An Insurance Claims Processor also called the Claims Adjustor is responsible for entering and processing the claims accurately and efficiently for this organization. Typical work activities seen on the Insurance Claims Processor Resume include the following – coordinating claims with Medicare and other group insurance carriers; auditing other team member’s claims; determining proper payees for benefits to discharge company’s liabilities; approving claim payments; processing flexible spending account claims as per established rules and guidelines and handling insurance claims reimbursements.
Those seeking this job role should be able to depict on the resume the following skills – insurance claims expertise, attention to details; writing skills; computer competencies; proficiency within the area of insurance, and familiarity in using claims processing software. Most of these processors possess a degree in a business-related field, although on-the-job training is provided by the insurance companies.
Objective : Seeking an Insurance Claims Processor position with outstanding career opportunities that will offer a rewarding work environment along with a winning team that will fully utilize management skills.
Skills : Customer Information, Company Policies, Police Reports.
Description :
Requested information from internal or external sources to ensure completeness and validity of the claim.
Answered inquiries regarding the claim.
Used customer software, sort claims according to network status.
Entered claim information for re-pricing.
Maintained a high level of accuracy and production rate.
Compared information from the application to criteria for policy reinstatement and approve reinstatement when criteria are met.
Processed, prepared, and submitted business or government forms, such as submitting applications for coverage to insurance carriers.
Experience
2-5 Years
Level
Executive
Education
High School Diploma
Insurance Claims Processor Resume
Objective : Over 1 year of experience in Insurance Claims Processor customer service dealing with all types of plans and claims and consistently exceeding performance levels.
Checked Medical Files for accuracy and doing data entry.
Entered numerical data into databases in a timely and accurate manner.
Reviewed medical records for completeness and filed records in alphabetic and numeric order.
Precisely completed appropriate claims paperwork, documentation, and system entry.
Produced monthly reports using advanced Excel spreadsheet functions.
Outlined the appropriate process and procedures necessary to fulfill and complete inquiries.
Received and routed medical records.
Experience
2-5 Years
Level
Executive
Education
High School Diploma
Insurance Claims Processor Resume
Objective : As an Insurance Claims Processor, responsible for processing unemployment insurance claims including determinations, wage audits, appeals, hearings, reimbursements payments. Experience in collecting analyzing data to prepare annual member contributions.
Skills : Legal Research, Quickbooks, Customer Service Representative, Planning Skills.
Description :
Updated, and processed existing policies and claims to reflect any change in beneficiary, amount of coverage, or type of insurance.
Processed and recorded new insurance policies and claims.
Reviewed and verified data, such as age, name, address, and principal sum and value of the property on insurance applications and policies.
Examined letters from policyholders or agents, original insurance applications, and other company documents to determine if changes are needed and the effects of changes.
Corresponded with the insured or agent to obtain information or inform them of account status or changes.
Transcribed data to worksheets and enter data into computer for use in preparing documents and adjusting accounts.
Interviewed clients and take their calls to provide customer service and obtain information on claims.
Experience
2-5 Years
Level
Executive
Education
Certification In CP
Insurance Claims Processor Resume
Headline : Over 10 years of experience, including as a Clerk/Line Cook, as a Cashier and as an Insurance Claims Processor in industries including Amusement and Recreation Services, Eating and Drinking Places, and Insurance Agents, Brokers, and Service. Most recently, have been working as a Clerk/Line Cook.
Skills : Reflect Changes, Outbound Calls, Customer Service, Communication Skills.
Description :
Processed insurance applications.
Updated insurance policies for changes, reinstatements, and cancellations.
Managed account documentation, including policy change and cancellations.
Responded to customer inquiries and complaints.
Provided information for regulatory compliance including proof of insurance.
Prepared documents, including identification cards and certificates.
Submitted applications for coverage to insurance carriers.
Prepared product or service reports by collecting and analyzing customer information.
Experience
5-7 Years
Level
Executive
Education
GEd
Insurance Claims Processor Resume
Objective : As an Insurance Claims Processor with 2+ years of experience in claims processing of new & existing claims, all correspondence related to claims.
Skills : Policy Provisions, Claims Data, Claims Issues, Communication Skills.
Description :
Processed insurance forms, applications, and requests for insurance information.
Efficiently handled questions and queries from customers.
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.
Contributed to team effort by accomplishing related results as needed. Maintained up to date paper and computer-based files and administrative systems.
