Claims Assessor Resume Samples

The basic job purpose of a Claims Assessor is to assess the various types of claims and assist the department with the necessary paperwork. The job description entails assessing, investigating, and settling insurance claims. Playing a vital role in providing exemplary customer experience, these individuals ensure that the process gets completed quickly and efficiently. A well-drafted Claims Assessor Resume mentions the following core duties – reviewing claims, gathering evidence and supporting documentation, verifying the accuracy of the information, computing the amount of the claim, providing the customers with settlement terms and offers, managing disputes or disagreements, and providing customer advice.

To ensure success in this role, the candidate should possess excellent communication skills, decision-making skills, and strong attention to detail. Proficiency in mathematics and accounting is as well needed. Additionally, a thorough understanding of insurance policies and procedures will be highly beneficial. The minimum education requirement for this role is typically a high school diploma or GED. Some employers prefer those having a college degree in a related field.

Claims Assessor Resume example

Claims Assessor Resume

Summary : A highly motivated and passionate individual who thrives in a challenging environment. Existing knowledge to grow and capitalize on skills to drive success in a business environment and to further professional career. Have a wide range of Legal, Project Management, Training, Recruitment, Sales, Customer Retention and Customer Service experience at management level.

Skills : Microsoft Office, Research, Presentation, Communicating, Customer Service.

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Description :

  1. Processed reports indicating all accidents with detail outstanding.
  2. Ensured all information and documentation is comprehensive and accurate.
  3. Managed monthly targets and ensured effective management of strategic initiatives.
  4. Captured details and updated the system timeously.
  5. Wrote accident reports when and if required.
  6. Utilized Assessor's coding system to identify/verify UPC numbers to documents.
  7. Verified legal descriptions of real property contained in deeds and other documents and compare them with information on IAS/cadastral maps to identify the location of the property.
Years of Experience
Experience
10+ Years
Experience Level
Level
Senior
Education
Education
BA


Claims Assessor Resume

Summary : As a Claims Assessor, examined numerous documents such as police reports, court records, and medical records or interview people including the claimant or witnesses to confirm the validity of the claim and determine the payment amount.

Skills : Wide knowledge of Medical and Scheme Underwriting, Analytical Skills.

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Description :

  1. Completed claims notification forms and submit them to third-party insurers Liaised with insurance companies regarding our client's liability.
  2. Managed end-to-end claims process, assessed and approved death and critical illness claims.
  3. Worked closely with the Divisional Vice President on various duties.
  4. Conducted discrepancy reviews on medical claims for re-submission.
  5. Performed insurance verification.
  6. Compiled federal, state, and commercial payer groupings for payment allocations and posting.
  7. Prepared written documents such as letters, memoranda, proposals, work plans, and investigative reports.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
Degree in Insurance


Claims Assessor Resume

Summary : As a Claims Assessor, responsible for delivering world-class service to our members, internal customers, and providers. Provided global support, front-line customer services, claims, and product expertise.

Skills : Excellent knowledge of key indicators for fraud detection, Customer Service.

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Description :

  1. Analyzed large environmental datasets, conducted statistical analyses, and prepared tables, figures, and other data exhibits.
  2. Reviewed and interpreted environmental and toxicological studies and reports.
  3. Conducted exposure and human health and ecological risk assessments in accordance with federal and state guidance.
  4. Supported remedial strategy development for contaminated sites.
  5. Performed analyses to support the allocation of remedial costs.
  6. Developed sampling and analysis plans for various media, including soil, groundwater, sediment, and indoor air.
  7. Performed environmental sampling.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
Degree in Insurance

Claims Assessor Resume

Summary : As a Claims Assessor, answered queries on the claims handling process and specific claims, whether those questions come from members directly, internal operations teams, account management teams, or brokers.

Skills : Estimating, Reviewing, and Understanding medical terminology.

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Description :

  1. Traced routine chains of title to determine ownership of property using coding knowledge.
  2. Reviewed, verified, and/or researched information submitted by taxpayers for accuracy.
  3. Maintained and updated property ownership information on Integrated Assessment System IAS.
  4. Responded to inquiries in person, in writing, and over the telephone in a courteous and exemplary manner; provide information within the scope of knowledge or refer to a supervisor or other personnel as necessary.
  5. Reviewed and verified daily transactions for quality assurance and accuracy of prior day data entry.
  6. Coordinated preparation, distribution, and processing of department mail and/or faxes.
  7. Researched appraisal records for comparison to tax records to determine property ownership and ensure appropriate measures are taken to correct discrepancies.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
Degree in Insurance

Claims Assessor Resume

Headline : As a Claims Assessor, responsible for overseeing the entire claims assessment process, including benefit explanation. Responsible for clerical functions and other necessary duties that are associated with insurance transactions.

