Almost all insurance companies hire a Claims Assistant to provide administrative and clerical staff. Apart from processing insurance claims, these assistants undertake all tasks that are mentioned on the Claims Assistant Resume – handling correspondence, taking phone calls, typing documents, ensuring the customer’s needs are met, assisting customers in filling their applications, gathering and organizing files, helping in auditing and mailing correspondence, providing general office and clerical assistance, reviewing bills, and executing all other duties as assigned.
It is recommended that the applicants have a thorough knowledge of using MS Office and relevant software to execute their jobs, the candidate should also show familiarity with the insurance industry, and they should be comfortable working with specific claims processing software. Candidates should possess fast typing skills as well. Eligible candidates should display on the resume an Associate’s degree in relevant areas.
Objective : Dedicated Claims Assistant with over five years of experience in claims processing and administration. Proficient in managing customer inquiries and facilitating efficient claim resolutions. Strong analytical skills and attention to detail, ensuring compliance with industry regulations. Committed to fostering positive relationships and enhancing customer satisfaction while adapting to dynamic environments.
Skills : 10-key Data Entry Skills, Typing Speed Of 35 Wpm, Claims Processing, Organizational Skills
Description :
Assists in the processing of claims by applying knowledge of claims procedures and policies.
Coordinates with various departments to ensure timely and accurate claims resolution.
Analyzes incoming claims and requests, ensuring proper documentation and compliance.
Serves as a point of contact for clients, providing updates and addressing inquiries.
Maintains organized claims folders and records to facilitate smooth operations.
Tracks and monitors claims status, escalating issues as necessary.
Ensures adherence to regulatory standards and internal policies throughout the claims process.
Experience
2-5 Years
Level
Executive
Education
AAS
Billing Claims Assistant Resume
Summary : Results-oriented Claims Assistant with a decade of comprehensive experience in claims processing and customer service. Adept at navigating complex claims issues with a focus on compliance and efficiency. Proven ability to enhance client satisfaction through effective communication and problem-solving strategies, while maintaining meticulous attention to detail.
Skills : Microsoft Office Suite, Filing Systems, Technical Proficiency, Regulatory Compliance, Record Keeping
Description :
Collaborated with examiners, specialists, and injured workers to facilitate claims processing.
Filed and served stipulations, settlements, and medical reports to relevant parties.
Assisted in processing insurance claims by gathering necessary documentation and information.
Processed disability notices and medical correspondence efficiently.
Coordinated medical appointments and transportation logistics for claimants.
Maintained communication with medical staff regarding patient status and recommendations.
Entered benefit compensation and service provider payments accurately and timely.
Experience
7-10 Years
Level
Management
Education
ASBA
Sr. Claims Assistant Resume
Headline : With seven years of specialized experience in claims processing, I excel at ensuring compliance and facilitating smooth claim resolutions. My strong analytical abilities and customer-centric approach enhance satisfaction while managing diverse inquiries. I thrive in dynamic environments, committed to accuracy and efficiency in every aspect of claims administration.
Skills : Attention To Detail, Workflow Management, Insurance Terminology, Data Analysis, Claim Settlement
Description :
Thoroughly examines claims to determine entitlement and appropriateness for payment under the Millennium Health Care Act, ensuring compliance with relevant regulations.
Develops and submits claims requiring additional information to clinical liaison for accurate final determination.
Ensures prompt payment for emergency services, adhering to established guidelines and enhancing patient satisfaction.
Reviews and processes claims for outpatient treatment medications and beneficiary travel for veterans, maintaining detailed records.
Conducts audits and processes invoices from vendors, ensuring all necessary information is complete and accurate.
Utilizes the Fee Payment Processing System (FPPS) for efficient electronic claims management.
Maintains extensive communication with private sector physicians and veterans, providing updates and resolving issues promptly.
Experience
5-7 Years
Level
Consultant
Education
A.A.B.A.
Medical Claims Assistant Resume
Objective : Accomplished Claims Assistant with five years of extensive experience in claims processing and customer service. Skilled in efficiently handling inquiries and ensuring compliance with regulations. A detail-oriented professional, dedicated to optimizing claims resolutions and enhancing client satisfaction through effective communication and problem-solving.
Assisted with worker's compensation claims for State of Illinois employees, ensuring accuracy in setup and documentation.
Utilized claims management software to track and update claim statuses efficiently.
Documented all claim activity in the electronic claim file for transparency.
Prepared and printed correspondence, benefit notices, and labels for timely communication.
Provided essential clerical support, including filing, sorting, and data management.
Reconciled checks and managed financial documentation specific to branch office needs.
Communicated critical claim information to clients, legal counsel, and medical providers efficiently.
Experience
2-5 Years
Level
Executive
Education
AAS
Dental Billing Resume
Headline : With seven years of dedicated experience in claims processing, I specialize in ensuring compliance and facilitating effective claim resolutions. My strong analytical skills and customer-focused approach contribute to enhanced client satisfaction. I thrive in fast-paced environments, adept at managing inquiries and fostering positive relationships in the claims administration landscape.
