Claims Assistant Resume Sample
Myrl Gerlach
6122 Stacy Stravenue,
Boston,
MA
+1 (555) 225 6418
Work Experience
WC Claims Assistant Lead
02/2016
-
PRESENT
Chicago, IL
- Provide customer service, such as giving limited instructions on how to proceed with claims, completing timely and accurate responses to customer inquiries and resolving minor complaints, which arise during the claims handling process
- Function as technical specialist for accumulators. Analyze complex operational accumulators problems and provide technical solutions. Identify and recommend areas where changes to existing processes and procedures can result in process and/or cost savings. Provide support to various IT staff
- Identify key issues with projects and offer solutions
- Identify accumulators that appear suspicious to management for further investigation
- Maintain and update required reference materials for accumulators
- Assists with general administration of the division; answers phone calls, distributes mail, orders supplies, books conference rooms, maintains and organizes claims filing system, and updates information in various procedures manuals
- Assists in processing and administering claims information, including creating physical and electronic files and entering claims data
Claims Assistant Manager
03/2013
-
12/2015
Detroit, MI
- Data clean up projects
- Log Tracking spreadsheets such as troubleshooting tracker, etc
- Administer policy requests related to Program Business - request policies where not in ANA 3.0, track and provide
- Assistance with claims reviews - obtain excel loss run, set diary for due date for statuses, confirm statuses are completed. Print statuses for CAM to review. Prepare materials – electronic for claim review. Assistant sets diaries to check for statuses and then when ready sends to CAA who sends to attendees
- Index large loss notices in AUI mail box and notify dedicated CAM
- Coding reviews on PEO’s/Programs where this is a critical issue, which includes assistance with request/follow up for data clean up
- Assist in preparation of Presentation materials for Marketing, Stewardship, Claim Reviews or other meetings to support Underwriting or claim related meetings with MP/Brokers/Agents
- Assist in Stewardship report generation in order to perform data analysis for CAA/CAM to complete report
Claims Assistant
11/2007
-
02/2013
San Francisco, CA
- Enters data in compliance with established procedures to ensure issuance of claimant and vendor payments
- Assists the Claims Manager with the preparation of periodic claim file audits of the Claims Adjusters including file selection and compilation of results of the audit
- Manages claim section document retention including claims files, coverage opinions, and insurance department complaints
- Provides answers to routine calls or questions in regards to filing a claim or the status of a claim
- Orders, receives, and distributes police and incident reports to claims staff as needed for their investigative purposes
- Coordinates scheduling, advertising, and documenting Claims Board Meetings in accordance with the Texas Open Meeting Act
- One (1) year of general office or administrative experience
Education
American Sentinel University
2002 - 2006
School's Degree in Business
Professional Skills
- Strong attention to detail and ability to organize work by using strong critical thinking skills
- Demonstrate strong human relations skills, including the ability to work with all levels of Cast Members, medical providers, and vendors
- Good written and oral communication skills including effective telephone skills
- Strong organization skills with ability to prioritize responsibilities
- Strong Interpersonal skills, including the ability to establish working relationships with federal, state and county agencies as well as the general public
- Demonstrates effective planning, organizational and time management skills
- Excellent grammar and writing skills essential
How to write Claims Assistant Resume
Claims Assistant role is responsible for computer, excel, organizational, interpersonal, customer, microsoft, typing, basic, telephone, word.
