Roles And Responsibilities
The primary responsibilities of a Claims Associate include interacting with policyholders and agents, reviewing claims, gathering data and, maintaining reports, and ensuring that the claim is approved if the terms of the policy are met.
- Accurate processing and completion of medical claims.
- Process claims that route out of automatic adjudication, within current turnaround standards.
- Demonstrate proficiency in product lines applicable to the processing unit.
- Understand and apply plan concepts: Deductible, Coinsurance, Copay, Out-of-pocket, State variations.
- Evaluate progress for all claims and coordinate with the team leader for all issues and effective resolution and develop new methods to handle all claims.
- Administer and settle all claims effectively and inform all customers and claimants of any denial on claims.
Education & Skills
Cover letter for Claims Associate Should preferably mention the following skills:
- Excellent communication skills.
- Claim analysis and processing.
- Customer service skills.
- Strong analytical and organizational skills.
- Multitasking abilities.
- Ability to work under pressure in a fast-paced environment.
Successful cover letters for Claims Associate Often mention the following qualification(s):
- An Associate’s degree in Business Administration or similar field; and at least 2-3 years of relevant experience.
Dear Mr./Ms.,
Please accept my application for the position of Claims Associate at [XXX Insurance]. With a Bachelor’s degree in Business Administration and proven work experience of over two years as a Claims Associate, I am sure my skills would be a great addition to the [XXX]’ s workforce.
Over the past few years, [XXX Company] has emerged as one of the leading Insurance companies in the country. The company is regarded highly for its ethical work practices in helping clients meet their goals. I sincerely believe that your company can provide an ideal platform for me to upgrade my skills.
I am a performance-driven individual offering excellent leadership and communication skills, and the crucial ability to work independently as well as in a team setting. With my skills and abilities, I have successfully solved problems, resolving conflicts, and contributed to shared objectives. I have over two years of experience as a Claims Associate at [YYY Insurance].
At YYY, my current responsibilities include:
- Evaluate all claim and policy information.
- Perform interviews and gather all statements from physicians, insured clients, and attorneys for all claim information.
- Investigate and prepare reports for all denials of settlements and claims
- Providing high-quality customer service.
- Administer all claims effectively and inform all customers and claimants of any denial of claims.
- Maintain proper records of all benefits and resolve all issues in claim processes.
Furthermore, I possess the ability to use the software required for this job, including MS Office, CCAP, and GEARS. I am adept at providing solutions in a fast-paced environment. I am looking forward to an opportunity to work in a reputed organization such as yours.
Thank you for your patience.
Sincerely,
[Your Name]
Tips
A good Claims Associate Cover Letter should highlight your technical skills, hands-on software experience, specialized certifications, and career achievements. Other basic information, such as educational background and work experience, can be included in your resume. For ideas on how to create a good resume for the said position, refer to our Claims Associate Resume Sample.
