Insurance Claims Representative Resume
Objective : Seeks to secure a position in a fast-paced organization that offers challenges and opportunities for career development by gaining new skills within a positive team environment.
Skills : Testing, Account Management.
Description :
- Managed customers' accounts, keeping records of customer interactions and transactions.
- Recorded details of inquiries, comments, and complaints, recorded details of actions taken.
- Ensured that claims payments are issued in a timely and accurate manner.
- Ensured that claims handling is conducted in compliance with applicable statutes, regulations, and other legal requirements and that all applicable company procedures and policies are followed.
- Maintained journal of claims processed and matched all open and closed mail to ensure proper tracking and processing of claims consistent with company guidelines and supervisory expectations.
- Used good organizational skills to manage competing demands while performing administrative tasks associated with processing claims such as establishing and maintaining files and folders and generating required correspondences.
- Alerted Team Manager to the possibility of fraud potential for claims being processed.
Experience
2-5 Years
Level
Junior
Education
HS Diploma
Insurance Claims Representative Resume
Headline : An experienced and dynamic Health Care professional with an extensive social work service and family preservation background. Seeks to obtain a Customer Service position to further skills and experience and become a great asset to the company.
Skills : MS Office, Data Entry, Customer Service
Description :
- Communicated professionally, over the phone, and in-person, with policyholders, claimants, and their representatives.
- Investigated and settled collision, property damage, and homeowner claims.
- Provided quality customer service to members in need of reporting insurance claims.
- Provided updates to members regarding current and previous claims.
- Collected customer information to process insurance claims on lost, stolen, and or physically damage wireless phones.
- Enrolled customers in the insurance program by explaining the terms and conditions of the insurance program.
- Educated the customers on the policy of the insurance program and the benefits of maintaining insurance.
- Transferred customer to the appropriate department to assist in phone replacement.
Experience
5-7 Years
Level
Executive
Education
Associates in Science
Insurance Claims Representative Resume
Summary : Goal-oriented management Insurance Claims Representative professional with excellent organizational and interpersonal skills seeks opportunities to contribute expertise while working for a reputable organization.
Skills : Typing 70+ wpm, 10-key proficient, Excellent Customer Service and Computer.
Description :
- Dealt directly with customers either by telephone or electronically.
- Performed daily data entry of incoming insurance claims to be processed by underwriting.
- Performed initial telephone interviews with applicants to obtain any additional information underwriting required.
- Responded promptly to customer inquiries, handle and resolve customer complaints.
- Obtained and evaluated all relevant information to handle inquiries and complaints.
- Performed customer verifications, process orders, forms, applications, and requests.
- Directed requests and unresolved issues to the designated resource.
Experience
7-10 Years
Level
Management
Education
N/A` in Sociology
Insurance Claims Representative Resume
Headline : Looking to obtain an Insurance Claims Representative position in a field wherein one can use skills to the full extent at the same time be an excellent asset to the company.
Skills : CPR Certified, MS Office.
Description :
- Investigated and maintained claims.
- Reviewed and evaluated coverage and/or liability.
- Secured and analyzed necessary information.
- Reviewed and researched incoming claims by navigating multiple computer systems and platforms and accurately captures the data/information necessary for processing.
- Completed on a daily basis all data entry required to document and communicate the status of claims as needed adhering to all.
- Obtained information and maintains accurate records.
- Maintained professional client relationships.
Experience
5-7 Years
Level
Executive
Education
EMT in Emergency Medical Technician
Insurance Claims Representative Resume
Headline : Background includes installing/working with various fiber optic, data, telephone, and security systems, have also supervised and maintained confidential employee records, invoices, and payroll.
Skills : Active Directory, Ticketing Systems, Lotus Notes, Remote Desktop, Java, HTML, Javascript, CSS.
Description :
- Reviewed and handled simple and straightforward claims (i.e., small theft or minor automobile property damage).
- Wrote or revised a brief description of loss to ensure that it accurately reflects the actual circumstances of the incident in question.
- Determined and establishes liability, enters claim reserve requirements, and made adjustments as necessary, during the processing of the claims.
- Communicated with policyholders, witnesses, and claimants in order to gather information regarding claims.
- Responded to various written and telephone inquiries including status reports.
- Explained the facts and logic behind decisions in a way that the customers were able to understand, even if they did not agree with the findings.
- Documented actual damages associated with claims and processed settlements within assigned authority limits.