Developed and maintained positive relationships with clients, vendors, and internal teams.
Draft and send settlement documents to the Workers' Compensation Appeals Board and Rehabilitation Unit.
Conduct three-point contact with insured, claimant, and physician within 24 hours.
Maintain regular contact with claimants every 30 days on indemnity claims.
Coordinate with physicians to ensure timely benefit payments.
Process vendor payments for services rendered on WC files.
Establish and maintain comprehensive claims files for accurate record-keeping.
Experience
5-7 Years
Level
Executive
Education
AABA
Claims Assistant Resume
Headline : Bringing seven years of robust experience in claims processing, I excel at ensuring compliance and expediting claim resolutions. My keen analytical skills, coupled with a commitment to client satisfaction, drive efficiency and accuracy in handling diverse inquiries. I am passionate about improving processes and fostering strong relationships to enhance overall customer experience.
Assisted in the implementation of new claims processing software and tools.
Participated in audits of claims files to ensure compliance with internal and external standards.
Facilitated transaction processing, including opening reserves, closing claims, and issuing checks.
Conducted follow-ups on claims with insurance companies to expedite resolutions.
Processed stop payments and coordinated the submission of police reports.
Provided comprehensive support to the claims manager, maintaining organized unit claim files.
Coordinated auditing functions by setting up and entering new claims into the claims management system.
Experience
5-7 Years
Level
Consultant
Education
AAS
Claims Assistant Resume
Objective : Bringing five years of experience in claims assistance, I excel in processing claims with precision and efficiency. My expertise lies in responding to inquiries and ensuring compliance with regulations. I prioritize customer satisfaction through effective communication and problem-solving, adapting seamlessly to changing circumstances in a fast-paced environment.
Processed and managed medical claims, ensuring timely and accurate resolutions.
Responded to vendor and patient inquiries regarding claim statuses, maintaining high customer satisfaction.
Verified eligibility and informed clients about the Millennium Health Care Act for emergent and non-emergent care.
Acted as a clinical liaison to ensure vendors received necessary information for claim processing.
Provided comprehensive payment information on claims and addressed discrepancies promptly.
Educated clients on their appellate rights regarding claim disputes to foster transparency.
Managed incoming mail for the Fee Basis Claims System, ensuring accurate scanning and documentation.
Experience
2-5 Years
Level
Executive
Education
AAS
Claims Assistant Resume
Summary : Accomplished Claims Assistant with a decade of experience in claims processing and customer service. Expertise in addressing complex claims inquiries and ensuring regulatory compliance. My analytical skills and client-focused approach drive efficient resolutions and enhance overall satisfaction. I thrive in dynamic environments, committed to delivering exceptional service and fostering strong relationships.
Skills : Claims Analysis, Claim Review, Communication Skills, Research Skills, Interpersonal Skills
Description :
Acted as the primary contact for General Liability Claims, ensuring timely and accurate processing.
Documented and managed telephone inquiries from claimants, attorneys, and adjusters.
Collaborated with the Senior Claims Manager to establish new claims in the database.
Conducted thorough analyses to determine liability based on collected facts and information.
Coordinated weekly status meetings with insurance adjusters and defense attorneys.
Built strong relationships with stakeholders, enhancing communication and resolution efficiency.
Represented the company at Small Claims hearings, negotiating settlements effectively.
Experience
10+ Years
Level
Senior
Education
AAS
Claims Assistant Resume
Headline : With seven years of extensive experience in claims assistance, I have honed my skills in processing and resolving claims efficiently. My commitment to compliance and exceptional customer service has consistently enhanced client satisfaction. I excel in fast-paced environments, leveraging strong analytical abilities to navigate complex claims while fostering positive relationships.
Prepared letters and issued total temporary disability benefit payments.
Responded to subpoenas by coordinating with applicant and defense attorneys.
Evaluated claims to accept, delay, or deny based on valid medical and statutory criteria.
Assessed probable monetary values of cases and regularly reviewed reserves for adequacy.
Ensured compliance with California Labor Code and departmental policies for benefit payments.
Monitored injured employees' progress on returning to work after absence.
Reported lost and modified workdays to supervisors and claims administration.
Experience
5-7 Years
Level
Consultant
Education
AA in Bus Admin
Claims Assistant Resume
Headline : Proficient Claims Assistant with seven years of experience in claims processing and client relations. Skilled in managing complex inquiries and ensuring regulatory compliance while delivering exceptional service. My analytical mindset and ability to streamline workflows contribute to efficient claim resolutions and increased customer satisfaction, making me a valuable asset to any team.
Established new Worker039;s Compensation claims by entering data into the database and creating physical files.
Digitized paper documents and maintained organized physical filing systems.
Delivered exceptional customer service via phone and email to clients and claimants.
Submitted electronic files to the State Board of Insurance to ensure compliance with reporting standards.
Processed payments for claims-related expenses, including legal fees and medical bills.
Managed incoming Worker039;s Compensation calls as the primary point of contact.
Developed and maintained a comprehensive filing system for a large volume of claims information.
