What does a claims assistant do?
A claims assistant takes tasks to support staff in processing insurance claims. Claims assistants manage correspondence, take phone calls, do paperwork, and type documents. Also called insurance claim clerks, the assistants do clerical and administrative tasks. They assist professionals working for financial services enterprises, medical providers, and insurance enterprises. Among the skills they need are strong communication skills, data entry, customer service, attention to detail, and knowledge about insurance. They are also expected to have management skills.
Claims assistant responsibilities
Here are examples of responsibilities from real claims assistant resumes:
- Manage adding and removing vendors through claims automate system to ensure they are in compliance with IRS regulations.
- Process all HMO member reimbursements.
- Create and provide weekly/monthly reports and PowerPoint presentations.
- Coordinate daily operations such as updating litigation calendars and client data files.
- Maintain a diary of complex, high dollar exposure, politically sensitive and high-visibility litigation claims.
- Process various compensation benefits applications for veterans in compliance with organizational laws, federal laws, rules and regulations.
- Reprice UB-04 and HICFA claims according to pre-negotiat PPO discounts and apply network discounts.
- Maintain arbitration responses within the field office.
- Train employees on subrogation tracking, arbitration tracking, and total loss processes.
- Handle a substantial amount of Allstate customers, third party carriers, and others who need assistance to file a claim.
- Set up payment arrangements with the at-fault party that cause harmed to the GEICO insure.
Claims assistant skills and personality traits
We calculated that 23% of Claims Assistants are proficient in Customer Service, Data Entry, and Photocopying. They’re also known for soft skills such as Organizational skills, Math skills, and Communication skills.
We break down the percentage of Claims Assistants that have these skills listed on their resume here:
- Customer Service, 23%
Assisted Claims Managers in preparing, investigating and recording general liability claims * Provided customer service support for claimant inquiries.
- Data Entry, 12%
Required data entry skills to create injury report by entering claimants' information into system and issue claimants temporary disability payments.
- Photocopying, 6%
Provided claim support to adjuster's including photocopying, filing, and created files manually and electronically.
- Insurance Claims, 5%
Assisted customers setting up initial car insurance claims, gathered information and investigated facts of loss to determine liability exposure.
- Insurance Adjusters, 5%
Examine medical claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
- Veterans, 4%
Authored a comprehensive training document, detailing the processes evolved in transferring claim records within the Veterans Benefits Administration.
"customer service," "data entry," and "photocopying" are among the most common skills that claims assistants use at work. You can find even more claims assistant responsibilities below, including:
Organizational skills. The most essential soft skill for a claims assistant to carry out their responsibilities is organizational skills. This skill is important for the role because "financial clerks must be able to arrange files so they can find them quickly and efficiently." Additionally, a claims assistant resume shows how their duties depend on organizational skills: "applied sharp organizational skills toward providing highly efficient administrative support to team of ten 10 bodily injury claims adjusters. "
Math skills. Another essential skill to perform claims assistant duties is math skills. Claims assistants responsibilities require that "the job duties of financial clerks includes calculating charges and updating financial records." Claims assistants also use math skills in their role according to a real resume snippet: "receive and process new claims provides statistics to clients outstanding claims verify accident facts to deterimine policy coverage"
Communication skills. Another skill that relates to the job responsibilities of claims assistants is communication skills. This skill is critical to many everyday claims assistant duties, as "financial clerks should be able to explain policies and procedures to colleagues and customers." This example from a resume shows how this skill is used: "keep control and dockets of veterans to be scheduled for hearings by telephone communications. "
The three companies that hire the most claims assistants are:
- Sedgwick LLP55 claims assistants jobs
- CorVel13 claims assistants jobs
- AmTrust Financial11 claims assistants jobs
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Compare different claims assistants
Claims assistant vs. Insurance clerk
An insurance clerk usually works to process insurance, reinstatement, changes, or cancellations for a company or an individual account. They are responsible for monitoring, processing, and organizing different insurance claims for a client. They usually work closely with the company's insurance agent to provide necessary information to process the clients' application. This career requires a broad knowledge of local and state insurance policies, good attention to detail, excellent communication skills, customer service skills, and administrative skills.
There are some key differences in the responsibilities of each position. For example, claims assistant responsibilities require skills like "photocopying," "insurance claims," "insurance adjusters," and "veterans." Meanwhile a typical insurance clerk has skills in areas such as "patients," "insurance verification," "insurance coverage," and "insurance carriers." This difference in skills reveals the differences in what each career does.
Insurance clerks earn the highest salaries when working in the finance industry, with an average yearly salary of $33,939. On the other hand, claims assistants are paid more in the government industry with an average salary of $40,004.The education levels that insurance clerks earn slightly differ from claims assistants. In particular, insurance clerks are 2.1% less likely to graduate with a Master's Degree than a claims assistant. Additionally, they're 0.2% less likely to earn a Doctoral Degree.Claims assistant vs. Insurance verifier
An insurance verifier specializes in dealing with the billing process and patient claims. As the process begins, insurance verifiers look into patient insurance information and verify treatments that their policies cover. They call the insurance companies and send proper documentation to verify pre-approval for the required procedure. Eventually, the insurance verifiers work with insurance companies to bill them for the procedure. Their tasks may also include communicating with patients about benefits, coverage, and care authorization, and liaising with patients and providers to communicate their needs and current state.
In addition to the difference in salary, there are some other key differences worth noting. For example, claims assistant responsibilities are more likely to require skills like "photocopying," "insurance adjusters," "veterans," and "strong customer service." Meanwhile, an insurance verifier has duties that require skills in areas such as "patients," "insurance verification," "insurance eligibility," and "health insurance." These differences highlight just how different the day-to-day in each role looks.
Insurance verifiers earn similar levels of education than claims assistants in general. They're 3.1% less likely to graduate with a Master's Degree and 0.2% less likely to earn a Doctoral Degree.Claims assistant vs. Insurance biller
An insurance biller is responsible for making daily reviews and processing documents concerning the insurance payment and bills of a client. They assess if all requirements are correct and complete, obtain different referrals and authorization papers, and prepare and transmit document claims using a particular software. Also, they do follow ups regarding unpaid claims and update spreadsheets for record purposes.
There are many key differences between these two careers, including some of the skills required to perform responsibilities within each role. For example, a claims assistant is likely to be skilled in "customer service," "photocopying," "insurance adjusters," and "veterans," while a typical insurance biller is skilled in "patients," "medi-cal," "medicaid," and "insurance billing."
Most insurance billers achieve a similar degree level compared to claims assistants. For example, they're 2.4% less likely to graduate with a Master's Degree, and 0.4% less likely to earn a Doctoral Degree.Claims assistant vs. Insurance coordinator
An insurance coordinator is responsible for evaluating and validating insurance information to verify claims and process the necessary claims resolutions for parties. Insurance coordinators submit claims statements timely to the insurance officers for review, coordinate with the clients for inquiries and updates, and reach out to medical institutions for accurate filing of payments. An insurance coordinator must have excellent communication and analytical skills to assess reports, resolve claims discrepancies, and escalate high-level complaints to the officers for immediate action.
Types of claims assistant
Updated January 8, 2025
