The major job description of a Claims Clerk is to gather all information from an insured person to settle claims from the insurance companies. The job role may vary based on the insurance company setting, but the common tasks mentioned on the Claims Clerk Resume mentions these tasks – preparing insurance claim forms and other related documents, entering claims information into database systems, paying small claims, calculating amount of claim, posting and attaching information to claim files, transmitting claims for payment, contacting insured person to gather relevant data, reviewing insurance policies to determine amount of coverage, and providing exceptional customer service.
Skills that will highlight a resume include – strong interacting skills, outstanding communication and negotiation skills, good networking skills, a deep understanding and knowledge of principles and processes of insurance policies; knowledge of administrative and clerical procedures; and the ability to apply general rules to specific problems. A College degree or an Associate’s degree is sufficient to step into this employment.
Summary : Seeking an employment opportunity that will benefit from skills and experience in an environment that will further enhance skills.
Skills : Linux, medical ledger, Kareo Billing, Nue MD, Medi Touch, Web PT and SPSS.
Description :
Contact the insured or other persons to obtain missing information.
Organize and work with detailed records, using computers to enter, access, search and retrieved data.
Prepare and review insurance-claim forms and related documents for completeness.
Review insurance policy to determine coverage.
Establishing loss reports for an established insurance company Updating claims, faxing, emailing correspondence Excellent communication skills
Responsible for initial claim processing of Life, Health/ Property, and Unemployment claims Educate policyholders and loss payee representatives of coverage and payment information Developed and maintained return check data for executive leadership Assist in special projects as directed by management.
Data enter medical claims into the computer via paper claims HCFA AND UB forms.
Provide customer service to providers on claim status and assist claim examiner on questions or concerns regarding a medical claims.
Experience
7-10 Years
Level
Management
Education
Business Administration
Sr. Claims Clerk Resume
Objective : Dedicated worker achieves high academic success, consistently punctual, keyboards accurately and quickly at 70 WPM, learns visually, and adapts to change readily. Resolveing problems quickly, communicates well with people of all ages. Extremely friendly and people-oriented.
Skills : PowerPoint, Outlook, SAP, Photoshop.
Description :
Assist the Supervisor of the Fee Service Unit in the day-to-day operations of the unit by monitoring all Fee Service Unit Fund Control Points to guarantee adequate funding, and the timely payment of batches.
Monitored the distribution of fee claims and prepared productivity reports as well as monitor backlogs.
Processed claims and determined entitlement for medical benefits for authorized and unauthorized medical services for the Clinic of Jurisdiction programs.
Obtained necessary files to ensure eligibility benefits were met and made determination of legal entitlement if files were unavailable.
Reviewed and evaluated records to make service-connection rating or non-service connection determination.
Contacted veteran, private hospitals, clinics, doctor's offices, Adjudication Division, ambulance companies, emergency rooms, and authorizing physician for determining eligibility for medical services at VA expense.
Made sure that all completed and accurate batches were routed to Financial Management Service for timely payment.
Experience
2-5 Years
Level
Junior
Education
Information Technology
Junior Claims Clerk Resume
Objective : Achievement-driven professional with a strong desire to progress in the service industry. Experience within the General Insurance Industry and specifically claims experience have endowed me with excellent written and verbal communication skills, and a passion for contributing to quality-focused customer service.
Skills : Data Entry, Customer Service, Account Management.
Description :
Inquire about damage incurred, drivability, and safety of the vehicle and assign appraisal accordingly.
Review damages as a result of loss, open lines of coverage and assign new losses to adjusters.
Order specific documents pertaining to the claim or policy.
Scan and import incoming documents into correct claim files.
Processed Cobra payments, verified and maintained member eligibility, and researched problem claims to apply the correct benefit level, third party liability, overpayment, and inappropriate coding.
Implemented self-audit procedures to ensure accuracy. Provided team leadership to accomplish department goals and monitored workflow.
