Insurance Customer Service Representative (Insurance CSR)
Insurance Claims and Policy Processing ClerksDescription
Serve as the primary point of contact for policyholders, handling inquiries, billing issues, and assisting with policy changes and claim initiation. Verify and update customer and policy information, explain coverages and procedures, and escalate complex matters to adjusters or underwriters. Document interactions and maintain accurate records to support timely service and compliance.
- • Assist customers in initiating claims and review submissions for completeness.
- • Explain deductibles, limits, and claim status; escalate valuation questions.
- • Enter and update data to generate quotes, ID cards, certificates, and billing adjustments.
- • Notify producers, carriers, and accounting of cancellations or non-pay status.
- • Process premium payments, refunds, and credits within authority.
- • Prepare and submit applications and required forms to carriers or regulators.
- • Accept payments and issue receipts or confirmations.
- • Handle inbound and outbound calls, emails, and chats to gather claim or policy information.
- • Monitor daily reports for cancellations, lapses, and exceptions; take follow-up action.
- • Draft customer communications and internal memos.
- • Calculate premium changes, endorsements, and refunds using rating guidelines; escalate complex rating.
- • Maintain accurate notes and upload documents in policy and claim systems.
- • Process updates to beneficiaries, coverages, vehicles, drivers, locations, or insured property.
- • Maintain organized electronic files for each account, including reinstatement and cancellation documentation.
- • Document and attach customer-provided information to policy and claim files.
- • Route claims and supporting documents to adjusters or carriers for review.
- • Contact customers and third parties to obtain missing details or documents.
- • Review policy terms to answer coverage and eligibility questions.
- • Process policy changes, endorsements, renewals, and basic new-business submissions.
- • Use agency and carrier systems and CRM to enter, access, and retrieve data.
- • Provide guidance on next steps, vendor referrals, and service procedures.
- • Correspond with customers and agents about account status, changes, and required actions.
- • Verify customer identity, contact details, and policy information for accuracy.
- • Evaluate and process reinstatement requests per guidelines.
- • Review customer requests and documents to determine needed policy updates and their impact.
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Last reviewed: Jan 2026
