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What is the difference between ....insurance clerk ....insurance processor ?

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Question ajoutée par abdulrhman frikha , MEDICAL CLAIMS SPECILAIST AND PROVIDER RELATIONSHIP , GLOBEMED SAUDI
Date de publication: 2016/03/06
Vinod Jetley
par Vinod Jetley , Assistant General Manager , State Bank of India

Agent An insurance agent is someone who sells insurance policies to people. Being an insurance agent may be a good job for you if you like to meet and talk with people. You will need at least a high school diploma to be an agent, and you may need to have a college degree to have certain agent jobs.

Underwriter An underwriter is a person who decides which people and things an insurance company should insure and which ones they should not. For instance, if a car is no longer running and dented, an underwriter will probably decided not to insure it. An underwriter also determines how much the company should charge for insurance. You will need at least a high school diploma to be an underwriter, and you may need to have a college degree to have certain underwriting jobs.

Customer Service Representative Customer service representatives talk with people to get details after their property is damaged. They often answer questions from people who need to know what their insurance does and does not pay for. You will need at least a high school diploma to be a claims representative, and you may need to have a college degree to have certain adjuster jobs.

Claims Representative Like a customer service representative, claims representatives work with people after their property has been damaged. They help people get the money they need to repair or replace their property. You will need at least a high school diploma to be a claims representative, and you may need a college degree.

Adjuster An adjuster is a person who helps people after their property has been damaged. They investigate how the property was damaged and determine whether or not the damage will be paid for by the insurance company. One of the most important things adjusters do is to determine how much the damage will cost to repair. You will need at least a high school diploma to be an adjuster, and you may need a college degree for some adjuster jobs.

Actuary An actuary is a person who helps insurance companies know how much money to charge for insurance. To be an actuary, you will need a college degree in mathematics or statistics. After you have a college degree, you must pass a series of tests to become an actuary.

Regulator Each state has an agency that makes sure that insurance companies obey the law. This is called regulation. In Texas, the Texas Department of Insurance (TDI) regulates the insurance industry. TDI has more than 1,000 employees in Austin and in field offices all across the state. To work at TDI, you need a high school diploma, but many jobs require a college degree.

حسين محمد ياسين
par حسين محمد ياسين , Finance Manager , مؤسسة عبد الماجد محمد العمر للمقاولات العامة

agree with answers >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Mamoun elbaghir abdalla mhamad Eltayeb
par Mamoun elbaghir abdalla mhamad Eltayeb , Insurance agent / Producer , Albaraka Insurance Company

In my opinion and understanding the insurance processor is the underwriter who assess and make the initial evaluation of the risk and subsequently determining the premium rate , policy excess and conditions.

Insurance clerk  is a subordinate who assist the completion and follow up of the said work , however the insurance clerk and insurance processor are complementary .

My best wishes

Apologized for the answer, I do not know, leave the answer for the professionals.

Ahmed Mohamed Ayesh Sarkhi
par Ahmed Mohamed Ayesh Sarkhi , Shared Services Supervisor , Saudi Musheera Co. Ltd.

agree with mr. vinod on his answer

 

Glaiza Balance
par Glaiza Balance , Data Encoder , Sutherland

Insurance clerks obtain information from policyholders to verify the accuracy  and completeness of information on claims forms,  review related insurance documents provided by the patient,  as well as review medical records to verify all relevant information while an insurance processor are clerks who process claims for insurance companies.  Some of the duties that they perform include processing new insurance policies,  modifying existing ones and obtaining information from policyholders to verify the accuracy of their accounts.  

Ghada Eweda
par Ghada Eweda , Medical sales hospital representative , Pfizer pharmaceutical Plc.

Agree with answer given by Mr. Vinod Jetey. Thanks

ghazi Almahadeen
par ghazi Almahadeen , Project Facilitator , Jordan River Foundation

Thank you for your invitation .... I do not have information about insurance

nsurance processors, often referred to as insurance claims and policy clerks, complete a wide array of behind-the-scenes duties for an insurance company

Ashok Reddy
par Ashok Reddy , Senior Medical Coder , Health Point Hospital

Insurence Clerk

  • calculate insurance premiums or awards
  • collect payment
  • compute financial data
  • examine documents for completeness, accuracy, or conformance to standards
  • examine financial documents to verify issue
  • fill out business or government forms
  • follow contract, property, or insurance laws
  • maintain insurance records
  • maintain inventory of office forms
  • maintain records, reports, or files
  • obtain information from individuals
  • operate business machines
  • review data on insurance applications or policies
  • transcribe spoken or written information
  • type letters or correspondence
  • use computers to enter, access or retrieve data
  • use oral or written communication techniques
  • verify signatures for financial transactions

Insurence Processor 

Medical insurance claims processors check new claims for various items, including whether the procedure is medically necessary and whether the insurance policy covers the procedure.

For example, some policies cover elective surgery, while others do not. The processor makes sure that the person filled out the claims form completely;

if there are any blanks, she contacts the patient, doctor or hospital to gain the missing information.

She also verifies that the procedure took place.

She must possess knowledge of medical terms, such as Current Procedural Terminology, or CPT, codes and International Classification of Diseases, or ICD, codes, to review the claim accurately.

Claim Process for Payment or Denial

 

Arpita Katiyar
par Arpita Katiyar , Medical Coder , Eli India

Insurance processor is underwriter, evaluate the risk factor and decide premium of insurance and insurance clerk  sells insurance policies to people, meet and talk with people regarding to benefits or drawback of policies.

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