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Insurance claims clerk skills for your resume and career

Updated January 8, 2025

2 min read

Quoted experts

Li Zhang Ph.D.,

Li Zhang Ph.D.

Below we've compiled a list of the most critical insurance claims clerk skills. We ranked the top skills for insurance claims clerks based on the percentage of resumes they appeared on. For example, 29.8% of insurance claims clerk resumes contained customer service as a skill. Continue reading to find out what skills an insurance claims clerk needs to be successful in the workplace.

15 insurance claims clerk skills for your resume and career

1. Customer Service

Customer service is the process of offering assistance to all the current and potential customers -- answering questions, fixing problems, and providing excellent service. The main goal of customer service is to build a strong relationship with the customers so that they keep coming back for more business.

Here's how insurance claims clerks use customer service:

Build client relationships by providing excellent customer service and customer follow-up.
Recognized for outstanding sales performance and customer service.

2. Medicare

Medicare is a federal government insurance program that offers health care coverage to people who are 65 and above. In some cases, younger people with disabilities whose status is identified by the SSA can also avail the insurance program. Medicare covers the health expenses of people who are not able to afford it plus it protects the payee from rising health care costs.

Here's how insurance claims clerks use medicare:

Verify insurance coverage with Medicare, Medicaid, worker's compensation, and all other Third Party Plans.
Filed claims to Medicare, Blue Cross/Blue Shield for payment.

3. Insurance Policies

Here's how insurance claims clerks use insurance policies:

Reviewed insurance policies and maintained accuracy and timeliness in clients insurance accounts.
Processed new insurance policies, modifications existing policies and claim forms.

4. Retrieve Data

Here's how insurance claims clerks use retrieve data:

Organized and worked with detailed office or warehouse records, using computers to enter access, search and retrieve data.
Utilized computer programs to enter, access, search, and retrieve data.

5. Medicaid

Here's how insurance claims clerks use medicaid:

Verified patient dental insurance coverage and limitations with major private and business dental insurance providers as well as Medicaid and Medicare.
Run Weekly and Monthly Reports Verify Insurance via HIQA/Medicare/GHP For Medicaid and Commercial Insurance

6. Medical Billing

Here's how insurance claims clerks use medical billing:

Performed medical billing and insurance coordination; interfaced with insurance companies to determine benefits.
Maintained and established medical billing procedures, and communicated appropriate data to billing agent.

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7. Patient Accounts

Patient accounts are a part of a hospital information system that is used for storing financial data, keeping a record of healthcare costs, and providing information regarding patient billing. It deals with the financial aspects of the healthcare setting.

Here's how insurance claims clerks use patient accounts:

Review and discuss patient accounts, billing status, and debts owed with patients.
Collected and posted payments to patient accounts.

8. Computer System

Here's how insurance claims clerks use computer system:

Complied appropriate claims data information, numbers and clients' names into computer systems.
Enter and retrieve information of varying complexity using computer systems and applications to process insurance transactions and payments.

9. Insurance Carriers

Here's how insurance claims clerks use insurance carriers:

Prepared UB04 and HCFA 1500 forms to submit to insurance carriers.
Answer phones*Prepares and submits hospital and hospital based physician claims to third-party insurance carriers either electronically or by hard copy billing.

10. Medical Insurance Claims

Here's how insurance claims clerks use medical insurance claims:

Process Medical Insurance claims received from Medical Providers and individual member.
Instructed and advised claimants on procedures and documentation required to process medical insurance claims

11. Front Desk

Here's how insurance claims clerks use front desk:

Relieved front desk when needed assisted with the mailroom when low on staff.
Communicated medical information with referring doctors/front Desk throughout MD/DC/VA.

12. ICD-9

Here's how insurance claims clerks use icd-9:

Audited claims for corrected ICD-9, CPT and diagnosis codes..
Maintain patient medical records insuring diagnosis codes (ICD-9) were itemized correctly and name and address of insurance carriers recorded.

13. CPT

CPT is a medical term that stands for Current Procedural Terminology. Whenever a procedure like surgery or diagnosis occurs or some other medical service is rendered to a patient, it is reported to the concerned physician, insurance company, or organization. The aforementioned practice is widely referred to as CPT.

Here's how insurance claims clerks use cpt:

Prepared mail, handled incoming calls regarding claims, current knowledge of CPT coding, and assisting Administration in various areas.
Worked with ICD-9 and CPT codes, making sure that we were getting paid for the procedures that were being preformed.

14. Scheduling Appointments

Scheduling appointments is the practice of finding a free slot with the person(s) you want to meet. The process of scheduling appointments involves finding mutually free time, negotiating follow-ups, sending reminders, and creating new appointments. Scheduling appointments is important to ensure that the timings of consecutive meetings do not clash with each other.

Here's how insurance claims clerks use scheduling appointments:

Provide assistance to front office with answering telephones, scheduling appointments, checking in patients and collecting payments.
Performed secretarial tasks scheduling appointments and maintained office.

15. Insurance Applications

Here's how insurance claims clerks use insurance applications:

Reviewed and verified data, such as age, name, and address for insurance applications and policies.
Maintained records, reports, files, and review data on insurance applications or policies.

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What skills help Insurance Claims Clerks find jobs?

Tell us what job you are looking for, we’ll show you what skills employers want.

What skills stand out on insurance claims clerk resumes?

Li Zhang Ph.D.

Professor, St. Cloud State University

There aren't many universities/colleges that offer a degree in insurance. Having some insurance education, such as a degree, or a certificate, or just taking a few insurance classes, will be sure to make applicants stand out. For those with no insurance background, demonstrating strong transferable skills from previously studied areas to the insurance industry (such as communication skills, analytical skills), strong commitment, ethical and professional attitude will make the applicants very competitive.

What soft skills should all insurance claims clerks possess?

Li Zhang Ph.D.

Professor, St. Cloud State University

I'd say communication skills. Many positions in insurance need to interact with others. The ability to listen carefully and responding effectively, conveying thoughts/ideas fluently is very important. Also, communicating throng writing is also important (it could range from simply completing the paperwork accurately to preparing annual reports for supervisors)

Do you want to know more?

List of insurance claims clerk skills to add to your resume

The most important skills for an insurance claims clerk resume and required skills for an insurance claims clerk to have include:

Customer Service
Medicare
Insurance Policies
Retrieve Data
Medicaid
Medical Billing

Patient Accounts
Computer System
Insurance Carriers
Medical Insurance Claims
Front Desk
ICD-9

CPT
Scheduling Appointments
Insurance Applications
Claims Process
Insurance Eligibility
Insurance Coverage

Updated January 8, 2025

Zippia Team

Editorial Staff

The Zippia Research Team has spent countless hours reviewing resumes, job postings, and government data to determine what goes into getting a job in each phase of life. Professional writers and data scientists comprise the Zippia Research Team.

Updated January 8, 2025

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