Experience
5-7 Years
Level
Executive
Education
Certifications in Telecom/ Fiber Optics/Security Systems
Insurance Claims Representative Resume
Objective : Seeks to become affiliated with a progressive organization where achievements and skills will provide opportunities for advancement.
Skills : Administrative Support, Customer Service.
Description :
- Attracted potential customers by answering product and service questions; suggesting information about other products and services.
- Openned customer accounts by recording account information.
- Maintained customer records by updating account information.
- Resolved product or service problems by clarifying the customer's complaint; determining the cause of the problem; selecting and explaining the best solution to solve the problem; expediting correction or adjustment; following up to ensure resolution.
- Maintained financial accounts by processing customer adjustments.
- Recommended potential products or services to management by collecting customer information and analyzing customer needs.
- Prepared product or service reports by collecting and analyzing customer information.
Experience
2-5 Years
Level
Junior
Education
Diploma
Insurance Claims Representative Resume
Headline : A detail-oriented professional employs a strong aptitude for decision making. Excel at troubleshooting. Ability to learn new software in a short amount of time with high retention.
Skills : CPR Certified, MS Office, Data Entry, Oracle.
Description :
- Responsible for taking calls regarding claims for medical and dental insurance.
- Took inbound and outbound calls from customers who were filing for vehicle accident claims.
- Resolved problems with upset customers and claims troubleshoot claims, filed while creating folders for the claims, did an inventory of claims numbers.
- Interpreted English and Spanish between the insurance adjuster and customers with language barriers.
- Called up the interpreter's 1-800 line for other foreign language barriers.
- Dealt with customer complaints and assisted customers with financial questions.
- Verified Mortgages to other creditors, updated customer accounts, performed general data entry, and handled payoff balances.
Experience
5-7 Years
Level
Executive
Education
EMT in Emergency Medical Technician
Insurance Claims Representative Resume
Headline : Goal-oriented, responsible professional dedicated to high levels of customer satisfaction and meeting aggressive business goals. Passionate and motivated, with a drive for excellence. Able to offer specialized knowledge in front & back office Medical Assistant and customer service. Handles tasks with accuracy and efficiency.
Skills : Computer Literate, Typing, Inventory, Customer service, Sales, and Manufacturing.
Description :
- Used computers for various applications, such as database management or word processing.
- Answered telephones and give information to callers, take messages, or transfer calls to appropriate individuals.
- Created, maintained, and entered information into databases.
- Operated office equipment, such as fax machines, copiers, or phone systems, and arrange for repairs when equipment malfunctions.
- Completed forms in accordance with company procedures.
- Managed projects or contribute to committees or teamwork.
- Supervised other clerical staff and training to new staff.
Experience
5-7 Years
Level
Executive
Education
Medical Assistant
Insurance Claims Representative Resume
Headline : Looking to obtain a fulfilling position at a fitness center, focusing on client goals, customer relations, and team leadership while providing excellent service and client satisfaction.
Skills : Computer, Communications, Telemarketing, Filing Documenting.
Description :
- Filled all glass claims while remaining pleasant and professional at all times.
- Answered all inbound calls and handling customer requests in a timely manner.
- Made outbound calls to preferred service shops to repair damaged vehicles.
- Noted accounts with detailed information for every caller.
- Followed detailed scripts for every account and providing the caller with necessary information.
- Worked with Microsoft windows programs to locate different repair shops and customer information.
- Provided a high level of customer service by being courteous, friendly, empathetic, and knowledgeable.
Experience
5-7 Years
Level
Executive
Education
Biomedical Informatics
Insurance Claims Representative Resume
Headline : Contributing to team effort by accomplishing related results as needed, and also completing Appeals for all Insurance carriers and have sent with Medical Records to ensure timely payments.
Skills : Communication Skills, Planning Skills, Claims.
Description :
- Specialized in insurance follow-up for all commercial, contracted, and non-government payers.
- Responsible to perform timely insurance follow up on billing submissions.
- Made calls to Insurance companies to find out if claims are paid, and/or paid correctly to contracts.
- Made decisions from calls as to what avenue to take
- Required to meet the daily/monthly averages per the productivity reports established by the Insurance Claim Supervisor.
- Emails to the Hospital Financial Counselors to ensure correct adjustments and patient responsibilities are correct.
- Emails to the Hospital Billing Department to ensure correct coding and corrected claims are sent to the correct address.
Experience
5-7 Years
Level
Executive
Education
HS Diploma