, etc.) when it appears
The ability to imagine how something will look after it is moved around or when its parts are moved or rearranged
Work activities elements are ranked by importance.
88 Getting Information Needed to Do the Job
Observing, receiving, and otherwise obtaining information from all relevant sources.
83 Processing Information
Compiling, coding, categorizing, calculating, tabulating, auditing, verifying, or processing information or data.
83 Evaluating Information Against Standards
Evaluating information against a set of standards and verifying that it is correct.
75 Performing Administrative Activities
Approving requests, handling paperwork, and performing day-to-day administrative tasks.
75 Making Decisions and Solving Problems
Combining, evaluating, and reasoning with information and data to make decisions and solve problems. These processes involve making decisions about the relative importance of information and choosing the best solution.
75 Communicating With Persons Outside Organization
Communicating with persons outside the organization, representing the organization to customers, the public, government, and other external sources. This information can be exchanged face-to-face, in writing, or via telephone/electronic transfer.
67 Documenting or Recording Information
Entering, transcribing, recording, storing, or maintaining information in either written form or by electronic/magnetic recording.
63 Analyzing Data or Information
Identifying underlying principles, reasons, or facts by breaking down information or data into separate parts.
58 Interpreting Meaning of Information to Others
Translating or explaining what information means and how it can be understood or used to support responses or feedback to others.
58 Establishing and Maintaining Relationships
Developing constructive and cooperative working relationships with others.
54 Identifying Objects, Actions, and Events
Identifying information received by making estimates or categorizations, recognizing differences or similarities, or sensing changes in circumstances or events.
54 Interacting With Computers
Controlling computer functions by using programs, setting up functions, writing software, or otherwise communicating with computer systems.
54 Communicating With Other Workers
Providing information to supervisors, fellow workers, and subordinates. This information can be exchanged face-to-face, in writing, or via telephone/electronic transfer.
50 Performing For or Working With Public
Performing for people or dealing directly with the public, including serving persons in restaurants and stores, and receiving clients or guests.
50 Updating and Using Job-Relevant Knowledge
Keeping up-to-date technically and knowing one's own jobs' and related jobs' functions.
46 Judging Qualities of Things, Services, or People
Making judgments about or assessing the value, importance, or quality of things or people.
46 Monitor Processes, Material, or Surroundings
Monitoring and reviewing information from materials, events, or the environment, often to detect problems or to find out when things are finished.
46 Handling and Moving Objects
Using one's own hands and arms in handling, installing, forming, positioning, and moving materials, or in manipulating things, including the use of keyboards.
38 Resolving Conflict or Negotiating with Others
Handling complaints, arbitrating disputes, and resolving grievances, or otherwise negotiating with others.
33 Organizing, Planning, and Prioritizing
Developing plans to accomplish work, and prioritizing and organizing one's own work.
33 Providing Consultation and Advice to Others
Providing consultation and expert advice to management or other groups on technical, systems-related, or process related topics.
33 Assisting and Caring for Others
Providing assistance or personal care to others.
29 Coordinating Work and Activities of Others
Coordinating members of a work group to accomplish tasks.
25 Controlling Machines and Processes
Using either control mechanisms or direct physical activity to operate machines or processes (not including computers or vehicles).
25 Estimating Needed Characteristics
Estimating the Characteristics of Materials, Products, Events, or Information: Estimating sizes, distances, and quantities, or determining time, costs, resources, or materials needed to perform a work activity.
21 Performing General Physical Activities
Performing physical activities that require moving one's whole body, such as in climbing, lifting, balancing, walking, stooping, where the activities often also require considerable use of the arms and legs, such as in the physical handling of materials.
21 Monitoring and Controlling Resources
Monitoring and controlling resources and overseeing the spending of money.
21 Implementing Ideas or Programs
Conducting or carrying out work procedures and activities in accord with one's own ideas or information provided through directions/instructions for purposes of installing, modifying, preparing, delivering, constructing, integrating, finishing, or completing programs, systems, structures, or products.
13 Teaching Others
Identifying educational needs, developing formal training programs or classes, and teaching or instructing others.
13 Scheduling Work and Activities
Scheduling events, programs, activities, as well as the work of others.
13 Coaching and Developing Others
Identifying developmental needs of others and coaching or otherwise helping others to improve their knowledge or skills.
8 Selling or Influencing Others
Convincing others to buy merchandise/goods, or otherwise changing their minds or actions.
