claim examiner resume example with 5+ years of experience
Jessica
Claire
resumesample@example.com
(555) 432-1000,
, , 100 Montgomery St. 10th Floor
Summary
Accustomed to answering questions, providing information and resolving concerns in a smooth and professional manner. Good communication, organizational and multitasking abilities.
An assertive individual who can adapt to different situations and challenges in meeting critical deadlines. Client-focused and skilled at problem solving to ensure customer satisfaction. Experienced insurance professional with almost two year career assessing travel claims, determining liabilities and negotiating settlements. Detail-oriented, observant and knowledgeable with excellent interpersonal and documentation skills. Efficiently handle high case volumes with accuracy and care.
Skills
- Bilingual in French and English
- Claims Evaluation
- Payment Processing
- Calm Under Pressure
- Report and Records Review
- Reserves Adjustment
- Fraudulent Claims Investigation
- Claims Processing
- Decision Making
- Legal Documentation and Reporting
- Critical Thinking
- Case Presentation
- Claim Form Analysis
- Quality control
- Mail sorting
- Customer relations
- Discrepancy reconciliation
- Problem solving
- Friendly
- Industrial coverage knowledge
- Client services
- Manual processing
- Reliable
- Accounting systems
Education and Training
Niagara College Niagara-on-the-Lake, ON, Expected in 04/2023 ā ā Advanced Diploma : Business Administration - :
Niagara College Niagara-on-the-Lake, ON Expected in 12/2018 ā ā Diploma : Business General - :
ELS Language Centers - Toronto Toronto, ON Expected in 12/2015 ā ā Certificate of Language Specialist : English Language And Literature - :
Middle School Sainte Camille Abidjan, Abidjan Autonomous District Expected in 07/2014 ā ā High School Diploma : - :
UIGB Grand-Bassam, ComoĆ© District Expected in ā ā Certificate in Business : - :
Certifications
- Certified QuickBooks Online Adviser
- Certified Quickbooks Online Accountant Adviser
- Certified Quickbooks Online Advanced and Standard Payroll support agent
- Certified Shopify Basic user - 2022
- Certified Shopify seller - 2022
Experience
National Indemnity Company - Claim Examiner
Denver, CO, 12/2021 - Current
Denver, CO, 12/2021 - Current
- Investigated potentially fraudulent claims with focus on thoroughness, quality and cost control.
- Input claim information and payments into company database.
- Analyzed information gathered by investigations and reported findings and recommendations.
- Reviewed police reports, medical treatment records, medical bills and physical property damage to determine extent of liability.
- Communicated with reinsurance brokers to obtain claim information for processing.
- Discussed current cases and issues in claim committee meetings.
- Verified liability extent with reviews of police reports, medical treatment histories and other records.
- Checked into questionable claims, interviewing agents and claimants to resolve errors and omissions.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
Southwest Airlines - Customer Service Agent
Albuquerque, NM, 10/2018 - 12/2021
Albuquerque, NM, 10/2018 - 12/2021
- Managed high-volume of inbound customer calls.
- Daily assisting customers on navigating their company settings and explore the product's features in order to meet their needs.
- Delivered fast, friendly and knowledgeable service for routine questions and service complaints.
- Able to use problem solving skills to determine the root cause of the customer's issue and offer appropriate resolution.
- Reviewed customers data to assess current issues and determine potential solutions.
- Assisted customer by performing data change in the back end system
- Documented customer's feedback in order to recommend process changes and products enhancement.
- Collected customer feedback and recommended procedural or product changes to enhance future service delivery.
- Addressed customers inquiries about unavailable features and suggested suitable options
Rr Donnelley & Sons - Sales Associate
Shakopee, MN, 09/2017 - 12/2017
Shakopee, MN, 09/2017 - 12/2017
- Maintained knowledge of current promotions, exchange guidelines, payment policies and security practices.
- Arranged new merchandise with signage and appealing displays to encourage customer sales and move overstock items.
- Built and maintained effective relationships with peers and upper management to drive team success toward common sales, service and operational goals.
- Negotiated and closed deals with minimal oversight.
- Sold various products by explaining unique features and educating customers on proper application.
- Prepared cash deposits with zero discrepancies.
- Collaborated with fellow sales team members to achieve group targets.
- Processed orders through system and coordinated product deliveries.
- Performed floor moves, merchandising, display maintenance and housekeeping to keep sales areas well-stocked, organized and current.
- Recommended merchandise to customers based on needs and preferences.
- Mixed and matched paints according to customer specifications.
- Demonstrated products to customers, discussed features and redirected objections to capture sales.
Independent Bank Group, Inc - Banking Assistant
Pearland, TX, 07/2016 - 11/2016
Pearland, TX, 07/2016 - 11/2016
- Answered customer questions in friendly and knowledgeable manner to maintain high satisfaction levels.
- Generated and distributed month-end statements for customers and resolved related concerns.
- Performed administrative tasks such as copying, scanning and mail sorting on daily basis.
- Built productive relationships with stakeholders to continually develop new business.
- Developed base of multiple clients through networking and seminar marketing.
- Maintained confidentiality of bank records and client information.
- Processed treasury, tax and loan payments.
- Examined checks for identification and endorsement.
- Delivered informational sales presentations to potential investors to build symbiotic client relationships.
- Achieved proper compliance and accurate executive level reporting.
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Resume Overview
School Attended
- Niagara College
- Niagara College
- ELS Language Centers - Toronto
- Middle School Sainte Camille
- UIGB
Job Titles Held:
- Claim Examiner
- Customer Service Agent
- Sales Associate
- Banking Assistant
Degrees
- Advanced Diploma
- Diploma
- Certificate of Language Specialist
- High School Diploma
- Certificate in Business
By clicking Customize This Resume, you agree to ourĀ Terms of UseĀ andĀ Privacy Policy
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