Experience
2-5 Years
Level
Executive
Education
High School Diploma
Insurance Claims Processor Resume
Objective : Motivated and highly productive Insurance Claims Processor professional with an insurance background. Detail-oriented with strong skills in multi-tasking and efficient management of day-to-day office operations. Adept at building and maintaining effective working relationships with co-workers and clients through outstanding interpersonal skills.
Skills : Computer Literate, Data Entry, Claims Processor.
Description :
Analyzed claims to determine the extent of company liability, determine if the vehicle is deemed a total loss or repairable by analyzing vehicle evaluation reports, Mitchell reports and pictures of the damaged vehicle, make approval or denial decisions, confirm ownership, and rectify titling and DMV issues.
Negotiated settlement with claimants and policyholders in accordance with policy provisions.
Collaborated with insurance agents, attorneys, and interview claimants to correct errors, rectify omissions and investigate questionable issues.
Provided optimum service to policyholders, negotiated fair settlements and identified fraudulent claims.
Selected by managers to assist file closures, resolve complex claim-processing issues.
Selected by managers to train classes and groups of new incoming claim processors, delegate tasks, and create training modules.
Answered any Insurance questions or handle any issues a patient/customer may have.
Experience
2-5 Years
Level
Executive
Education
Chartered Life Underwriting
Insurance Claims Processor Resume
Headline : An energetic, dependable individual with a strong work ethic, task-oriented, and solid interpersonal skills. Possess the ability to adapt to the demands of diverse and challenging workloads. Ability to work independently or as part of a team. Excellent communication skills and able to interact with all levels and types of individuals.
Excelled in a role requiring the ability to handle a variety of customer service and administrative tasks and resolve customer issues with expediency.
Demonstrated proficiencies in telephone and front-desk reception within a high volume environment.
Researched and rapidly solved problems and rebuilt client trust to prevent the loss of patient accounts.
Accelerated data input, processing, and retrieval times.
Consistently praised by management for the quality and timeliness of reports, attention to detail, exemplary customer service delivery, and team player attitude.
Provided back-up support for general receptionist duties including telephone, customer records management, and scheduling.
Handled pre-certification and scheduling for surgeries; prepared reconciliation reports, manage records, and administer the database.
Experience
5-7 Years
Level
Executive
Education
GED
Insurance Claims Processor Resume
Objective : To secure a position with a well-established organization with a stable environment that will lead to a lasting relationship in the field of Quality Assurance.
Skills : Data Entry, Customer Service, Insurance, Organization Skills.
Description :
Contacted insured or other involved persons to obtain missing information.
Posted or attached information to the claim file.
Prepared insurance claim forms or related documents and reviewed them for completeness.
Provided customer service, such as limited instructions on proceeding with claims.
Reviewed insurance policy to determine coverage.
Transmitted claims for payment or further investigation.
Organized or worked with detailed office or warehouse records, used computers to enter, access, search, or retrieve data.
Experience
2-5 Years
Level
Executive
Education
Diploma
Insurance Claims Processor Resume
Objective : To obtain a rewarding Insurance Claims Processor position within an innovative and professional organization where can contribute knowledge and skills for the benefit of the company.
Skills : Customer Service, Medical Terminology, Insurance.
Description :
Provided instructions for claims proceedings.
Attached information to claim files.
Provided referrals to auto repair facilities.
Ensured timely and accurate claims payments.
Reported denied claims.
Submitted write-off and refund requests.
Explained policy coverage to clients.
Experience
2-5 Years
Level
Executive
Education
High School Diploma
Insurance Claims Processor Resume
Headline : To secure an Insurance Claims Processor position with a company that is on the cutting edge of technology, and customer service, so that my abilities can shine and flourish as put forth my personal best.
Skills : MS Office, Customer Service, Claims Processor, Assisting Skills.
Description :
Processed claims and bills for a transport company that transported patients to and from their homes to doctors' appointments, hospitals, nursing facilities, etc.
Assisted with dispatching the drivers on emergent and nonemergent runs.
Coordinated trips with hospitals, doctors, nursing facilities, and patients locally and long-distance to higher-level medical institutions.
Received extensive training on the laws regarding patient billing, Medicaid, Medicare, and many private insurance companies.
Assisted patients with payment options and coordinating home health care needs and medical transports.
Processed insurance claims and verified correct Medicare codes for clean billing.
Coordinated property inspection scheduling of ladder assistance for property field adjusters Retrieve and data entry ladder assist requests.
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.
