Insurance Claims Payment Clerk
ほけんきんしはらいじむいん
Industry & Occupation
Classification
- Major : Clerical Occupations
- Middle : Accounting Clerical Occupations
- Minor : Other Accounting Clerical Occupations
Summary
Clerical role that accepts insurance claims from customers based on insurance contracts, conducts document review and assessment, and handles payment processing.
Description
Insurance claims payment clerks accept insurance claim documents from policyholders or insured individuals, review and assess them against policy terms and contract conditions, and determine payment eligibility and amounts. They confirm accident or medical details as needed, collaborate with relevant departments or external investigators for fact-checking, process transfers after payment approval, contact customers, handle inquiries and complaints. They are required to accurately perform data entry into internal systems and create various reports.
Future Outlook
While insurance claims processing is advancing with digitalization and automation, complex cases and those requiring customer interaction still need human involvement. Enhancing expertise and IT literacy will maintain future market value.
Personality Traits
Accurate and cautious / Customer-oriented / Polite and courteous / Strong sense of responsibility
Work Style
About 120 annual holidays / Flexitime / Office work / Remote
Career Path
Insurance Claims Payment Clerk → Chief Clerk/Leader → Team Manager → Claims Adjuster → Insurance Administration Supervisor
Required Skills
Communication Skills / Insurance Claim Document Processing / Office Software / Understanding Insurance Products and Contract Terms
Recommended Skills
Customer Service / Data Analysis / English Document Reading / Financial Planning
Aptitudes (Strengths Preferred)
| Item | Description |
|---|---|
| Analytical & Logical Thinking | To logically judge insurance contracts and accident situations. |
| Attention to Detail & Accuracy | To prevent errors in contract details or documents and make accurate payment decisions. |
| Communication Skills | To smoothly coordinate and explain with customers and internal/external stakeholders. |
| Problem Solving | Required for handling complaints and resolving complex cases. |
| Stress Tolerance | Necessary to calmly handle complaints and urgent cases. |
Aptitudes (Weaknesses Acceptable)
| Item | Description |
|---|---|
| Physical Stamina & Endurance | Mainly desk work with low physical demands. |
Related Qualifications
- Certified Financial Planner
- Life Insurance Solicitation Qualification
- Property and Casualty Insurance Solicitation Qualification
Aliases
- Claims Clerk
- Insurance Claims Handler
- Insurance Payment Clerk
Related Jobs
- Accounting Clerk
- Claims Adjuster
- Insurance Clerk
- Insurance Salesperson