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.
Objective : Motivated Claims Clerk with two years of experience in processing and managing insurance claims effectively. Skilled at analyzing data and communicating with clients to ensure swift resolutions. Committed to delivering exceptional customer service and maintaining accurate records to support the claims process.
Accurately processed life, health, property, and unemployment claims while ensuring compliance with company policies.
Educated policyholders about coverage details and payment timelines, enhancing customer satisfaction.
Performed data entry for medical claims using HCFA and UB forms, ensuring prompt processing.
Managed customer inquiries regarding claim status and provided assistance to examiners on complex cases.
Prepared loss reports for management review, contributing to strategic decision-making.
Coordinated with various departments to facilitate claim resolution and improve service delivery.
Maintained detailed records of claims adjustments and payments for auditing purposes.
Experience
0-2 Years
Level
Entry Level
Education
A.S. in BA
Junior Claims Clerk Resume
Objective : Dynamic Junior Claims Clerk with 5 years of experience in efficiently processing and managing insurance claims. Proven expertise in data analysis and client communication, ensuring timely resolutions and compliance with policies. Eager to contribute to a team focused on delivering exceptional service while maintaining meticulous records.
Skills : Claims Processing Software, Client Communication, Data Analysis, Problem Solving, Filing Systems
Description :
Assisted the Supervisor of the Fee Service Unit by monitoring fund control points, ensuring timely payments and adequate funding.
Monitored fee claims distribution and prepared productivity reports while managing backlogs effectively.
Processed claims and determined entitlement for medical benefits, ensuring compliance with authorization protocols.
Obtained necessary documentation to confirm eligibility and made determinations regarding legal entitlements.
Reviewed records to assess service-connection ratings and non-service connection determinations.
Contacted various healthcare providers and agencies to verify eligibility for medical services covered by VA.
Ensured accuracy in completed batches for timely routing to Financial Management Service for payments.
Experience
2-5 Years
Level
Junior
Education
AAS
Claims Clerk Resume
Headline : Detail-oriented Claims Clerk with 7 years of extensive experience in managing and processing insurance claims. Adept at conducting thorough investigations, ensuring compliance with regulations, and providing exceptional customer support. Proven ability to streamline processes and improve operational efficiency, contributing to positive outcomes for clients and the organization.
Processed Cobra payments, verified and maintained member eligibility, and researched claims to ensure accurate benefit applications, third-party liabilities, and coding corrections.
Implemented self-audit procedures to enhance accuracy and compliance, while providing leadership to meet departmental goals.
Managed year-end stop-loss projects and facilitated training on medical claims processing to ensure adherence to company policies.
Initiated and tracked new claims, issuing claim numbers and managing data input for disbursements.
Maintained accurate filing systems to support efficient claims processing and retrieval.
Collaborated with cross-functional teams to communicate updates on claims status and resolve discrepancies.
Utilized claims management software to streamline operations and enhance reporting capabilities.
Experience
5-7 Years
Level
Senior
Education
AAS
Lead Claims Clerk Resume
Summary : Accomplished Lead Claims Clerk with a decade of expertise in overseeing the entire claims process. Proven ability to enhance operational efficiency through meticulous data analysis and client engagement. Dedicated to fostering a collaborative environment while ensuring compliance and accuracy in all claims activities.
Skills : Claims Processing Specialist, Organizational Skills, Microsoft Office, Record Keeping, Attention To Detail, Time Management
Description :
Ensured the accuracy and timely processing of insurance claims, maintaining a 95% accuracy rate.
Conducted thorough audits of claims documents to verify compliance with established standards.
Collaborated with cross-functional teams to resolve complex claims issues and enhance service delivery.
Utilized data analysis tools to identify trends and optimize claims processing workflow.
Provided exceptional customer service, addressing inquiries and concerns promptly.
Managed the organization and distribution of claims for efficient processing.
Monitored and documented claims statuses, ensuring compliance with regulatory requirements.
Experience
7-10 Years
Level
Management
Education
B.S. in Bus. Admin.
Claims Clerk Resume
Objective : Dedicated Claims Clerk with two years of experience in efficiently managing insurance claims and ensuring client satisfaction. Proficient in data analysis, regulatory compliance, and adept at fostering communication between parties. Passionate about improving processes and delivering high-quality service while maintaining accurate documentation.
Facilitated communication between claimants, insurance companies, and relevant parties to expedite claims processing.
Acted as a liaison to gather necessary information for accurate claims assessment.
Ensured compliance with state laws and company policies throughout the claims process.
Assisted clients and providers with inquiries regarding claims status and procedures.
Performed administrative tasks to support upper management in claims operations.
Compiled and analyzed statistical data to improve claims processing efficiency.
Maintained strict confidentiality regarding claimant information and corporate data.
Experience
0-2 Years
Level
Entry Level
Education
AAS
Senior Claims Clerk Resume
Summary : Accomplished Senior Claims Clerk with a decade of extensive experience in managing complex insurance claims processes. Expert in analyzing data, ensuring compliance, and delivering exceptional client service. Proven track record in enhancing operational efficiency and fostering strong relationships with stakeholders, driving positive outcomes for both clients and the organization.
Skills : Microsoft Office Suite, Advanced Excel Proficiency, Internet Research And Navigation, Process Improvement
Description :
Contacted insured and involved parties to gather essential information for claims processing.
Managed detailed records using advanced computer systems to ensure data accuracy.
Reviewed and prepared insurance claim forms for completeness and regulatory compliance.
Provided expert customer service, guiding clients through the claims process and offering referrals.
