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Become A Claims Technician

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Working As A Claims Technician

  • Getting Information
  • Processing Information
  • Documenting/Recording Information
  • Interacting With Computers
  • Organizing, Planning, and Prioritizing Work
  • Mostly Sitting

  • Repetitive

  • $63,565

    Average Salary

What Does A Claims Technician Do At Kelly Services

* Research and investigation into missing information, make phone calls to providers, access resource materials and support files in order to process and adjudicate claims timely and accurately.
* Resolve complex pended claims, duplicate claims and adjustments.
* Process claims, involving communications with participating plans and/or Service Units.
* Resolve various issues.
* Research and identify other insurance, Medicare, Medicaid and update patient file as needed.
* Coordinate benefits; request explanation of benefits as needed.
* Maintain a working understanding of medical terminology and CPT, HCPCS, and ICD9 coding.
* Maintain knowledge of pre-existing condition and waiting period requirements as they relate to specific contracts.
* Resolve error messages as they relate to pre-existing conditions.
* Prepare reports, maintain files and records.
* Learn and maintain knowledge of DOL ERISA and prompt pay legislation.
* Assist with testing system changes and enhancements.
* Requirements

What Does A Claims Technician Do At The Hartford

* Assisting multiple lines of business with operations duties
* Analysis & resolution of both routine and complicated work requests
* Financial transaction processing and regulatory compliance
* Meeting & exceeding hard deadlines
* Business and IT project work
* Continuous process improvement
* New claim triage and assignment process
* May be required to assist Claims Customer Care team with calls
* Behaviors at the Hartford
* Deliver Outcomes – Demonstrate a bias for speed and execution that serves our shareholders and customers.
* Operate as a Team Player – Work together to drive solutions for the good of The Hartford.
* Build Strong Partnerships – Demonstrate integrity and build trust with others.
* Strive for Excellence – Motivate yourself and others to achieve high standards and continuously improve.
* We are looking for individuals with consistent high level of performance and achievement over career span as well as demonstrated efforts and achievement toward self-development

What Does A Claims Technician Do At Liberty Mutual

* This position can be a grade 7 or 9 depending on education and experience.
* Conducts investigation to secure essential facts from injured worker, employer and providers regarding workers' compensations through telephone or written reports.
* Verifies information from claimants, physicians, and medical providers to assess compensability and/or causal relation of medical treatment, and make evaluations for cases with typically up to twelve weeks disability and/or claim specific on-going medical management.
* Provides on-going medical and/or disability case management for assigned claims.
* Initiates calls to injured worker and medical provider if projected disability exceeds maximum triage model projection or to resolve medical treatment issues as needed.
* Maintains contact with injured worker, provider and employer to ensure understanding of protocols and claims processing and/or to confirm return-to-work date or medical treatment.
* Continually assesses claim status to determine if problem cases or those exceeding protocols should be referred to Claims Service Team and/or would benefit from, MP RN review or other medical claims resources.
* Refers case to SDU/MP RN if light duty potential is identified at any point or for issues involving medical treatment or dispute involving disability or based on exception reports and defined departmental protocols.
* Arranges Independent Medical Exam and Peer Review as necessary.
* Maintains accurate records and handles administrative responsibilities associated with processing and payment of claims.
* Records and updates status notes; documents results of contacts, relevant medical reports, and duration information per file posting standards including making appropriate medical information viewable to customers in Electronic Document Management (EDM).
* Generates form letters following set guidelines (i.e., letters to physicians projecting disability, letters confirming medical treatment and disability and letters outlining expected outcome to employers).
* Authorizes payment of weekly benefits, medical payments and/or medical treatment
* Recognizes potential subrogation cases, prepares cases for subrogation and refers these cases to the Subrogation Units

What Does A Claims Technician Do At Kelly Services

* Under supervision, you will be responsible for processing complex claims requiring further investigation, including coordination of benefits, and resolving pended claims
* Review and compare information in computer systems and apply proper codes/documentation
* May place outgoing calls to providers and/or pharmacies for further investigation before processing claims

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How To Become A Claims Technician

Health information technicians typically need a postsecondary certificate to enter the occupation, although some may need an associate’s degree. Certification is often required.


Postsecondary certificate and associate’s degree programs in health information technology typically include courses in medical terminology, anatomy and physiology, health data requirements and standards, classification and coding systems, healthcare reimbursement methods, healthcare statistics, and computer systems. Applicants to health information technology programs may increase their chances of admission by taking high school courses in health, computer science, math, and biology.

A high school diploma or equivalent and previous experience in a healthcare setting are enough to qualify for some positions, but most jobs for health information technicians require postsecondary education.

Important Qualities

Analytical skills. Health information technicians must be able to understand and follow medical records and diagnoses, and then decide how best to code them in a patient’s medical records.

Detail oriented. Health information technicians must be accurate when recording and coding patient information.

Integrity. Health information technicians work with patient data that are required, by law, to be kept confidential. They must exercise caution and a strong sense of ethics when working with this information in order to protect patient confidentiality.

Interpersonal skills. Health information technicians need to be able to discuss patient information, discrepancies, and data requirements with other professionals such as physicians and finance personnel.

Technical skills. Health information technicians must be able to use coding and classification software and the electronic health record (EHR) system that their healthcare organization or physician practice has adopted.

Licenses, Certifications, and Registrations

Most employers prefer to hire health information technicians who have certification, or they may expect applicants to earn certification shortly after being hired. A health information technician can earn certification from several organizations. Certifications include the Registered Health Information Technician (RHIT) and the Certified Tumor Registrar (CTR), among others.

Some organizations base certification on passing an exam. Others require graduation from an accredited program. Many coding certifications also require coding experience in a work setting. Once certified, technicians typically must renew their certification regularly and take continuing education courses.

A few states and facilities require cancer registrars to be licensed. Licensure requires the completion of a formal education program and the Certified Tumor Registrar (CTR) certification.


Health information technicians may advance to other health information positions by receiving additional education and certifications. Technicians may be able to advance to a position as a medical or health services manager after completing a bachelor’s or master’s degree program and taking the required certification courses. Requirements vary by facility.

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Claims Technician jobs

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Claims Technician Demographics


  • Female

  • Male

  • Unknown



  • White

  • Hispanic or Latino

  • Asian

  • Unknown

  • Black or African American

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Languages Spoken

  • Spanish

  • Dakota

  • Portuguese

  • Italian

  • French

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Claims Technician

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Claims Technician Education

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Top Skills for A Claims Technician


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Top Claims Technician Skills

  1. Customer Service Skills
  2. Insurance Claims
  3. Loss Reports
You can check out examples of real life uses of top skills on resumes here:
  • Achieved excellent customer service skills, recognized by senior management.
  • Type with 10-key pad medical, dental, and vision insurance claims into computer database.
  • Provide service to insureds, claimants, and others relating to first notice of loss reports.
  • Reviewed and maintained all required data entry programs to insure all demographic information are accurate.
  • Assisted claims adjusters by requesting and typing medical narratives and correspondences into the database.

Top Claims Technician Employers

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