Claims Processor Job Description Template

The Claims Processor is responsible for reviewing, processing and maintaining insurance claims. This includes verifying claim information, investigating and resolving discrepancies, and authorizing payments. The role also entails updating records, preparing reports, and providing customer service. To be successful in this role, one must have excellent attention to detail, strong organizational skills, and the ability to multitask.

Claims Processor Job Responsibilities

  • Receive and review insurance claims
  • Determine if claims are valid
  • Calculate reimbursement amount
  • Issue payments
  • Maintain records of claims processed

Objectives

  • To process insurance claims in an accurate and timely manner.
  • To work with insurance carriers to ensure that claims are paid promptly and correctly.
  • To maintain detailed records of all claims processed.
  • To investigate and resolve any discrepancies on claims.
  • To provide excellent customer service to policyholders filing claims.

Claims Processor Job Skills & Qualifications Needed

  • Some claims processors may require certification, but in most cases, claims processors need only have a high school diploma or equivalent. Many claims processing positions are entrylevel jobs, and on-the-job training is typically provided. Claims processors should be detail oriented and able to work independently. They must also have strong computer skills, as they will be using computers to process claims.