Recruiter's Glossary

Examples: Risk Assessment • IBAN (International Bank Account Number) • Bloomberg Terminal

Claims Processing

Term from Financial Services industry explained for recruiters

Claims Processing is an essential function in insurance and healthcare industries where professionals handle and review requests for payment or reimbursement. It involves verifying information, determining coverage, and ensuring proper payment for services or losses. Think of it as managing the paperwork and decisions that happen after someone files an insurance claim, whether it's for medical treatment, car accidents, or property damage. This role has become increasingly digital, with many companies using specialized software to make the process faster and more accurate.

Examples in Resumes

Managed Claims Processing team of 12 staff handling 500+ weekly insurance claims

Streamlined Claims workflow reducing processing time by 40%

Implemented new Claims Processing software and trained staff on digital systems

Handled complex Insurance Claims and maintained 98% accuracy rate

Typical job title: "Claims Processors"

Also try searching for:

Claims Specialist Claims Adjudicator Claims Representative Claims Analyst Insurance Claims Processor Benefits Specialist Claims Administrator

Where to Find Claims Processors

Professional Associations

Job Boards

Professional Networks

Example Interview Questions

Senior Level Questions

Q: How would you handle implementing a new claims processing system across multiple departments?

Expected Answer: Look for answers that show experience in change management, team training, and maintaining service quality during transitions. They should mention stakeholder communication and risk management.

Q: Describe a situation where you improved a claims processing workflow.

Expected Answer: Strong answers should include specific examples of identifying bottlenecks, implementing solutions, measuring improvements, and managing team adoption of new processes.

Mid Level Questions

Q: What steps do you take to ensure accuracy in claims processing?

Expected Answer: Candidate should discuss verification procedures, documentation requirements, and quality control measures they've used. They should mention both system checks and manual review processes.

Q: How do you handle difficult claimants while maintaining professional standards?

Expected Answer: Look for answers demonstrating customer service skills, conflict resolution, and knowledge of company policies while maintaining compliance requirements.

Junior Level Questions

Q: What are the basic steps in processing an insurance claim?

Expected Answer: Should be able to outline the basic workflow: receiving claims, verifying information, determining coverage, processing payment, and documentation requirements.

Q: How do you prioritize your claims workload?

Expected Answer: Should demonstrate understanding of urgency levels, deadline management, and basic organizational skills in handling multiple claims simultaneously.