Skills : Customer Service, Investigation, and Interview.

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Description :

  1. Managed the process of a claim assessment.
  2. Liaised with people in person, by phone, or in writing.
  3. Determined the cause of the damage.
  4. Provided empathetic customer service to clients and stakeholders.
  5. Conducted investigations and interviews to assess the claim.
  6. Estimated the cost of repairs.
  7. Collected and shared complex information in a way that is easy for people to understand.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Degree in Insurance

Claims Assessor Resume

Objective : As a Claims Assessor, assessed the damage and loss of insured properties and businesses, estimated insurance costs, and inspected insured properties in order to evaluate the conditions that affect underwriting standards.

Skills : Claims Assessment, Liaising, Empathy.

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Description :

  1. Reviewed documentation including medical records or court reports.
  2. Calculated and processed claim-related payments.
  3. Prepared recommendations to reduce risks.
  4. Identified and investigated claims for possible abuse and fraud.
  5. Conducted outreach activities including but not limited to email, member calls, and provider calls as part of the claims adjudication process.
  6. Prescribed operational guidelines, manages claims on desk, route/queues, and all systems within specified turn-around-time parameters.
  7. Utilized all applicable system functions available ensuring accurate and timely claim processing service (i.e., use of all documented resources).
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
Degree in Insurance

Claims Assessor Resume

Objective : A Claims Assessor is responsible for evaluating insurance claims on behalf of insurance companies in order to determine who is liable. Investigated the circumstances of insurance claims by consulting with witnesses, reviewing police reports, and compiling evidence from other sources.

Skills : Excellent communication skills, Oral and written communication skills.

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Description :

  1. Obtained all necessary information on claims for the purpose of completing processing.
  2. Uncovered fraudulent claim scheme.
  3. Assisted underwriters and insurance agents in the field to investigate claims and determine the cost and extent of damages.
  4. Developed and maintained a strong understanding of insurance policies and legal issues.
  5. Inputted claims into the computer system accurately.
  6. Contributed to the continuous development of the claims process by identifying and implementing several opportunities for the development of products and process improvement.
  7. Suspended claims that require further investigation in order to resolve them appropriately.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
Degree in Finance

Claims Assessor Resume

Objective : As a Claims Assessor, responsible for reviewing settled insurance claims to determine that payments and settlements have been made in accordance with company practices and procedures. Reported overpayments, underpayments, and other irregularities. Conferred with legal counsel on claims requiring litigation.

Skills : Analytical skills, Technical skills.

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Description :

  1. Resolved claims using the best method of communication and initiative.
  2. Responded to all relevant incoming correspondence and queries from the company’s internal departments.
  3. Worked on a shift basis as required by the organization.
  4. Protected the interest of the insurance company when dealing with claimants.
  5. Investigated the nature of the damage being claimed.
  6. Interviewed witnesses to understand the nature of the claim and gain an understanding of what occurred prior to the claim.
  7. Evaluated police reports, video footage, previous insurance claims, and other information to further understand the incident.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
Degree in Finance

Claims Assessor Resume

Objective : As a Claims Assessor, responsible for reviewing client claims, determining allowable benefits, and providing professional testimony in a court of law. Highly analytical, and possess in-depth knowledge of the latest policies and regulations in the insurance industry.

Skills : Ability to maintain accuracy and production standards, Analytical Skills.

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Description :

  1. Created reports detailing the events and damage related to the claim.
  2. Researched the costs of repairing the damage.
  3. Reviewed the claim holder's insurance policy in order to determine what should be covered.
  4. Coordinated the services of mechanics, architects, contractors, etc in order to ensure damage is repaired.
  5. Negotiated claim settlements with claimants and/or their legal teams.
  6. Performed assessment and assisted in the settlement of technical claims.
  7. Monitored claims arising from accidents, income protection, and illness.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
Degree in Finance

Claims Assessor Resume

Objective : As a Claims Assessor, collected information from various sources to determine insurance liability based on the extent of property or personal damage. Interviewed claimants and witnesses, and often consult with specialists, such as policyholders and engineers.

Skills : Strong analytical and mathematical skills.

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Description :

  1. Performed investigation on various fraudulent claims.
  2. Coordinated with underwriters and maintained the accuracy of all information.
  3. Ensured compliance with marketing and sales department regulations.
  4. Provided technical support to claim offices throughout the region.
  5. Reviewed and processed new claims reports and court verdicts.
  6. Uphold relationships and communication with insurance departments and clients.
  7. Organized and presented claim review plans.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
Degree in Finance