To write great resume for claims assistant job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Claims Assistant Resume
The section contact information is important in your claims assistant resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Claims Assistant Resume
The section work experience is an essential part of your claims assistant resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous claims assistant responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular claims assistant position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Claims Assistant resume experience can include:
- Provide customer service, such as giving limited instructions on AmTrust Online tutorial and completing timely and accurate responses to customer inquiries and resolving minor items which arise during the claims handling process
- Strong multi-tasking skills needed and ability to prioritize tasks
- Providing basic clerical and customer service skills,
- Providing advance clerical and customer service skills
- Providing basic clerical and customer service skills
- Providing advanced clerical and customer service skills
Education on a Claims Assistant Resume
Make sure to make education a priority on your claims assistant resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your claims assistant experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Claims Assistant Resume
When listing skills on your claims assistant resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical claims assistant skills:
- Strong PC skills, including extensive experience working on Windows and good knowledge of MS Outlook, Word, and Excel
- Strong organization and time management skills, including demonstrated ability to prioritize work
- Computer skills required: proficient at using Microsoft applications and accurate typing skills
- Strong analytical skills & results oriented
- 3) Excellent desk management skills
- Strong clerical and telephone skills
List of Typical Experience For a Claims Assistant Resume
1
Experience For Surety Claims Assistant Resume
- Superior organizational skills and the ability to effectively manage multiple priorities
- Strong customer service skills, excellent phone etiquette
- Excellent Oral and written communication skills; ability to interpret documents, reports, manuals, and correspondence
- Demonstrated initiative as evidenced by the ability to self-manage, organize and prioritize work
- Effectively communicate orally with people from a variety of backgrounds and with varying levels of understanding
- Effectively analyze workload for processing and/or referral to proper RO, Division or Team
- Claims processing experience or related insurance and/or administrative experience at a management level of corporation
2
Experience For WC Claims Assistant Lead Resume
- Need to have intermediate/advanced excel skills
- Effectively communicate in written format to facilitate next actions or needed information
- Possesses analytical, organizational skills and a keen eye for details
- Demonstrate strong commitment to customer service
- Proficiency in computer skill, including MS Word, Excel and Chinese word processing with fast and accurate typing
3
Experience For Claims Assistant Oa Resume
- Operates personal computers using word processing, spreadsheets, and databases, copiers, and other standard office equipment
- Identifies cases requiring additional development; expedites sensitive/priority requests and processes to completion using established guidelines
- Computer experience – Typing at least 45 - 60 wpm, moderate understanding of Word and e-mail programs
- Review policies to confirm coverage prior to reporting a claim
- One year of experience processing medical-only claims for a self-insured employer
- Florida 6-20 All Lines Claims Adjuster license in good standing
- Previous claims processing experience
- Strong working knowledge of computer systems and various Microsoft applications such as Word and Outlook
- Experience with list of ICD-10 codes and Current Procedural Terminology (CPT)
4
Experience For Bodily Injury Claims Assistant Resume
- General office experience required
- Organized, detail oriented, and able to priorities
- Related administrative work experience in law, construction, claims or other business
- Tertiary educated with 1-2 years of administrative/clerical experience, ideally in General Insurance
- Experience in administrative role or policy administration activities would be an advantage
- Customer service experience required in a related field
- Maintains a skilled, competent and motivated work force
- Screen, organize, prioritize and route mail and phone calls; take appropriate actions as necessary
- Prior formal education in surety or insurance desirable
5
Experience For Recovery Claims Assistant Resume
- Operate mail machine
- At least one year of experience in the insurance industry is required
- Experience in claims payment and adjudication for an IPA, or other health care company
- General office experience
- Accounts payable/receivable, accounting and/or finance experience
6
Experience For IDI Claims Assistant Resume
- Work independently, establish priorities and organize work to stay within prescribed time limits
- Operate and contribute positively in a team-based environment
- Demonstrates the ability to communicate in a complete, concise and logical manner on adjuster level files with supervisor oversight