4 Inspecting Equipment, Structures, or Material
Inspecting or diagnosing equipment, structures, or materials to identify the causes of errors or other problems or defects.
4 Thinking Creatively
Originating, inventing, designing, or creating new applications, ideas, relationships, systems, or products, including artistic contributions.
4 Operating Vehicles or Equipment
Running, maneuvering, navigating, or driving vehicles or mechanized equipment, such as forklifts, passenger vehicles, aircraft, or water craft.
4 Repairing and Maintaining Electrical Equipment
Fixing, servicing, adjusting, regulating, calibrating, fine-tuning, or testing machines, devices, and equipment that operate primarily on the basis of electrical or electronic (not mechanical) principles.
4 Guiding, Directing and Motivating Subordinates
Providing guidance and direction to subordinates, including setting performance standards and monitoring subordinates.
Work context elements are ranked by frequency (F), importance (I), responsibility (R), amount of contact (C), how serious (S), objective vs. subjective (O), automation (A), extent of frustration (E), responsible for health and safety (H), likelihood of injury (L), degree of injury (D) .
96 (F) Indoors
How frequently does this job require the worker to work: Indoors
83 (F) Sitting
How much time in a usual work period does the worker spend: Sitting?
73 (I) Importance of Being Sure All Is Done
How important is it to be sure that all the details of this job are performed and everything is done completely?
73 (I) Importance of Being Exact or Accurate
How important is being very exact or highly accurate in performing this job?
64 (C) Job-Required Social Interaction
How much does this job require the worker to be in contact (face-to-face, by telephone, or otherwise) with others in order to perform it?
63 (I) Deal With External Customers
How important are interactions requiring the worker to: Deal with external customers (e.g., retail sales) or the public in general (e.g., police work)?
60 (I) Provide a Service to Others
How important are interactions requiring the worker to: Provide a service to others (e.g., customers)?
46 (F) Deal With Unpleasant or Angry People
How frequently does the worker have to deal with unpleasant, angry, or discourteous individuals as part of the job requirements?
42 (F) Frequency in Conflict Situations
How frequently do the job requirements place the worker in conflict situations?
39 (A) Degree of Automation
Indicate the level of automation of this job.
36 (O) Objective or Subjective Information
How objective or subjective is the information communicated in this job?
33 (F) Standing
How much time in a usual work period does the worker spend: Standing?
33 (F) Using Hands on Objects, Tools, Controls
How much time in a usual work period does the worker spend: Using hands to handle, control, or feel objects, tools or controls?
33 (F) Making Repetitive Motions
How much time in a usual work period does the worker spend: Making repetitive motions?
30 (I) 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?
29 (F) Walking or Running
How much time in a usual work period does the worker spend: Walking or running?
28 (S) Consequence of Error
How serious would the result usually be if the worker made a mistake that was not readily correctable?
28 (E) Frustrating Circumstances
To what extent do frustrating circumstances ("road blocks" to work that are beyond the worker's control) hinder the accomplishment of this job?
23 (I) Importance of Being Aware of New Events
How important is being constantly aware of either frequently changing events (e.g. security guard watching for shoplifters) or infrequent events (e.g. radar operator watching for tornadoes) to performing this job?
17 (I) Take a Position Opposed to Others
How important are interactions requiring the worker to: Take a position opposed to coworkers or others?
13 (F) Contaminants
How often during a usual work period is the worker exposed to the following conditions: Contaminants (pollutants, gases, dust, odors, etc.)?
13 (F) Very Hot
How often during a usual work period is the worker exposed to the following conditions: Very hot (above 90 F) or very cold (under 32 F) temperatures?
13 (F) Sounds or Noise Levels Are Distracting
How often during a usual work period is the worker exposed to the following conditions: Sounds and noise levels that are distracting and uncomfortable?
13 (I) Pace Determined by Speed of Equipment
How important is it to this job that the pace is determined by the speed of equipment or machinery? (This does not refer to keeping busy at all times on this job.)
13 (F) Bending or Twisting the Body
How much time in a usual work period does the worker spend: Bending or twisting the body?
13 (F) Kneeling, Crouching or Crawling
How much time in a usual work period does the worker spend: Kneeling, stooping, crouching or crawling?
13 (F) Outdoors
How frequently does this job require the worker to work: Outdoors
12 (R) Responsibility for Outcomes and Results
How responsible is the worker for work outcomes and results of other workers?
10 (I) Coordinate or Lead Others
How important are interactions requiring the worker to: Coordinate or lead others in accomplishing work activities (not supervision)?