Managed company yearend stop-loss project also handled processing dental claims, and training provided on medical claims processing and applying correct company benefits to claims submitted.
Take new claims and issue claim numbers Filing and data input for check disbursement Transcribed Q & A's and Home Office Referral Reports.
Experience
2-5 Years
Level
Junior
Education
Automotive Technology
Claims Clerk Secretary Resume
Headline : Responsible for Providing general claims support by reviewing, researching, investigating, negotiating, processing, and adjusting claims, and also Authorizing the appropriate payment or refers claims to investigators for further review.
Skills : Underwriting Assistant, Communication Skills.
Description :
Making sure the claims are correct and mailing out in a timely manner.
Ability to examine documents for accuracy, and completeness, and to work to precise, and established.
Standards of accuracy to enter data at a high rate of speed.
Possess excellent customer service, and communication skills.
Experience with AS400, and on-base functions.
Responsible for sorting claims by procedure code so they could be batched and sent to the claims processors for processing.
Responsible for putting provider numbers on claims Responsible for placing batched claims in the claims to be processed inventory for the claims.
Experience
5-7 Years
Level
Executive
Education
Health Care Administration
Claims Clerk Resume
Summary : Claims Clerk Professional, with 4 plus years experience, with a proven track record of customer satisfaction. A Professional who delivers the versatility of office management skills with proficiency in Microsoft Office programs. Strong planner and problem solver who readily adapts to change, works fast, independently, and exceeds expectations.
Skills : Data Entry, Typing, Customer Service, Quality Control, Management.
Description :
Communicate with claimants, insurance companies and or any other parties involved with claims.
Acts as liaison between corporate and field officers to coordinate the gathering of information which will facilitate the proper response to claim losses and legal documents.
Comply with state laws, policy and company procedures.
Assist claimants, providers, and clients with problems or questions regarding claims.
Oversee and performs administrative support tasks for upper-level management.
Compile and prepares statistical data and reports.
Maintain strict confidentiality related to the claimant and corporate information.
Experience
7-10 Years
Level
Management
Education
Business Management
Asst. Claims Clerk Resume
Summary : Strongly organized, highly motivated, results-driven professional in search of the right opportunity. An extensive background in departmental support and scheduling. A self-starter that believes in dependability, honesty, accuracy, and timeliness. Enjoys challenges and dedicated to meeting goals.
Skills : Microsoft Word, Excel, Internet, Type 45 Wpm.
Description :
Contact the insured or other involved persons to obtain missing information.
Organize and work with detailed office or warehouse records, using computers to enter access, search and retrieve data.
Prepare and review insurance-claim forms and related documents for completeness.
Provide customer services, such as giving limited instructions on how to proceed with claims or providing referrals to auto repair facilities or local contractors.
Review insurance policy to determine coverage.
Processing and developing claims, daily use of microfiche and SADAR computers (with cross-training on switchboard and reception).
Special projects included learning SADAR system input and training staff.
Experience
7-10 Years
Level
Management
Education
Certified Nursing Assistant
Claims Clerk Resume
Headline : Aa a Claims Clerk, responsible for Providing general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims, Authorizing the appropriate payment or refers claims to investigators for further review.
Skills : Direct Support Staff, Customer Service.
Description :
Performed a variety of insurance claims and utilizing office web based software in a fast paced and demanding atmosphere.
Responsible for scanning and coping all EOB's in an archive folder.
Responsible for calling all insurance claims for patients for claim status for approvals and denials.
Maintaining record of insurance claims and mailing insurance claims that are not paid in full or denied for appeals.
Performed special reports in proficiency time.
Request medical records for patients for patient's insurance purposes only Responsible for new employees hired in my department and also making sure they have what they need and make them feel comfortable.
Performed clerical duties for the Supervisor in an accurate and timely matter.
