Disability Claims Analyst Resume
Objective : Dedicated professional with two years of experience in disability claims analysis, adept at evaluating complex cases and ensuring compliance with regulatory standards. Skilled in effective communication and collaboration with stakeholders to facilitate timely claim resolutions and enhance customer satisfaction.
Skills : Analytical Thinking, Data Analysis, Report Writing, Regulatory Compliance
Description :
- Evaluate disability claims to determine eligibility based on policy guidelines and medical evidence.
- Applied appropriate risk management strategies that impacted the company’s financial results, reputation, and client relationships.
- Review medical records and documentation to assess the validity of claims and support decisions.
- Provided high-level customer service, managing reputational risk and implementing return-to-work strategies.
- Communicate with claimants to gather necessary information and clarify details regarding their claims.
- Communicated sensitive claim outcomes to clients, ensuring confidentiality throughout.
- Managed a large caseload of disability claims, prioritizing efficiency and accuracy.
Experience
0-2 Years
Level
Entry Level
Education
B.S. in HA
Junior Disability Claims Analyst Resume
Objective : Motivated claims analyst with two years of experience in disability claims processing, specializing in case evaluation and compliance. Proficient in collaborating with stakeholders to streamline claim resolutions and enhance service delivery. Committed to leveraging analytical skills to support accurate benefit determinations and improve client outcomes.
Skills : Stakeholder Engagement, Policy Interpretation, Risk Assessment, Case Management, Communication Skills
Description :
- Evaluated submitted documentation to determine disability status and benefit eligibility.
- Oversaw claims lifecycle, ensuring timely payments and communication with clients.
- Maintained strong relationships with clients and advisors, clarifying requirements and claim statuses.
- Processed claim documents accurately and communicated effectively regarding claims handling.
- Adjudicated claims by verifying insurance policy provisions and determining payment amounts.
- Requested and assessed medical and financial information to support claims evaluations.
- Coordinated with internal resources and external vendors for thorough claims investigations.
Experience
0-2 Years
Level
Junior
Education
B.S. in BA
Disability Claims Analyst Resume
Headline : Accomplished Disability Claims Analyst with 7 years of experience in assessing complex claims and ensuring compliance with regulatory standards. Proven expertise in collaborating with cross-functional teams to expedite claim resolutions and enhance client satisfaction while maintaining adherence to industry regulations.
Skills : Claims Analysis, Workflow Management, Training And Mentoring, Presentation Skills, Database Management, Claims Investigation
Description :
- Obtained and reviewed necessary claim documents, engaging with clients, advisors, and external vendors to facilitate the claims process.
- Conducted in-depth analysis of contestable claims, ensuring compliance with all regulatory standards.
- Maintained detailed case files, documenting subjective and objective findings along with analytical assessments.
- Ensured adherence to Fair Claim Handling and state regulations, mitigating risk during claim adjudication.
- Identified potential claim risks and implemented strategies to address them effectively.
- Collaborated with referral resources and vendors to monitor claims' progress and associated costs.
- Investigated claimant compensation requests by gathering and verifying pertinent information and documentation.
Experience
5-7 Years
Level
Senior
Education
B.S.B.A.
Lead Disability Claims Analyst Resume
Summary : With a decade of experience in disability claims analysis, I excel in leading teams to evaluate complex claims and ensure compliance with regulatory standards. My strong analytical and communication skills enable me to drive timely resolutions and enhance stakeholder satisfaction, ultimately improving client outcomes and operational efficiency.
Skills : Disability Program Knowledge, Team Collaboration, Technical Proficiency, Problem-solving, Documentation Skills, Empathy And Compassion
Description :
- Ensure compliance with federal and state regulations governing disability claims processing.
- Developed and implemented effective claim management strategies to ensure timely and accurate disability payments.
- Provided exceptional customer service to claimants and policyholders, enhancing overall satisfaction.
- Actively participated in departmental projects, contributing to process improvements and operational efficiencies.
- Conducted thorough investigations into claimants’ medical conditions and occupational demands to determine eligibility.
- Identified discrepancies and secured additional documentation to resolve outstanding issues within set timeframes.
- Mentored junior analysts, enhancing team performance through knowledge sharing and guidance on best practices.
Experience
7-10 Years
Level
Consultant
Education
B.S. in Bus. Admin.
Disability Claims Analyst Resume
Summary : Bringing a decade of expertise in disability claims analysis, I excel at comprehensively evaluating complex cases while ensuring strict adherence to regulatory standards. My ability to effectively communicate with stakeholders facilitates timely resolutions, improves client satisfaction, and enhances operational efficiency.
Skills : Adaptability, Confidentiality Awareness, Workflow Optimization, Quality Assurance, Client Advocacy, Statistical Analysis
Description :
- Developed and implemented comprehensive disability management strategies for effective claims handling.
- Conducted thorough investigations and analysis to ensure timely and accurate claim resolutions.
- Engaged in proactive communication with claimants and stakeholders to address inquiries and resolve issues.
- Maintained compliance with industry regulations while delivering high-quality customer service.
- Served as the primary liaison between clients and internal departments, ensuring seamless service delivery.
- Analyzed claim trends and developed reports to identify areas for service improvement.
- Represented the company in client meetings, fostering strong relationships and enhancing trust.
Experience
7-10 Years
Level
Management
Education
B.S.B.A.