- One year relevant Worker’s Compensation experience
- Performing administrative functions by completing tasks such as completing standard letters, maintaining spread sheets, photocopying and filing documents
- Filing and entering employees in system, taking out of system and updating info
- Identifying errors in the coding and billing process, abuse and fraudulent billing practices, waste and provider overpayments
- Typing, photocopying, indexing and filing
7
Experience For Claims Assistant Professional Liability Resume
- Scanning & imaging case files and storing them appropriately on our server
- Printing of, sorting, and mailing of all weekly and bi-weekly letters
- Handling travel arrangements, as required; ordering and purchasing supplies
- Intercepting and screening phone calls
- Preparing written correspondence using form letters to send to insureds, claimants, and brokers
- Answering provider questions regarding reimbursement
- Directing of incoming documentation to appropriate departments
- Tracking and ordering mailroom supplies
8
Experience For Casualty Claims Assistant Resume
- Filing claims for workers compensation for officers of the law
- Providing support to the Management & Professional Liability Claims Department by
- Meeting department quality and productivity metrics
- Determining proper policy coverage to conclude, investigate, evaluate and negotiate assigned cases
- Maintaining electronic mailbox and courier mail
- Assisting HR director
9
Experience For Claims Assistant Manager Resume
- Understanding and moderate individual interpretation of Title 51 RCW and other statutes as they relate to industrial insurance
- Understanding of modern office methods and practices and be efficient with computers
- Bring individuals in directly for in-person
- Provide clerical support, including filing, faxing, sorting, photocopying, etc
- Assist in the planning and coordination of meetings/training sessions, including monthly & quarterly Business Unit meetings including taking minutes
- Maintain supplies for the department, including ordering, organizing, and staying on top of inventory
- Coordinates incoming data from a variety of sources, Utilization Review, community resource admitting, community resources billing and clinicians
10
Experience For Contestable Claims Assistant Resume
- Process mail; handle filing, faxing and photocopying
- Blues/emails, and mail - reading, inputting, and scanning
- Process incoming mail, case intakes, making phone calls for follow-up and mailing packets
- Assist Surety Claims Adjusters/Counsel with bond claim file maintenance as directed, including scanning and saving documentation to electronic files
- Assist with general administrative functions including distribution and scanning of mail as well as meeting coordination activity
- Consults with managers on problem cases to ensure correct processing/routing of medical records
- Provide admin support to Senior Recruiter by entering applicant data to tracking system
- Assist Enterprise Shared Services (ESS) staff with inquiries regarding the processing of transitioned functions
- Prepares claim payments and billing statements. Researches and resolves claim payment discrepancies. Assembles all supporting documentation as needed
List of Typical Skills For a Claims Assistant Resume
1
Skills For Surety Claims Assistant Resume
- Good English oral and written skills, French skills would be beneficial
- Keyboarding skills (30+ wpm)
- Effectively communicate orally and in writing with people from a variety of backgrounds and with varying levels of understanding
- Computer skills, including PowerPoint, Word, Excel, Outlook and Adobe Acrobat knowledge
- Exceptional customer service skills with a passion for providing superior support to internal and external customers
- Demonstrated record for improving services and/or processes in prior role
- Exercise good judgment and display strong analytical thinking
- Moderate to high-end personal computer skills including MS Word and Excel
- Moderate to high-end personal computer skills including MS Word and Excel is necessary
2
Skills For WC Claims Assistant Lead Resume
- Basic PC skills- Word, Excel , Outlook, Internet
- Prior claims experience in a claims support role
- Prior knowledge and experience with SharePoint development
- Client-Service Focused: Demonstrate value add in the claims experience, delivering on our promises to clients
- Moderate customer services skills for phone, email and letter production
- Demonstrated office administration or related experience are required
3
Skills For Claims Assistant Oa Resume
- Communicate clearly and effectively on a one-on-one basis with various types of callers and visitors
- Two to four years experience in an insurance claims department or related experience
- 2) Proficient skills with Microsoft Office
- Detail oriented with fine time management and organizational skills
- Knowledge of basic computer applications, proficient 10-key skills
4
Skills For Bodily Injury Claims Assistant Resume
- Effectively exchange routine and non-routine information verbally and in writing and apply knowledge of the department`s policies and procedures
- Basic computer skills (MS Office, website navigation) required
- Relevant Work Experience: 1- 2 years related work experience in professional office environment required