Experience
5-7 Years
Level
Consultant
Education
AAS in BA
Claims Assistant Resume
Objective : Proficient Claims Assistant with five years of experience in claims administration and customer support. Expertise in processing claims efficiently while ensuring compliance with industry standards. Demonstrated ability to analyze complex data, resolve inquiries, and foster positive client interactions. Committed to enhancing operational workflows and delivering exceptional service in fast-paced environments.
Screened and assessed claims for eligibility, ensuring adherence to regulatory requirements.
Managed the entry and tracking of claims data, maintaining accurate records.
Acted as the primary liaison for client inquiries, providing timely updates and resolutions.
Facilitated communication among stakeholders to expedite claim processing.
Compiled and prepared documentation for performance reviews and compliance audits.
Ensured confidentiality and protection of sensitive information in all interactions.
Maintained updated knowledge of industry practices and policy changes affecting claims processing.
Experience
2-5 Years
Level
Executive
Education
B.S.B.A.
Claims Assistant Resume
Objective : Seasoned Claims Assistant with five years of expertise in claims processing and customer service. Adept at resolving complex claim issues while ensuring adherence to regulatory standards. My strong analytical skills and commitment to client satisfaction drive efficient operations, facilitating positive interactions and swift resolutions in a dynamic environment.
Drafted correspondence for property, auto, and surety claims based on adjusters' requests.
Conducted thorough reports on filed claims to prevent duplicates or fraud.
Coordinated the processing of total loss vehicle titles for timely resale.
Digitized and indexed documents for future retrieval and compliance.
Facilitated interdepartmental mail delivery to support claims operations.
Reviewed and verified glass claims closure through detailed spreadsheet analysis.
Assisted in bill payment processes and maintained accurate data entry for claims documentation.
Experience
2-5 Years
Level
Executive
Education
AAS in Business
Sr. Claims Assistant Resume
Objective : Results-focused Claims Assistant with five years of experience in claims processing and customer support. Adept at managing inquiries, ensuring compliance, and driving efficient claim resolutions. My strong analytical skills and commitment to client satisfaction enhance service delivery, while my adaptability allows me to thrive in fast-paced environments.
Skills : Problem Solving, Customer Service Skills, Customer Advocacy, Statistical Analysis, Claims Documentation
Description :
Conduct initial reviews of compensation and pension claims, ensuring accuracy and completeness.
Maintain and organize claims folders, analyzing documentation to determine appropriate actions.
Collaborate with team members and Veterans Service Centers to streamline claims workflows.
Process claims efficiently, ensuring Veterans receive the benefits earned through service.
Deliver high-quality customer service by assessing individual needs and providing tailored support.
Update databases with claim application information and status changes.
Communicate current information about benefits to Veterans, ensuring they are informed of their entitlements.
Experience
2-5 Years
Level
Executive
Education
A.S. in BA
Claims Assistant Resume
Objective : Proficient Claims Assistant with five years of specialized experience in claims processing and customer relations. Skilled in efficiently managing inquiries and ensuring compliance with industry standards. My strong analytical abilities and commitment to client satisfaction drive effective resolutions, enhancing overall service delivery. I thrive in fast-paced environments, dedicated to optimizing claims administration.
Skills : Email Communication, Claims Analytics, Effective Time Management, Multi-channel Communication, Prioritization And Multi-tasking
Description :
Provides administrative support to claims representatives, ensuring efficient operations.
Handles the processing and accuracy of Social Security Administration forms.
Communicates effectively with customers via phone, email, and in-person interactions.
Enters critical data into the Case Management system to track the progress of claims.
Documents all relevant information in the Notes database for accurate claim tracking.
Establishes appropriate next steps for each claim to ensure timely resolution.
Prepares and dispatches necessary forms and correspondence to clients and agencies.
Experience
2-5 Years
Level
Executive
Education
ASBA
Claims Assistant Resume
Summary : Experienced Claims Assistant with a decade in claims processing and customer service. Skilled in efficiently managing complex inquiries, ensuring compliance, and fostering positive client relationships. My analytical mindset and commitment to accuracy drive effective resolutions, enhancing customer satisfaction. Passionate about streamlining processes and delivering exceptional service in a fast-paced environment.
Creating an account is free and takes five seconds.
You'll get access to the PDF version of this resume template.
Choose an option.
Sign up with Google
Sign up with Facebook
Sign up with Linkedin
This helps us make sure you're human and prevents spammers from abusing our services.
By continuing, you agree to our Privacy Policy and Terms.
Unlock the Power of Over 10,000 Resume Samples.
Take your job search to the next level with our extensive collection of 10,000+ resume samples. Find inspiration for your own resume and gain a competitive edge in your job search.
Get Hired Faster with Resume Assistant.
Make your resume shine with our Resume Assistant. You'll receive a real-time score as you edit, helping you to optimize your skills, experience, and achievements for the role you want.
Get Noticed with Resume Templates that Beat the ATS.
Get past the resume screeners with ease using our optimized templates. Our professional designs are tailored to beat the ATS and help you land your dream job.
