Standard Occupational Classification (SOC): Insurance Claims and Policy Processing Clerks

Insurance claims and policy processing clerks in healthcare are responsible for processing and maintaining healthcare insurance claims and policies. They may work for insurance companies, healthcare providers, or government agencies.

Their duties may include reviewing and verifying insurance coverage, determining the appropriate level of coverage, and processing claims and policy changes. They may also be responsible for communicating with patients, healthcare providers, and insurance companies to obtain the necessary information to process claims and policies. They may also be involved in maintaining and updating electronic databases, and in preparing and submitting claims to insurance companies.

They may also be responsible for ensuring that claims and policies are processed in a timely and accurate manner, and for resolving any issues that may arise. They may also work with other healthcare professionals to ensure that claims and policies are in compliance with state and federal regulations. They may also be involved in developing and implementing policies and procedures related to insurance claims and policy processing. Additionally, they may be responsible for answering customer inquiries, communicating with the insurance carrier to resolve claims, and ensuring compliance with insurance regulations.