Sample Job Description for Claims Payment Clerk III
Job Description Management
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Claims Payment Clerk III Job Overview
Claims Payment Clerk III Job Description Sample
Reviews insurance claim forms and supporting documents for completeness and accuracy and obtains missing information as necessary.
JOB LEVEL
A03
EDUCATION/DEGREE
High School Diploma or Technical Certificate
REPORTS TO
Supervisor
Salary Range
BASE 50%
$56,800
TOTAL 50%
$58,500
Job Responsibilities for Claims Payment Clerk III
Inputs claim information into system for processing. Verifies coverage eligibility. Calculates settlement amounts according to guidelines. Processes routine claim payments.
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View Job Description Templates of Similar Jobs
| Job Title | Job Description | |
|---|---|---|
| 1 | Administrative Postal and Messenger Services - Entry | The Administrative Postal and Messenger Services - Entry collects and processes outgoing mail. Receives, sorts and distributes incoming mail. Being an Administrative Postal and Messenger Services - Entry typically requires a high school diploma or its equivalent. Operates postage machine and other mailroom equipment as needed. In addition, Administrative Postal and Messenger Services - Entry typically reports to a Mailroom Supervisor. Being an Administrative Postal and Messenger Services - Entry possesses a moderate understanding of general aspects of the job. Works under the close direction of senior personnel in the functional area. May require 0-1 year of general work experience. |
| 2 | Vice President of Claims | The Vice President of Claims is responsible for managing and implementing claims programs for all lines of insurance. Plans and directs all aspects of an organization's insurance claims function. Being a Vice President of Claims develops procedures and policies to enhance and improve the processing, investigation, and settlement of claims. Directs the review and settlement of complex or high dollar claims. In addition, Vice President of Claims ensures legal examinations are made when appropriate. Requires a bachelor's degree. Typically reports to top management. The Vice President of Claims manages a departmental function within a broader corporate function. Develops major goals to support broad functional objectives. Approves policies developed within various sub-functions and departments. Comprehensive knowledge of the overall departmental function. Working as a Vice President of Claims typically requires 8+ years of managerial experience. |
| 3 | Claims Payment Clerk I | The Claims Payment Clerk I inputs claim information into system for processing. Reviews insurance claim forms and supporting documents for completeness and accuracy and obtains missing information as necessary. Being a Claims Payment Clerk I calculates settlement amounts according to guidelines. Verifies coverage eligibility. In addition, Claims Payment Clerk I processes routine claim payments. Requires a high school diploma or equivalent. Typically reports to a supervisor. Being a Claims Payment Clerk I works under the close direction of senior personnel in the functional area. Possesses a moderate understanding of general aspects of the job. May require 0-1 year of general work experience. |
| 4 | Claims Examinations/Adjustments Manager | The Claims Examinations/Adjustments Manager oversees the investigation, evaluation, negotiation, and settlement of claims to meet operational, financial, and service requirements. Manages the operations of an insurance claims department to ensure timely, accurate, and compliant claims handling. Being a Claims Examinations/Adjustments Manager reviews complex or high-exposure claims and provides technical guidance and settlement authority to staff. Develops and enforces procedures, quality controls, and performance metrics to maintain consistency and compliance. In addition, Claims Examinations/Adjustments Manager monitors caseloads, productivity, and reserve accuracy to meet departmental goals. Ensures compliance with applicable regulations, company policies, and customer service expectations. Requires a bachelor's degree. Typically reports to a director. The Claims Examinations/Adjustments Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Working as a Claims Examinations/Adjustments Manager typically requires 5 years experience in the related area as an individual contributor. 1-3 years supervisory experience may be required. Extensive knowledge of the function and department processes. |
| 5 | Human Resource Information System Clerk III | The Human Resource Information System Clerk III inputs data into a computer processing system and reviews output for accuracy. Performs routine administrative tasks in support of the HRIS (Human Resources Information Systems) group. Being a Human Resource Information System Clerk III alters query variables in order to generate more complex or ad-hoc reports. Generates standard reports for Human Resources or managing personnel. In addition, Human Resource Information System Clerk III analyzes and maintains HRIS system for assigned projects. Requires a high school diploma or its equivalent. Typically reports to a supervisor. Being a Human Resource Information System Clerk III has gained proficiency in multiple competencies relevant to the job. Works independently within established procedures associated with the specific job function. Working as a Human Resource Information System Clerk III typically requires 3-5 years of related experience. |
Claims Payment Clerk III Skills & Proficiency Level
| Skills | Proficiency Level |
|---|---|
| Standard Operating Procedures (SOP) | Level 2 |
| Attention to Detail | Level 2 |
| Maintaining Focus | Level 2 |