Experience
5-7 Years
Level
Executive
Education
General Studies
Claims Clerk II Resume
Summary : Highly qualified Claims Clerk with experience in the industry. Enjoy creative problem solving and getting exposure on multiple projects, and the collaborative environment in which your company prides itself.
Skills : Microsoft Word, Microsoft Excel, Adobe Photoshop, Adobe.
Description :
Assist adjusters with outgoing mail, locating files, contacting customers, and completion of claims.
Preparing salvage documents and sending them to the state.
Knowledge of different state laws based on property damage and injury.
Assign field appraisals for property and auto damage claims.
Entering vendors tax information into a database.
Enter incoming mail, faxes, and e-mail to the corresponding files.
Assigned by staff members, performs essential tasks necessary in the processing of Cargo Claims Maintains orderly and up-to-date files Using the computer system, obtains and prints information needed to process claims.
Assigned by staff members, gathers all necessary documents from the appropriate parties.
Experience
10+ Years
Level
Senior
Education
AA In Studio Art
Claims Clerk III Resume
Summary : Highly qualified Claims Clerk with experience in the industry. Enjoy creative problem solving and getting exposure on multiple projects, and I would excel in the collaborative environment on which your company prides itself.
Skills : Phone skills, Filing, Typing, Ms Access, Ms Offfice, MS Excell, Photocopying, Ten-key adding maching.
Description :
Inquire about damage incurred, drivability, and safety of the vehicle and assign appraisal accordingly.
Review damages as a result of loss, open lines of coverage and assign new losses to adjusters.
Order specific documents pertaining to the claim or policy.
Scan and import incoming documents into correct claim files.
Data Entry Process all insurance claims Customer service Implemented training course for new recruits - speeding profitability.
Obtain information from insured or designated persons for the purpose of settling a claim with an insurance carrier.
Make appointments with the claimant for the adjustors.
Experience
10+ Years
Level
Senior
Education
Automotive Technology
Claims Clerk/Specialist Resume
Headline : Responsible for Conducting data entry and re-work; analyzes and identifies trends and provides reports as necessary, Analyzing and identifying trends, and provide reports as necessary
Skills : MS Office, Clerical Skills.
Description :
Perform administrative duties, such as maintaining reports and files, data entry, entering claims, transcribing, recording, storing and maintaining information.
Calculate insurance premiums or awards, code data from records distribute correspondence.
Obtain information from individuals provide customer service.
Recommend claim action review data on insurance applications or review records for completeness search legal records, or correspondences.
Experience
5-7 Years
Level
Executive
Education
Medicine
Claims Clerk Resume
Summary : Claims Clerk with 6 years of experience in Conducting data entry and re-work; analyzes and identifies trends and provides reports as necessary, Analyzing and identifying trends and provide reports as necessary.
Skills : Microsoft Excel, Adobe Photoshop, Adobe.
Description :
Work directly with litigation department assisting management with paying attorney fees, drafting correspondence, and locating coverages on policies.
Assist adjusters with outgoing mail, locating files, contacting customers, and completion of claims.
Preparing salvage documents and sending to state.
Knowledge of different state laws based on property damage and injury.
Assign field appraisals for property and auto damage claims.
Entering vendors tax information into database.
Enter incoming mail, faxes, and e-mail to the corresponding files.
Experience
10+ Years
Level
Senior
Education
AA In Studio Art
Claims Clerk Resume
Summary : To secure a challenging and responsible position were previously experienced and related skills may be utilized. The preferred position will offer opportunities for advancement based upon performance.
Skills : Microsoft Word, Excel, PowerPoint.
Description :
Index, sort and distribute daily incoming mail and packages.
Maintain records and files in order, process and code documents.
Prepare mail and packages for shipment, researches improperly mails address.
Photocopying, ordering standard office supplies and maintain mailing supplies.
Organizing information by using spreadsheet, database or word processing application.
Responsible for incoming and outgoing faxes, answer and direct phone calls, greet and direct visitors.
Assigned among other related duties upon request..
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