Lead Disability Claims Analyst Resume
Summary : Leveraging a decade of extensive experience in disability claims analysis, I specialize in leading teams to assess complex claims and ensure regulatory compliance. My proven ability to analyze intricate data and communicate effectively with stakeholders drives timely resolutions and enhances operational success, ultimately improving client outcomes and satisfaction.
Skills : Claims Liability Assessment, Medicare Compliance Expertise, Research Skills, Decision-making
Description :
- Ensured accurate establishment of company reserve liabilities by identifying and applying all relevant claim offsets, maintaining precise claim and system data.
- Analyzed complex medical, contractual, and legal information to effectively manage a diverse range of disability claims while mentoring others in best practices.
- Managed both claim trends and individual claims, ensuring consistent application of company policies.
- Expert in Federal, State, and local laws affecting claim investigations, including ERISA and the Americans with Disabilities Act.
- Oversaw the implementation of disability management principles, integrating medical, vocational, and financial analyses.
- Collaborated with cross-functional teams to enhance automated claim adjudication systems and improve operational practices.
- Achieved department goals through resource optimization and fostering a collaborative team environment.
Experience
10+ Years
Level
Executive
Education
B.S. in BA
Disability Claims Analyst Resume
Objective : Results-oriented Disability Claims Analyst with two years of experience in evaluating claims and ensuring compliance with governmental regulations. Proven ability to analyze medical documentation and collaborate with stakeholders to expedite claim processing while enhancing client satisfaction. Committed to delivering accurate benefit determinations and improving operational efficiency.
Skills : Confidentiality, Critical Thinking, Organizational Skills, Multi-tasking, Insurance Knowledge, Conflict Resolution
Description :
- Completed a comprehensive training program to enhance proficiency in medical eligibility determination for various claim types.
- Investigated and analyzed critical information to identify issues, ensuring organized management of multiple priorities.
- Communicated effectively and made informed decisions while maintaining high production standards.
- Utilized various software applications and data systems to mentor and support colleagues.
- Reviewed medical records and conducted thorough analyses, preparing detailed reports and assessments.
- Delivered exceptional customer service, demonstrating sensitivity and professionalism in all interactions.
- Applied new information to the adjudication process, responding positively to feedback and guidance.
Experience
0-2 Years
Level
Fresher
Education
B.S. in B.A.
Senior Disability Claims Analyst Resume
Headline : Bringing 7 years of expertise in disability claims analysis, I excel in evaluating complex cases and ensuring regulatory compliance. My strong analytical acumen and collaborative approach drive efficient claim resolutions, enhancing client satisfaction and operational effectiveness within the disability claims landscape.
Skills : Claims Processing, Regulatory Knowledge, Customer Service, Work Ethic, Cultural Competence, Emotional Intelligence
Description :
- Utilized advanced analytical skills to assess disability claims, ensuring accurate and timely determinations.
- Expertly navigated laws and regulations governing the Social Security disability program to maintain compliance.
- Gathered and evaluated medical and vocational data to establish eligibility for benefits.
- Engaged with claimants and third parties to obtain comprehensive information for claims processing.
- Conducted in-depth interviews with stakeholders to substantiate claims and clarify details.
- Proactively requested additional information to support complex claims and enhance decision-making.
- Collaborated with cross-functional teams to streamline processes and improve claim resolution timelines.
Experience
5-7 Years
Level
Senior
Education
B.S.B.A.
Disability Claims Analyst Resume
Objective : Enthusiastic Disability Claims Analyst with five years of expertise in evaluating intricate claims and ensuring regulatory compliance. Adept at collaborating with medical professionals and stakeholders to streamline processes, I drive timely and accurate benefit determinations, ensuring client satisfaction and operational excellence in the disability claims arena.
Skills : Claim Processing, Legal Compliance, Financial Analysis, Process Improvement, Decision Making, Client Communication
Description :
- Evaluated and analyzed evidence to determine the sufficiency for claim decisions.
- Requested specialized examinations when medical data was inadequate for determinations.
- Gathered essential vocational evidence to accurately assess claimants' work issues.
- Determined eligibility for Social Security disability benefits to ensure effective claims handling.
- Reviewed medical documentation to prepare comprehensive residual functional capacity assessments.
- Coordinated with medical consultants for sign-offs on functional assessments and to address medical interpretation challenges.
- Assessed vocational information to evaluate claimants' employability based on age, education, and work history.
Experience
2-5 Years
Level
Freelancer
Education
B.S. in BA
Disability Claims Analyst Resume
Objective : Proficient in disability claims analysis, I bring two years of experience in evaluating claims and ensuring adherence to regulatory standards. My expertise lies in collaborating with stakeholders to facilitate timely resolutions and enhance client satisfaction. Committed to leveraging analytical skills for accurate benefit determinations and streamlined claims processing.
Skills : Disability Law Knowledge, Empathy, Negotiation Skills, Time Management, Interpersonal Skills
Description :
- Drafted comprehensive rationales to support claim decisions based on thorough analysis of medical, psychological, and vocational records.
- Assessed the necessity for future reviews, determining appropriate review dates based on claimant status.
- Managed caseloads effectively, ensuring timely case processing and compliance with regulatory requirements.
- Utilized a database management system to prioritize and track claims progress.
- Coordinated actions to order medical records, schedule exams, and follow up on claim statuses for efficient processing.
- Reviewed and edited claim files through an electronic disability system to ensure accuracy and compliance.
- Input data into claims analysis software, guiding assessments through the evaluation process.
Experience
0-2 Years
Level
Entry Level
Education
B.S. Health Admin.