8 (F) Special Uniform
How often does the worker wear: A special uniform, such as that of a commercial pilot, nurse, police officer, or military personnel?
8 (F) Hazardous Situations
How often does this job require the worker to be exposed to harardous situations? Hazardous Situations involving likely cuts, bites, stings, or minor burns
7 (I) Persuade Someone to a Course of Action
How important are interactions requiring the worker to: Persuade someone to a course of action (informally) or influence others to buy something (to sell)?
5 (L) Hazardous Situations
What is the likelihood that the worker would be injured as a result of being exposed to hazardous situations while performing this job? Hazardous Situations involving likely cuts, bites, stings, or minor burns
4 (F) Common Protective or Safety Attire
How often does the worker wear: Common protective or safety attire, such as safety shoes, glasses, gloves, hearing protection, hard-hat, or personal flotation device?
4 (F) Deal With Physically Aggressive People
How frequently does this job require the worker to deal with physical aggression of violent individuals?
4 (F) Extremely Bright or Inadequate Lighting
How often during a usual work period is the worker exposed to the following conditions: Extremely bright or inadequate lighting conditions?
4 (F) Keeping or Regaining Balance
How much time in a usual work period does the worker spend: Keeping or regaining balance?
3 (I) Supervise, Coach, Train Others
How important are interactions requiring the worker to: Supervise, coach, train, or develop other employees?
3 (D) Hazardous Situations
If injury, due to exposure to hazardous situations, were to occur while performing this job, how serious would be the likely outcome? Hazardous Situations involving likely cuts, bites, stings, or minor burns
Interest elements are ranked by occupational interest.
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 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 occupations frequently involve working with, communicating with, and teaching people. These occupations often involve helping or providing service to others.
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 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 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 values elements are ranked by extent.
63 Support-Mean Extent
Occupations that satisfy this work value offer supportive management that stands behind employees. Corresponding needs are Company Policies, Supervision: Human Relations and Supervision: Technical.
54 Relationships-Mean Extent
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.
53 Working Conditions-Mean Extent
Occupations that satisfy this work value offer job security and good working conditions. Corresponding needs are Activity, Compensation, Independence, Security, Variety and Working Conditions.
31 Achievement-Mean Extent
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.
30 Recognition-Mean Extent
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.
23 Independence-Mean Extent
Occupations that satisfy this work value allow employs to work on their own and make decisions. Corresponding needs are Creativity, Responsibility and Autonomy.
84 Moral Values
Workers on this job are never pressured to do things that go against their sense of right and wrong
75 Supervision, Human Relations
Workers on this job have supervisors who back up their workers with management
72 Working Conditions
Workers on this job have good working conditions
66 Company Policies and Practices
Workers on this job are treated fairly by the company
Workers on this job are busy all the time
Workers on this job do their work alone
Workers on this job have opportunities for advancement
Workers on this job have steady employment
Workers on this job have co-workers who are easy to get along with
47 Supervision, Technical
Workers on this job have supervisors who train their workers well
Workers on this job are paid well in comparison with other workers
31 Ability Utilization
Workers on this job make use of their individual abilities
Workers on this job get a feeling of accomplishment
28 Social Service
Workers on this job have work where they do things for other people
28 Social Status
Workers on this job are looked up to by others in their company and their community
Workers on this job make decisions on their own
Workers on this job receive recognition for the work they do
Workers on this job plan their work with little supervision
Workers on this job have something different to do every day
Workers on this job try out their own ideas
Workers on this job give directions and instructions to others
|DOT91 (Dictionary of Occupational Titles):||
241362010 Claims Clerk I
205367018 Claims Clerk II
|AIM97 (Apprenticeship Information Management):||
|CEN90 (1990 Census Occupations):||
375 Insurance Adjusters, Examiners, and Investigators
|CIP90 (Classification of Instructional Programs):||
520803 Banking and Financial Support Services
520801 Finance, General
|GOE93 (Guide for Occupational Exploration):||
070402 Oral Communications: Order, Complaint, and Claims Handling
070502 Records Processing: Record Verification and Proofing
|MOC97 (Military Occupational Codes):||
|OES98 (Occupational Employment Statistics):||
53311 Insurance Claims Clerks
|OPM97 (Office of Personnel Management Occupations):||
0998 Claims Clerical
|SOC98 (Standard Occupational Classification):||
43-9041 Insurance Claims and Policy Processing Clerks