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O*NET-SOC 43-9041.00

Insurance Claims and Policy Processing Clerks

Process new insurance policies, modifications to existing policies, and claims forms. Obtain information from policyholders to verify the accuracy and completeness of information on claims forms, applications and related documents, and company records. Update existing policies and company records to reflect changes requested by policyholders and insurance company representatives.

From O*NET 30.3

Tasks

From O*NET 30.3, by importance, as O*NET OnLine lists them

Free · O*NET 30.3
  1. Prepare insurance claim forms or related documents, and review them for completeness.Core23313
  2. Pay small claims.Supplemental23328
  3. Calculate amount of claim.Core23314
  4. Post or attach information to claim file.Core23315
  5. Transmit claims for payment or further investigation.Core23316
  6. Contact insured or other involved persons to obtain missing information.Core23317
  7. Review insurance policy to determine coverage.Core23318
  8. Process and record new insurance policies and claims.Core23319
  9. Process, prepare, and submit business or government forms, such as submitting applications for coverage to insurance carriers.Supplemental23329
  10. Organize or work with detailed office or warehouse records, using computers to enter, access, search or retrieve data.Core23320
  11. Provide customer service, such as limited instructions on proceeding with claims or referrals to auto repair facilities or local contractors.Core23321
  12. Correspond with insured or agent to obtain information or to inform them of account status or changes.Core23322
  13. Review and verify data, such as age, name, address, and principal sum and value of property, on insurance applications and policies.Core23323
  14. Compare information from application to criteria for policy reinstatement, and approve reinstatement when criteria are met.Core23324
  15. Examine letters from policyholders or agents, original insurance applications, and other company documents to determine if changes are needed and effects of changes.Core23325
  16. Transcribe data to worksheets, and enter data into computer for use in preparing documents and adjusting accounts.Core23326
  17. Collect initial premiums and issue receipts.Supplemental23330
  18. Interview clients and take their calls to provide customer service and obtain information on claims.Supplemental23332
  19. Obtain computer printout of policy cancellations, or retrieve cancellation cards from file.Supplemental23333
  20. Compose business correspondence for supervisors, managers, and professionals.Supplemental23334
  21. Notify insurance agent and accounting department of policy cancellation.Core23327
  22. Calculate premiums, refunds, commissions, adjustments, or new reserve requirements, using insurance rate standards.23336
  23. Enter insurance- and claims-related information into database systems.23337
  24. Modify, update, or process existing policies and claims to reflect any change in beneficiary, amount of coverage, or type of insurance.23338
  25. Organize or work with detailed office or warehouse records, maintaining files for each policyholder, including policies that are to be reinstated or cancelled.23339

Technology Skills

From O*NET 30.3, 27 examples in 14 categories, 7 Hot Technology

Free · O*NET 30.3

Accounting software

  • Account management software

Data base user interface and query software

  • Alpha Software Alpha Five
  • Automated information system software
  • Claim processing system software
  • Database software
  • IBM Check Processing Control System CPSC
  • Microsoft AccessHot Technology
  • Policy issuance system software
  • St. Paul Travelers e-CARMA
  • Xactware Xactimate

Billing and invoicing software

  • Billing software

Instant messaging software

  • GroupMe

Medical software

  • Healthcare common procedure coding system HCPCS
  • Medical condition coding software
  • Medical procedure coding software

Electronic mail software

  • IBM Lotus Notes
  • MicroFocus GroupWise
  • Microsoft OutlookHot TechnologyIn Demand

Financial analysis software

  • Insurance rating software

Document management software

  • InSystems Calligo Enterprise

Spreadsheet software

  • Microsoft ExcelHot TechnologyIn Demand

Internet browser software

  • Microsoft Internet Explorer
  • Web browser software

Office suite software

  • Microsoft Office softwareHot TechnologyIn Demand

Presentation software

  • Microsoft PowerPointHot TechnologyIn Demand

Operating system software

  • Microsoft WindowsHot Technology

Word processing software

  • Microsoft WordHot TechnologyIn Demand

Detailed Work Activities

From O*NET 30.3, under their work activities; open one for the AI skills Workforce Automation maps to it

Free · O*NET 30.3

Getting Information

  • Obtain personal or financial information about customers or applicants.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet
  • Interview employees, customers, or others to collect information.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet

Estimating the Quantifiable Characteristics of Products, Events, or Information

  • Calculate financial data.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet

Processing Information

  • Check data for recording errors.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet
  • Verify accuracy of financial or transactional data.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet
  • Compile data or documentation.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet

Evaluating Information to Determine Compliance with Standards

  • Review customer insurance information.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet

Making Decisions and Solving Problems

  • Calculate costs of goods or services.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet

Working with Computers

  • Enter information into databases or software programs.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet

Documenting/Recording Information

  • Maintain operational records.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet
  • Maintain financial or account records.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet
  • Prepare documentation for contracts, transactions, or regulatory compliance.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet

Interpreting the Meaning of Information for Others

  • Explain regulations, policies, or procedures.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet

Communicating with Supervisors, Peers, or Subordinates

  • Provide information to coworkers.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet

Communicating with People Outside the Organization

  • Answer telephones to direct calls or provide information.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet
  • Discuss account status or activity with customers or patrons.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet
  • Provide notifications to customers or patrons.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet

Performing Administrative Activities

  • Prepare business correspondence.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet
  • Execute sales or other financial transactions.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet
  • Send information, materials or documentation.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet

Monitoring and Controlling Resources

  • Collect deposits, payments or fees.
    WFA · Part of the paid plan when accounts open

    WFA (Workforce Automation) analysis: 0 of 0 AI skills mapped to this activity, by automation level

    • No tools yet
    • Not mapped yet

Job Zone

From O*NET 30.3

Free · O*NET 30.3

Job Zone 1-2: Very Little to Some Preparation Needed

Workforce Automation analysis, not part of the source

WFA coverage: AI skills for this job

WFA · Part of the paid plan when accounts open

Pilot mapping: these skill links come from our seed list and haven’t been reviewed yet. Expect them to change as each one is checked.

DWAs covered by an AI skill0 of 21
Distinct tools0
Level mix
  • No tools yet

Equivalents

NICE work roles, with their DCWF equivalents

Mapped to this job by the ETO-CSET NICE/O*NET crosswalk (2024); roles from NICE Framework Components v2.2.0, DCWF equivalents from DoD DCWF Tool v5.3 (2026-09-25)

Free · NICE Framework Components v2.2.0 and DoD DCWF Tool v5.3 (2026-09-25)

No NICE work role maps to this job.