Assessment Template For Insurance Claims and Policy Processing Clerks

Process new insurance policies, modifications to existing policies, and claims forms. Obtain information from policyholders to verify the accuracy and completeness of information on claims forms, applications and related documents, and company records. Update existing policies and company records to reflect changes requested by policyholders and insurance company representatives.
Insurance Claims and Policy Processing Clerks

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Popular Job Roles
Claims AdjudicatorClaims AnalystClaims ClerkClaims Customer Service Representative (Claims CSR)Claims ProcessorClaims Representative (Claims Rep)Claims Technician (Claims Tech)Insurance AnalystPolicy AnalystUnderwriting Assistant

Occupation-Specific

Technology Skills
Data base user interface and query software
Questions25
Time Limit20 min

Tasks

  • Prepare insurance claim forms or related documents, and review them for completeness.
  • Calculate amount of claim.
  • Post or attach information to claim file.
  • Transmit claims for payment or further investigation.
  • Contact insured or other involved persons to obtain missing information.

Technology Skills

Data base user interface and query software

Alpha Software Alpha Five, Database software, Microsoft Access, Policy issuance system software

Instant messaging software

GroupMe

Medical software

Healthcare common procedure coding system HCPCS, Medical condition coding software, Medical procedure coding software

Electronic mail software

IBM Lotus Notes, MicroFocus GroupWise, Microsoft Outlook

Accounting software

Account management software, Billing software

Worker Requirements

Technology Skills
Data base user interface and query software
Questions25
Time Limit20 min
Skills
Reading Comprehension
Questions25
Time Limit15 min
Knowledge
Customer and Personal Service
Questions20
Time Limit20 min

Skills

Reading Comprehension

Understanding written sentences and paragraphs in work-related documents.

Time Management

Managing one's own time and the time of others.

Speaking

Talking to others to convey information effectively.

Active Listening

Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.

Critical Thinking

Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.

Knowledge

Customer and Personal Service

Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.

Administrative

Knowledge of administrative and office procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and workplace terminology.

English Language

Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.

Computers and Electronics

Knowledge of circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming.

Worker Characteristics

Technology Skills
Data base user interface and query software
Questions25
Time Limit20 min
Skills
Reading Comprehension
Questions25
Time Limit15 min
Knowledge
Customer and Personal Service
Questions20
Time Limit20 min
Abilities
Oral Comprehension
Questions20
Time Limit15 min
Interests
Conventional
Questions30
Time Limit25 min
Work Values
Relationships
Questions20
Time Limit15 min
Work Styles
Attention to Detail
Questions20
Time Limit15 min

Abilities

Oral Comprehension

The ability to listen to and understand information and ideas presented through spoken words and sentences.

Written Comprehension

The ability to read and understand information and ideas presented in writing.

Near Vision

The ability to see details at close range (within a few feet of the observer).

Oral Expression

The ability to communicate information and ideas in speaking so others will understand.

Speech Clarity

The ability to speak clearly so others can understand you.

Interests

Conventional

Conventional occupations frequently involve following set procedures and routines. These occupations can include working with data and details more than with ideas. Usually there is a clear line of authority to follow.

Enterprising

Enterprising occupations frequently involve starting up and carrying out projects. These occupations can involve leading people and making many decisions. Sometimes they require risk taking and often deal with business.

Social

Social occupations frequently involve working with, communicating with, and teaching people. These occupations often involve helping or providing service to others.

Work Values

Relationships

Occupations that satisfy this work value allow employees to provide service to others and work with co-workers in a friendly non-competitive environment. Corresponding needs are Co-workers, Moral Values and Social Service.

Support

Occupations that satisfy this work value offer supportive management that stands behind employees. Corresponding needs are Company Policies, Supervision: Human Relations and Supervision: Technical.

Independence

Occupations that satisfy this work value allow employees to work on their own and make decisions. Corresponding needs are Creativity, Responsibility and Autonomy.

Work Styles

Attention to Detail

Job requires being careful about detail and thorough in completing work tasks.

Dependability

Job requires being reliable, responsible, and dependable, and fulfilling obligations.

Integrity

Job requires being honest and ethical.

Cooperation

Job requires being pleasant with others on the job and displaying a good-natured, cooperative attitude.

Self-Control

Job requires maintaining composure, keeping emotions in check, controlling anger, and avoiding aggressive behavior, even in very difficult situations.

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