Telephone Claims Representative Resume Samples

A Telephone Claims Representative is a claims investigator or representative who provides support and assistance about insurance coverage. Typical work activities found on the Telephone Claims Representative Resume are – interviewing and corresponding with claimants, witnesses, and police; preparing reports of findings of the investigation, interviewing and corresponding with agents and claimants, analyzing the information gathered by investigation, referring questionable claims to the investigator, negotiating claims settlements and recommending litigations, investigating and assessing property damage, reviewing property damage estimates, and obtaining credit information from banks and other credit services.

Those seeking this job role must be able to mention on the resume such skills as – knowledge of insurance coverage rules and regulations, telephone mannerism, multitasking skills, strong verbal and written communication skills, numerical accuracy, and knowledge of using relevant software. Formal education beyond a high school diploma or GED is not needed for this role.

Telephone Claims Representative Resume example

Telephone Claims Representative Resume

Headline : Results-driven professional with self-confidence, integrity, and commitment to customer service excellence. Graduate of the University of Phoenix earning my bachelors degree in Business Marketing. Creative, pragmatic and proactive problem-solver; Organized and attentive to detail, with demonstrated time management skills.

Skills : Microsoft Office, Claims Handling, Customer Service, Negotiation, Sales.

Description :

    1. Evaluated all evidence with the ultimate goal of creating positive outcomes for the client's claims.
    2. Reviewed new files to determine current status of injury claim and to develop a plan of action.
    3. Answered questions posed by insured and attorneys.
    4. Answered customer questions regarding deductibles.
    5. Maintained contact with claimants and attorneys to determine treatment status.
    6. Investigated claims involving potential and suspected fraudulent activities.
    7. Substantiated legitimate claims and denied unjustified claims.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Junior
Education
Education
Associate Of Science In Nursing


Telephone Claims Representative Resume

Summary : To establish a long-term career in a company where I may utilize my Telephone Claims Representative professional skills and knowledge to be an effective Associate Program Manager and inspiration to those around me.

Skills : Microsoft Office, CCTV, Forklift Operator, Phone Etiquette, Computer Skills.

Description :

    1. Investigated, evaluated, and settled claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
    2. Handled those claims that meet the Telephone Claims criteria from start to finish.
    3. Opened, reviewed, and recommended proper reserves on all claim files assigned, and ascertain the proper amount of damages on all assigned claims in a prompt and efficient manner.
    4. Submitted reports to the District Claims Manager on each claim assigned in accordance with Claims department procedures.
    5. Confirmed status of policy and coverage.
    6. Paid and processed claims.
    7. Planned, organized, and completed detailed work independently or in a team environment.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
GED


Telephone Claims Representative Resume

Summary : Substantial experience working in the workforce development and training industry. Excellent analytical and problem-solving skills. Self-motivated, enthusiastic, and organized. Demonstrated ability to manage multiple priorities.

Skills : Microsoft Office, Telephone Communications, Data Entry, Work Independently.

Description :

    1. Contacted or interviewed claimants.
    2. Evaluated insurance policies and analyzed damages to determine coverage.
    3. Answered multiple calls per day by addressing customer inquiries and solving problems.
    4. Maintained an up-to-date diary(or daily tasks).
    5. Learned to handle most aspects of auto claims.
    6. Developed a basic understanding of the content of policies written by the company.
    7. Developed a basic understanding of the insurance industry and the organizational relationships of the company.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
MS

Telephone Claims Representative Resume

Headline : Making appropriate contacts to discuss a settlement; extend an offer to the appropriate party; documenting all file activity and payment/settlement information in file notes clearly outlining the basis for settlement.

Skills : Microsoft Office Suite, Claim Representative

Description :

    1. Investigated complex claims that involve liability disputes.
    2. Interacted with policyholders, claimants, medical insurers, and body shops.
    3. Verified accident facts, review supporting case files, and negotiate settlements.
    4. Delivered on GEICO's promise to be there when policyholders need us most.
    5. Verified accident facts, determine policy coverage, and review insurance contracts.
    6. Helped settle claims where there are no injuries and everyone agrees to the accident details.
    7. Developed a basic understanding of the functions of other departments, such as Policy Ops and Marketing.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
BS

Telephone Claims Representative Resume

Headline : Self-motivated Telephone Claims Representative with relevant years of experience and related proficiencies within the Insurance Industry. Detail-oriented with extensive experience in reading and applying insurance policies, and auto claims. Organized and hardworking with the ability to handle multiple tasks while solving complex problems in a timely manner. Eager for professional growth, and increased responsibility within the challenging insurance environment.

Skills : Planning Skills, Researching Skills.

Description :

    1. Contacted customers in a call center environment via phone, internet, or email to develop rapport in regards to filing a claim.
    2. Promptly input data entry as well as file and copy information electronically in regards to a client's claim.
    3. Demonstrated attention to detail, organization skills, and ability to excel in a fast-paced environment in regard to claim to handle.
    4. Obtained recorded statements of parties involved in the loss.
    5. Responded to all situations in a timely fashion to comply with Insurance laws.
    6. Negotiated with claimants in order to settle various claims outside of court.
    7. Resolved disputes in accidents, handled GEICO policy holder's injury claims; resolved coverage conditions on the policy, for instance, canceled policies or policies being set up after the date of the loss; set up rental vehicles for the customer, as well as inspections for the vehicle.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
GED

Telephone Claims Representative Resume

Headline : Receiving claim assignments and verifying/investigating coverage and document all appropriate information before the Manager is involved with the review of claims to ensure they are commensurate with ability.

Skills : Management, MS Office, Marketing, Customer Service.