- Extensive knowledge of and superior skill in using computer software including Word, Excel, Power Point
- Operates personal computers using word processing, spreadsheets, and databases, copiers, and other standard office equipment
- Demonstrates a basic understanding of insurance industry
- Demonstrates working knowledge of claims systems
- Demonstrates a working knowledge of the content of auto policies written by the company
5
Skills For Recovery Claims Assistant Resume
- Demonstrates a working knowledge of departmental organizational structure/ function
- Demonstrates a thorough understanding of NGIC brand and ability to exhibit the behaviors associated with it
- Effective at managing multiple deadlines
- Proven ability to work on multiple projects simultaneously while remaining organized, detailed, and flexible
- Skill in using a variety of computer software and automation systems
- Strong reasoning ability is required
6
Skills For IDI Claims Assistant Resume
- Experience in filing and phone system
- Demonstrates knowledge of claims processes
- Demonstrates a familiarity with company policies/procedures
- 1) At least 3 years of customer service experience
- 6 months of service-oriented office experience
- Computer experience – Typing at least 45 - 60 wpm, moderate understanding of e-mail programs
- Build effective working relationships with other team members, key customers and across Claims
- Think quickly and prioritize multiple work streams without sacrificing quality, act with a sense of urgency
7
Skills For Claims Assistant Professional Liability Resume
- Correspond with brokers and insureds to support the effective management of claims
- Excellent knowledge of MS Office Suite (Word, Excel, PowerPoint)
- Four years of education, from an accredited institution, and/or experience in an insurance claims administration environment
- 0-2 yrs. relevant business experience
- Insurance or related industry experience
- Work independently and in a team environment, establish priorities, and organize work to stay within prescribed time limits
8
Skills For Casualty Claims Assistant Resume
- Working experience in Insurance A&H Claim
- CLAIMS ADJUDICATION experience
- Related claims experience in the insurance field
- Bilingual in English and French is a strong asset
- Insurance experience
- Able to organize, set, and maintain priorities
- Capture/validate necessary metrics in compliance with task based service level agreements
9
Skills For Claims Assistant Manager Resume
- Collects, sorts, distributes, and prioritizes correspondence, business client’s requests
- Easily adapts to new or changing situations, requirements and priorities
- Good Working knowledge of LTC claim systems
- Strong working knowledge of computer systems preferable CARS, Outlook, EDOCS, Word and basic Excel
- Organized, detail oriented, and able to prioritize
- Input data and process work items in a timely, cost effective manner that is compliant with state regulations and company policies
- Good Product knowledge: BLC LTC policies
- Experience with development of workplace procedures and processes
10
Skills For Contestable Claims Assistant Resume
- Balance and prioritize multiple projects and deadlines
- Demonstrate ability to work as part of a cohesive team
- Develop evidence for claims
- Makes final eligibility determinations, establishes priority/category/authorization for care, refers for appointment, etc
- Evaluates evidence pertaining to issues of credited earnings and benefit eligibility
List of Typical Responsibilities For a Claims Assistant Resume
1
Responsibilities For Surety Claims Assistant Resume
- Demonstrates subject matter expertise and continuously builds product, procedural and technical systems knowledge
- Experience in participating on a team in a culture of continuous business process improvement
- Experience with the following systems: CARS, HMS, WorkBrain, e-Docs
- Adjudicating claims using standard principles and state specific policies and regulations
- Monitors incoming claims, promptly assigns to Claims Representatives, confirms coverage with Underwriting and opens claims in the Claims IT systems
- Research and compile documents to set up bond claim files by coordinating with underwriting department and other branch locations
- Process informal claims providing the claimant with the necessary application and stipulating the appropriate time limit
- Processes transactional items such as mailing correspondence and preparing invoices, ensures all correspondence is compliant
- Provide support for event and meeting planning
2
Responsibilities For WC Claims Assistant Lead Resume
- Responsible for evaluation of documents, calling providers or policy holder or their legal representatives, to request missing claim requirements,
- File, Sort, and distribute incoming mail as well as collect and process outgoing mail
- Participates in ongoing training programs for support staff
- Ensures all appropriate correspondence is completed for applicants, informing them of decisions and advising of appellant rights
- Resolve discrepancies and adjust records relating to earnings and issues of initial and continuing entitlement
- Determine eligibility by evaluating claim submission and comparing to policy benefits
3
Responsibilities For Claims Assistant Oa Resume
- Provide customer service to policyholders, agents and doctors answering a variety of questions both in writing and by phone
