What does an insurance clerk do?

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.
Insurance clerk responsibilities
Here are examples of responsibilities from real insurance clerk resumes:
- Manage front office check-in, insurance verification and certifications from doctors.
- Establish and implement procedures for completion of patient super bills with proper diagnostic coding utilizing ICD-9 and CPT code manuals.
- Maintain patient medical records insuring diagnosis codes (ICD-9) are itemized correctly and name and address of insurance carriers record.
- Schedule and obtain authorization for outpatient procedures for patients via private insurance, worker's compensation, and Medicare/ Medicaid.
- Complete several ICD-10 training courses.
- Perform medical coding with most accurate and descriptive HCPCS code.
- Code patient diagnoses and procedures using the ICD-9 and CPT-4 coding systems.
- Pull, print, and file EOB's from primary insurance to file secondary claims.
- Update patient charts into the computer to ensure accurate recording of CPT codes for billing purposes.
- Process secondary claims for payment, locating EOB's from primary carrier and following up on payment.
- Attend annual in-service training on HIPPA guidelines and other medical policies and procedures regarding patients' bill of rights.
- Process and meter all outgoing mail including confidential HIPAA information, prepare outgoing faxes for transition and distribute incoming faxes.
- Send appeals and reconsideration documentation as necessary.
- Process insurance appeals & re-determinations on deny claims.
- Examine claims for Medicaid guideline compliance and ensure completion before submission.
Insurance clerk skills and personality traits
We calculated that 25% of Insurance Clerks are proficient in Patients, Insurance Verification, and Data Entry. They’re also known for soft skills such as Math skills, Communication skills, and Organizational skills.
We break down the percentage of Insurance Clerks that have these skills listed on their resume here:
- Patients, 25%
Communicated directly with providers and patients in order to obtain all necessary information and documentation required for proper billing of claims.
- Insurance Verification, 7%
Maintain appropriate information relating to the medical chart such as maintaining current laboratory stickers and insurance verification forms.
- Data Entry, 7%
Collected and processed insurance payments Maintained filing systems Adjusted and recorded changes in insurance policies Customer service Data entry Clerical duties
- Customer Service, 6%
Served as the Receptionist/Customer Service Specialist, answering telephone calls, providing information and answering customer's questions.
- Insurance Coverage, 5%
Assisted in the verification and entry of patient demographics as they related to insurance coverage information.
- Computer System, 3%
Completed secondary insurance claims, entered patient information into computer system, and filed miscellaneous insurance information.
Most insurance clerks use their skills in "patients," "insurance verification," and "data entry" to do their jobs. You can find more detail on essential insurance clerk responsibilities here:
Math skills. One of the key soft skills for an insurance clerk to have is math skills. You can see how this relates to what insurance clerks do because "the job duties of financial clerks includes calculating charges and updating financial records." Additionally, an insurance clerk resume shows how insurance clerks use math skills: "handle insurance claims, billing issues, statistics, and some utilization. "
Communication skills. Many insurance clerk duties rely on communication skills. "financial clerks should be able to explain policies and procedures to colleagues and customers.," so an insurance clerk will need this skill often in their role. This resume example is just one of many ways insurance clerk responsibilities rely on communication skills: "provided excellent customer service via verbal and written communication. "
Organizational skills. This is an important skill for insurance clerks to perform their duties. For an example of how insurance clerk responsibilities depend on this skill, consider that "financial clerks must be able to arrange files so they can find them quickly and efficiently." This excerpt from a resume also shows how vital it is to everyday roles and responsibilities of an insurance clerk: "demonstrated superb ability to work with confidential and sensitive information adhering to hipaa privacy rules compliance and internal organizational policies. ".
