6 hard skills or competencies (industry competencies) for Claims Clerk I
Skill definition-Applying knowledge of the insurance industry to provide risk management services and protection to various individuals from financial loss.
Level 1 Behaviors
(General Familiarity)
Explains the policy conditions of various insurance contracts and products.
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Level 2 Behaviors
(Light Experience)
Provides prompt responses to clients’ insurance-related questions and concerns.
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Level 3 Behaviors
(Moderate Experience)
Utilizes various tools and technologies to optimize insurance claims turnaround cycles.
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Level 4 Behaviors
(Extensive Experience)
Provides recommendations for improving methods and procedures to enhance insurance claims handling.
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Level 5 Behaviors
(Mastery)
Leads the deployment of strategic approaches to address complex insurance risk management programs.
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Skill definition-Creating, executing, and adhering to state and federal laws governing insurance operations to ensure financial security and consumer protection.
Level 1 Behaviors
(General Familiarity)
Discusses the importance of insurance regulations in protecting clients' financial security and assets.
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Level 2 Behaviors
(Light Experience)
Gathers and interprets policy contracts to understand insurance legal and regulatory standards.
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Level 3 Behaviors
(Moderate Experience)
Maintains financial and market regulation to validate insurance's accounting methods and procedures.
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Level 4 Behaviors
(Extensive Experience)
Sets guidelines to promote fairness and transparency in financial markets in providing insurance products.
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Level 5 Behaviors
(Mastery)
Develops compliance and risk management standards to manage overall insurance legal and regulatory environment.
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2 general skills or competencies (Job family competencies) for Claims Clerk I
Skill definition-Transcribing information into an electronic medium such as a computer or other electronic device.
Level 1 Behaviors
(General Familiarity)
Explains codes and instructions in performing data entry.
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Level 2 Behaviors
(Light Experience)
Conducts basic data entry tasks to ensure information accuracy and completion.
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Level 3 Behaviors
(Moderate Experience)
Uses various technologies in performing data entry transactions to improve the overall efficiency.
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Level 4 Behaviors
(Extensive Experience)
Facilitates timely entry of data into the system to correct data incompatibilities.
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Level 5 Behaviors
(Mastery)
Establishes data entry systems to detect data errors and initiate corrective action plans.
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Skill definition-Completing transfer of funds from the transaction to the merchant's account.
Level 1 Behaviors
(General Familiarity)
Explains the essential payment processing terms to clients and the staff.
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Level 2 Behaviors
(Light Experience)
Receives invoices from vendors for payment processing.
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Level 3 Behaviors
(Moderate Experience)
Reviews the transactions through the relevant systems to provide accurate payment processing.
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Level 4 Behaviors
(Extensive Experience)
Manages the payment processing tasks for our business.
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Level 5 Behaviors
(Mastery)
Establishes and implements controls for the payment processing team.
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7 soft skills or competencies (core competencies) for Claims Clerk I
Skill definition-A set of written instructions that describes the step-by-step activities to complete tasks in compliance with business standards and industry regulations.
Level 1 Behaviors
(General Familiarity)
Discusses the considerations and concerns on applying SOP for the first time.
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Level 2 Behaviors
(Light Experience)
Gathers information on workflows and business controlling points.
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Level 3 Behaviors
(Moderate Experience)
Initiates SOP revisions to support continuous improvement of processes.
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Level 4 Behaviors
(Extensive Experience)
Evaluates the benefits and drawbacks of a specific SOP; oversees the corresponding enhancements.
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Level 5 Behaviors
(Mastery)
Establishes formal policies and procedures to guide the our SOP practices.
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Skill definition-Executing and completing a task with a high level of accuracy.
Level 1 Behaviors
(General Familiarity)
Identifies the procedures for making sure that results are mistake-free.
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Level 2 Behaviors
(Light Experience)
Records all appointments on the calendar to easily track daily activities.
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Level 3 Behaviors
(Moderate Experience)
Reviews and analyzes the accuracy of data and details.
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Level 4 Behaviors
(Extensive Experience)
Designs systems to help the team organize and track details and project progress.
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Level 5 Behaviors
(Mastery)
Develops best practices for identifying and correcting errors, oversights, and omissions.
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Summary of Claims Clerk I skills and competencies
There are 6 hard skills for Claims Clerk I, Insurance Industry, Insurance Legal and Regulatory Environment, Insurance Products, etc.
2 general skills for Claims Clerk I, Data Entry, Payment Processing.
7 soft skills for Claims Clerk I, Standard Operating Procedures (SOP), Attention to Detail, Maintaining Focus, etc.
While the list totals 15 distinct skills, it's important to note that not all are required to be mastered to the same degree. Some skills may only need a basic understanding, whereas others demand a higher level of expertise.
For instance, as a Claims Clerk I, he or she needs to be proficient in Standard Operating Procedures (SOP), be proficient in Attention to Detail, and be proficient in Maintaining Focus.