- Responsible for setting up new claims and creating files,
- Request closing or canceling of the bond files
- Participate in weekly Round Table discussion regarding cases being managed
- Knowledge of medical terminology, billing claim forms and requirements for billing and reimbursement of third party claims
- Comfortable working with, and gathering information from, multiple applications and databases
- Mail sorting and scanning
- Backup existing Administrative Assistants during vacations/absences
- Opens, date stamps, sorts and distributes incoming mail. Matches mail with files or faxes documents to Imaging Center to attach to electronic files
4
Responsibilities For Bodily Injury Claims Assistant Resume
- Responsible for maintaining the integrity of the claims folder during folder review by claimants
- Conducts initial review of incoming mail to the Fiduciary unit to include substantive review for completeness of federal and court fiduciary accounting
- Active involvement in stretch assignments, i.e., enhancing claims knowledge through e-learnings and classroom led training
- Focus on specific team metrics, i.e., quality monitoring, security verification, adherence to schedule, production, attendance, and quality processing
- Request follow-up letters on pending claims
- Responds to Adjuster and Unit Manager request’s such as retrieving files, data inquiries, preparation for audit, research and problem resolution
5
Responsibilities For Recovery Claims Assistant Resume
- Acquire general knowledge of the unit’s business functions and standard operating procedures
- Prepare claims reports from loss runs, ensuring user-friendly format and accuracy of data
- Provide cross funcional coverage for the HR director during sick/ vacation leave
- Triage queries and routing calls from external contacts (i.e. brokers, insureds, and claimants) to support the Claims Team
- Provide assistance with training to ESS staff where necessary
- Processes and files claims within the claims systems, including routine letters of acknowledgement, status and denial
- Assists in drafting Claim Department procedures and processes
6
Responsibilities For IDI Claims Assistant Resume
- Oversees the timely and accurate posting of payments to accounts receivable
- Oversees manual billing activities for Pharmacy, ESRD dialysis and all non-CARG locations
- Monitors daily CARG/Reg+/ACRS records at month-end reconciliation of sub-ledger activity to G/L to ensure that data is being reported accurately
- Assist claim management and designated Hub examiners on projects and day to day reporting
- Working with a brokerage or insurance company
- Support project manager including, preparation of documents, and follow-up on timelines and deliverables
- Attend project meetings and prepare meeting minutes and action items
- Responds to inquiries from policyholders, field offices, other company units, outside agencies, brokers, etc. concerning various product/service provisions
7
Responsibilities For Claims Assistant Professional Liability Resume
- Receive, open and review all incoming correspondence
- Maintain files and perform filing
- Prepare correspondence including template letters
- Send reimbursement checks to assigned mailing address
- Monthly monitoring of TPA paid amounts to determine if reimbursement is due
- Assist with on/off-boarding for employees in HUB
- Basic Understanding of state insurance regs
8
Responsibilities For Casualty Claims Assistant Resume
- Occasional back up to claims clerk (New claim set up and importing documents)
- O Reply to claimant using department e-mail box, approximately 250-300 e-mails on a daily basis
- Support Staff Responsibilities for assisting Guest Claims Department when another assistant is off
- Assist with claims investigations by requesting - reports, forms, SAP lookups, set appoitments as needed
- Answers phone, takes messages, makes copies, does filing, saves documents/email into EDOCS
- Creates Confidential Incident reports, vendors and claimant bills, does claim file coding. Purchases items for Guest Claim files
- Work in a fast paced, team-oriented, changing environment
- Key data into online processing system
- Conduct telephone assessments for continuing disability claims
9
Responsibilities For Claims Assistant Manager Resume
- Adhere to strict time deadlines and claims handling standards
- Handle incoming mail, emails, faxes
- Responsible for setting up and assignment of new claims
- Handles incoming telephone calls and resopnds to claim status inquiries/information requests
- Complete underwriting alerts
- Inbound mail tracking support
- Maintain existing location code database and handle any queries from carriers. Ensure that claims are properly coded and report any errors to insurers
- Assist the Liability Administrators with claims handling to include subrogation
- Assist with a variety of different projects and assignments, including data entry
10
Responsibilities For Contestable Claims Assistant Resume
- Answer and route incoming department phone calls, take messages and respond appropriately
- Organize incoming mail and paperwork from the Stores
- Maintain calendar and scheduling for assigned area
- Responsible for maintaining confidential records and files for management
- Meet deadlines, work under pressure, work independently, and adjust to changing situations
- Data entry, file coding as assigned
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