Description :

    1. Provided exceptional customer service to all interested parties in a high pace environment and Telephone Claims Representative 2 plus additional duties.
    2. Handled other customers serious injuries; for instance fractured bones, amputations, surgeries, and death; handling the additional insurance coverage called Underinsured Motorist, which includes serious injuries and non-serious injuries; and lastly the handling of claims that go to the lawsuit, which also include serious and non-serious injuries.
    3. Developed an understanding of the functions of other departments, such as Policy Ops and Marketing.
    4. Handled those claims that meet the Telephone Claims criteria from start to finish, including most non-disputed claims with a loss value of $2500 or less.
    5. Investigated, evaluated, and settled claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
    6. Made proper assignment of claims to appropriate Claims Representative, Telephone Claims Representative, or other Claims personnel, in and out of the territory.
    7. Opened, reviewed, and recommended proper reserves on all claim files assigned, and ascertain the proper amount of damages on all assigned claims in a prompt and efficient manner.
                                              Years of Experience
                                              Experience
                                              5-7 Years
                                              Experience Level
                                              Level
                                              Executive
                                              Education
                                              Education
                                              MS

                                              Telephone Claims Representative Resume

                                              Headline : Accomplished Telephone Claims Representative major with extensive experience in customer service, seeks to leverage post-secondary education and advancement within customer service and customer care.

                                              Skills : Microsoft Office, Medical Terminology, Medical Records, Customer Service.

                                              Description :

                                                1. Investigated auto claims to determine coverages, liability, and damages.
                                                2. Answered high volume inbound calls and respond to inquires from policyholders, claimants, attorneys, body shops, and medical providers.
                                                3. Partnered with auto adjusters, appraisers to set up auto inspections in order to get customers back to a pre-accident state.
                                                4. Mitigated losses by preparing arbitration reports to recover damages paid.
                                                5. Negotiated with adverse carriers to resolve claims.
                                                6. Provided exceptional customer service to all interested parties in a high pace environment.
                                                7. Worked on a desk handling GEICO customer's claims.
                                              Years of Experience
                                              Experience
                                              5-7 Years
                                              Experience Level
                                              Level
                                              Executive
                                              Education
                                              Education
                                              GED

                                              Telephone Claims Representative Resume

                                              Headline : Establishing an investigative plan; initiating an investigation by gathering facts and evidence with all interested parties; complete appropriate reports; take recorded statements when necessary, may review loss reserves, and adjust or opens hidden exposures as necessary.

                                              Skills : Communication Skills, Written Skills.

                                              Description :

                                                1. Handled everything from Telephone Claims Representative 1 plus additional duties.
                                                2. Maintained above satisfactory ratings since being promoted to my current job.
                                                3. Worked knowledge of medical coding to understand medical bills that are submitted.
                                                4. Promoted to the Continuing Unit after only a year.
                                                5. Investigated claims by collecting appropriate data and information pertinent to each specific case in order to determine the cause of car accidents and liability exposures.
                                                6. Promptly and equitably settled and paid injury and property loss claims.
                                                7. Executed strong written and verbal communication skills through daily correspondence with all parties involved in the settlement of claims, including claimants, attorneys, other insurance adjusters, colleagues, and management.
                                              Years of Experience
                                              Experience
                                              5-7 Years
                                              Experience Level
                                              Level
                                              Executive
                                              Education
                                              Education
                                              BBA In Accounting

                                              Telephone Claims Representative Resume

                                              Objective : Obtain a rewarding and challenging Telephone Claims Representative position as an Operations Manager with VRMI. Apply the customer service skills and leadership I have to make your company better. Use organizational, deadline management, and follow-up skills to keep projects on time, under budget & professional.

                                              Skills : Proficient In Microsoft Office Proficient In Adobe Acrobat Excellent Reasoning, Negotiating, And Critical Thinking Abilities.

                                              Description :

                                                1. Acted as the first point of contact for customers.
                                                2. Resolved non-injury and undisputed liability claims.
                                                3. Explained applicable coverage and claims processes to clients.
                                                4. Identified and referred suspect claims accordingly.
                                                5. Managed emails and electronic correspondence.
                                                6. Organized and scheduled rental cars for clients when the cases warranted.
                                                7. Learned how to determine subrogation or fraud potential and how to handle it.
                                              Years of Experience
                                              Experience
                                              2-5 Years
                                              Experience Level
                                              Level
                                              Junior
                                              Education
                                              Education
                                              Bachelor Of Arts In Sociology

                                              Telephone Claims Representative Resume

                                              Objective : Establishing an investigative plan; initiating an investigation by gathering facts and evidence with all interested parties; complete appropriate reports; take recorded statements when necessary, may review loss reserves, and adjust or opens hidden exposures as necessary.

                                              Skills : Sales, Telephone.

                                              Description :

                                                1. Developed a basic understanding of systems and technology used within the company.
                                                2. Identified customer needs and works to meet those needs using appropriate customer service skills.
                                                3. Evaluated and adjusted claims within the limit of authority and summarize claims in excess of authority and submit to the manager for approval.
                                                4. Evaluated settlement alternatives by reviewing regulatory compliance and fair claims practices; make decisions on the best option.
                                                5. Made appropriate contacts to discuss a settlement; extend an offer to appropriate party; document all file activity and payment/settlement information in file notes clearly outlining the basis for settlement.
                                                6. Determined subrogation or fraud potential and refer to Unit when the potential exists or handle to the conclusion.
                                                7. Identified customer needs and works to meet those needs using appropriate customer service skills.
                                                              Years of Experience
                                                              Experience
                                                              2-5 Years
                                                              Experience Level
                                                              Level
                                                              Executive
                                                              Education
                                                              Education
                                                              Bachelor Of Business Administration