The three companies that hire the most insurance clerks are:
- Brown & Brown5 insurance clerks jobs
- Swope Health Services4 insurance clerks jobs
- The Center for Health Care Services2 insurance clerks jobs
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Insurance clerk vs. Billing specialist
Billing specialists are accounting or finance employees who are responsible for sending out billing invoices to clients. They calculate charges that their clients have incurred. They then write bills, ensure that all details are correct, and send these out to clients. They also manage payment due dates and ensure that clients are duly reminded of such deadlines. Billing specialists also manage client accounts and ensure that they are paying on time. They help identify clients who have outstanding payables and send out collection notices to them. At times, billing specialists also manage the receipt of payments to manage account records better.
There are some key differences in the responsibilities of each position. For example, insurance clerk responsibilities require skills like "patient insurance," "medicare," "telephone calls," and "insurance forms." Meanwhile a typical billing specialist has skills in areas such as "submit claims," "billing issues," "medical claims," and "appeals." This difference in skills reveals the differences in what each career does.
Billing specialists tend to make the most money working in the manufacturing industry, where they earn an average salary of $37,417. In contrast, insurance clerks make the biggest average salary, $33,939, in the finance industry.billing specialists tend to reach similar levels of education than insurance clerks. In fact, billing specialists are 0.2% more likely to graduate with a Master's Degree and 0.0% less likely to have a Doctoral Degree.Insurance clerk vs. Medical receptionist
Medical receptionists are responsible for manning the front desk at a medical facility such as a clinic or a hospital. They manage schedules and appointments in the clinic or hospital. They help patients to their respective appointments. They also assist doctors, nurses, and other medical practitioners by ensuring that the schedule for the day is being followed. They are also in charge of assisting visitors by directing them wherever they would need to go. Medical receptionists also answer inquiries by patients or visitors. Medical knowledge, great customer service skills, and a friendly attitude are needed.
While some skills are similar in these professions, other skills aren't so similar. For example, resumes show us that insurance clerk responsibilities requires skills like "insurance carriers," "medicare," "scheduling appointments," and "insurance policies." But a medical receptionist might use other skills in their typical duties, such as, "check-in," "patient care," "phone calls," and "patient referrals."
On average, medical receptionists earn a lower salary than insurance clerks. Some industries support higher salaries in each profession. Interestingly enough, medical receptionists earn the most pay in the health care industry with an average salary of $32,483. Whereas insurance clerks have higher pay in the finance industry, with an average salary of $33,939.In general, medical receptionists achieve similar levels of education than insurance clerks. They're 0.8% less likely to obtain a Master's Degree while being 0.0% less likely to earn a Doctoral Degree.Insurance clerk vs. Billing representative
A billing representative assists with the overall operations of the organization's billing department. Billing representatives post payments timely on the database, update account statements, generate financial reports, release invoices, and resolve account discrepancies. They also perform client accounts reconciliation as needed, monitor account receivables, review overdated balance, and notify clients of payment updates to ensure accurate and timely billing. A billing representative must have strong analytical and communication skills to manage clients' accounts, as well as comprehensive knowledge on the accounting industry to explain the payment terms and policies of an organization to a client.
There are many key differences between these two careers, including some of the skills required to perform responsibilities within each role. For example, an insurance clerk is likely to be skilled in "patient insurance," "medicare," "telephone calls," and "scheduling appointments," while a typical billing representative is skilled in "appeals," "medical claims," "billing system," and "icd-10."
Billing representatives make a very good living in the technology industry with an average annual salary of $35,295. On the other hand, insurance clerks are paid the highest salary in the finance industry, with average annual pay of $33,939.When it comes to education, billing representatives tend to earn similar degree levels compared to insurance clerks. In fact, they're 0.2% more likely to earn a Master's Degree, and 0.0% more likely to graduate with a Doctoral Degree.Insurance clerk vs. Registration specialist
A registration specialist is responsible for managing patient information, including the verification of their insurance details and medical treatment schedules. Registration specialists assign admission rooms and processing payments for discharge. They also assist patients with the completion of medical forms by helping them fill-out papers with the most accurate information. A registration specialist performs administrative and clerical duties as needed, requiring them to have excellent data management skills to process information and provide the highest quality care services for the patients.
Types of insurance clerk
Updated January 8, 2025











