6 hard skills or competencies (industry competencies) for Claims Clerk II
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)
Reviews and analyzes claim applications to determine coverage eligibility and rates.
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Level 4 Behaviors
(Extensive Experience)
Monitors market trends in insurance services to deliver improved business impacts.
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Level 5 Behaviors
(Mastery)
Establishes and enforces standards for handling claims to maximize insurance workflow efficiency.
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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)
Performs compliance reviews to determine possible violations and deficiencies in insurance regulations.
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Level 4 Behaviors
(Extensive Experience)
Trains teams on new laws and regulations to reduce liability risks and compliance violations.
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Level 5 Behaviors
(Mastery)
Establishes best practices in creating insurance laws and regulations to prevent frauds and malpractices.
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2 general skills or competencies (Job family competencies) for Claims Clerk II
Skill definition-Transcribing information into an electronic medium such as a computer or other electronic device.
Level 1 Behaviors
(General Familiarity)
Lists commonly used tools and applications in conducting effective data entry.
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Level 2 Behaviors
(Light Experience)
Reports data entry-related areas to meet and exceed performance expectations.
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Level 3 Behaviors
(Moderate Experience)
Utilizes data resources in collecting and reviewing data to correct information errors and incompatibilities.
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Level 4 Behaviors
(Extensive Experience)
Organizes data submitted for entry to prevent data losses and ensure confidentiality.
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Level 5 Behaviors
(Mastery)
Leads the overall automation and optimization of data entry to eliminate manual processing.
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Skill definition-Completing transfer of funds from the transaction to the merchant's account.
Level 1 Behaviors
(General Familiarity)
Lists major activities involved in payment processing.
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Level 2 Behaviors
(Light Experience)
Records the periodic processing of payables to handle payment processing.
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Level 3 Behaviors
(Moderate Experience)
Works with the relevant staff to minimize administrative burdens relating to payment processing.
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Level 4 Behaviors
(Extensive Experience)
Oversees the day-to-day operations related to payment processing in support of business activities.
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Level 5 Behaviors
(Mastery)
Leads the provision of invoice processing instruction and training for posting invoices for payment.
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7 soft skills or competencies (core competencies) for Claims Clerk II
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)
Lists the typical processes of SOP development.
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Level 2 Behaviors
(Light Experience)
Supports the analysis of our business and operations processes for SOP design and development.
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Level 3 Behaviors
(Moderate Experience)
Researches new tools and techniques for SOP daily management.
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Level 4 Behaviors
(Extensive Experience)
Resolves complex issues arising from SOP practices; develops preventative solutions accordingly.
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Level 5 Behaviors
(Mastery)
Monitors industry for SOP trends and best practices; makes recommendations about those that benefit our business.
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Skill definition-Executing and completing a task with a high level of accuracy.
Level 1 Behaviors
(General Familiarity)
Lists the traits of an employee showing great attention to detail.
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Level 2 Behaviors
(Light Experience)
Utilizes specific approaches and tools for checking and cross-checking outputs.
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Level 3 Behaviors
(Moderate Experience)
Uses tools to organize and monitor work progress.
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Level 4 Behaviors
(Extensive Experience)
Manages training to improve staffs' concentration and attention to detail.
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Level 5 Behaviors
(Mastery)
Learns from previous works' strengths and weaknesses to guide new projects.
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Summary of Claims Clerk II skills and competencies
There are 6 hard skills for Claims Clerk II, Insurance Industry, Insurance Legal and Regulatory Environment, Insurance Products, etc.
2 general skills for Claims Clerk II, Data Entry, Payment Processing.
7 soft skills for Claims Clerk II, 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 II, he or she needs to be proficient in Standard Operating Procedures (SOP), be proficient in Attention to Detail, and be proficient in Maintaining Focus.