Analyzed insurance policies to determine appropriate coverage for claims.
Processed and developed claims while utilizing microfiche and specialized computer systems.
Led special projects focused on system training and staff development.
Experience
10+ Years
Level
Consultant
Education
AAS in BA
Claims Clerk Resume
Objective : Results-oriented Claims Clerk with 5 years of experience in efficiently processing and managing insurance claims. Expertise in data analysis, regulatory compliance, and client communication ensures timely resolutions. Passionate about delivering high-quality service while maintaining precise documentation and enhancing operational efficiency.
Skills : Technical Proficiency, Research Skills, Communication Skills, Critical Thinking, Adaptability, Workflow Management
Description :
Efficiently processed a variety of insurance claims using web-based software in a high-paced environment.
Managed the archiving of Explanation of Benefits (EOB) documents for easy retrieval.
Communicated with insurers to obtain claim status, ensuring swift approvals or denials.
Maintained comprehensive records of all claims, facilitating timely appeals for denied cases.
Generated special reports to track claims processing efficiency and accuracy.
Coordinated the onboarding process for new team members, ensuring they received necessary training and resources.
Provided clerical support to the supervisor, ensuring timely completion of tasks.
Experience
2-5 Years
Level
Junior
Education
AAS in BA
Claims Clerk III Resume
Headline : Accomplished Claims Clerk with 7 years of comprehensive experience in processing and managing insurance claims. Expert in data analysis and client communication, ensuring compliance and prompt resolutions. Committed to enhancing operational efficiency and delivering exceptional service while maintaining meticulous records throughout the claims lifecycle.
Skills : Data Entry, Customer Service, Adobe Acrobat For Document Management, Insurance Knowledge, Time Tracking, Analytical Skills
Description :
Process and manage a high volume of insurance claims efficiently, ensuring all documentation is accurate and complete.
Conduct thorough investigations into claims, gathering necessary evidence and documentation from clients and third parties.
Utilize claims processing systems to track, update, and manage claims status, ensuring compliance with company policies.
Provide exceptional customer service by addressing inquiries and resolving issues related to claims processing.
Analyze data trends in claims to identify areas for improvement and implement solutions.
Maintain organized and up-to-date records of all claims activities to support audits and compliance reviews.
Collaborate with team members to enhance processes and improve overall efficiency in claims management.
Experience
5-7 Years
Level
Senior
Education
AAS in BA
Claims Clerk Resume
Objective : Proficient Claims Clerk with two years of hands-on experience in managing insurance claims and resolving client inquiries. Adept at performing detailed data analysis and ensuring compliance with industry regulations. Eager to leverage my organizational skills and commitment to accuracy to contribute positively to your team.
Skills : Customer Communication, Data Management Software, Office Suite Proficiency, Excel Data Analysis, Telephone Etiquette, Customer Follow-up
Description :
Investigated damages and assessed vehicle safety to determine appropriate appraisals.
Reviewed claims for coverage and assigned new losses to adjusters.
Requested and ordered necessary documentation related to claims.
Managed the scanning and importing of documents into designated claim files.
Processed insurance claims with a focus on exemplary customer service.
Gathered information from claimants to expedite claims settlement.
Coordinated appointments between claimants and adjusters for efficient follow-up.
Experience
0-2 Years
Level
Entry Level
Education
ASBA
Claims Support Clerk Resume
Summary : Results-focused Claims Support Clerk with 10 years of experience in managing complex claims processes and ensuring regulatory compliance. Proficient in data analysis, client communication, and maintaining meticulous records. Driven to enhance operational efficiency and deliver outstanding customer service throughout the claims lifecycle.
Skills : Team Collaboration, Administrative Support, Insurance Terminology, Risk Assessment
Description :
Perform administrative duties, including maintaining reports and files, data entry, and managing claims documentation.
Calculate insurance premiums and awards, ensuring accurate coding of data from records.
Examine files and documents to gather necessary information for claims processing.
Maintain comprehensive insurance and medical records for efficient retrieval.
Manage client databases and maintain accurate telephone logs for effective communication.
Deliver exceptional customer service by obtaining information and addressing inquiries promptly.
Review claims data to recommend actions and ensure completeness of documentation.
Experience
7-10 Years
Level
Management
Education
AAS in BA
Claims Clerk Resume
Headline : Experienced Claims Clerk with 7 years of expertise in processing and managing insurance claims. Proficient in data analysis, compliance verification, and client communication, ensuring efficient resolution of claims. Passionate about optimizing workflows and enhancing service delivery to contribute positively to organizational goals.
Skills : Data Analysis And Reporting, Document Preparation And Management, Multi-tasking, Mathematical Skills, Customer Support
Description :
Collaborate with the litigation department to manage attorney fees, draft correspondence, and identify coverage options in policies.
Support adjusters by organizing outgoing mail, locating files, and facilitating customer communication for claims resolution.
Prepare and submit salvage documents to state authorities as required.
Maintain knowledge of state regulations regarding property damage and personal injury claims.
Assign field appraisals for property and auto damage claims to ensure comprehensive evaluations.
Input vendor tax information accurately into the claims database.
Process incoming correspondence, including mail, faxes, and emails, ensuring proper documentation in client files.
Experience
5-7 Years
Level
Senior
Education
AAS-BA
Claims Clerk Resume
Summary : Seasoned Claims Clerk with 10 years of experience expertly managing complex insurance claims. Adept at utilizing analytical skills to assess claims and ensure compliance with regulations. Committed to enhancing client satisfaction through effective communication and precise documentation, while continuously improving operational processes.
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.
