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claims adjudicator resume example with 2+ years of experience

Jessica Claire
, , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
Home: (555) 432-1000 - Cell: - resumesample@example.com - : - -
Professional Summary

Advanced computer literacy, including experience with all Microsoft Software Office programs such as Excel, Word, and PowerPoint.

Effective at collecting data, applying financial analysis techniques and producing timely reports. Familiar with GAAP.

Mathematical and analytical skills to make proficient, independent decisions.

Excellent customer service skills acquired through work experience and internship

Very reliable, flexible, organized, and open to learning new material.

Extremely personal worker with strong social skills who works well in team environments.

Good interpersonal, communication, critical thinking, and time management skills.

Education
Expected in 05/2019 to to
Bachelor of Science: Dual BS in Finance And International Business
Barry University - Miami, FL
GPA:
  • Student Managed Investment Fund (SMIF) Member
  • Financial Management Association (FMA) Member
  • National Society of Leadership and Success (NSLS) Member
  • Dean's List Honoree Spring & Fall 2018
  • 3.6 GPA
  • Cum laude graduate
Expected in 12/2016 to to
Associate of Arts: Business Administration
Broward College - Fort Lauderdale, FL
GPA:
  • The Robert "Bob" Elmore Honors College graduate
  • 3.9 GPA
Work History
04/2021 to 10/2021
Claims Adjudicator Pacific Medical Centers Renton, WA,
  • Investigated and analyzed questionable claims to determine payment authorization.
  • Completed required investigations on referred files within established timeframes.
  • Processed claims paperwork efficiently with in-depth research and top-notch fact-finding and communication skills.
  • Made determination on eligibility for benefits in disputed claims by conducting fact-finding interviews to gather information from claimants and employers and/or third-party agents.
  • Issued timely notices of such determinations, together with the rationale behind there, to parties in accordance with Massachusetts Employment Security Law.
10/2019 to 04/2020
Management Trainee Erickson Living Houston, TX,
  • Shadowed managers to gain understanding of organizational expectations and management techniques.
  • Evaluated accounts assigned to the branch to determine accuracy and resolve issues to maintain customer satisfaction.
  • Managed corporate and retail accounts assigned to the branch.
    Analyzed and audited rental agreements based on terms and conditions.
  • Communicated with insurance, corporate, and dealership providers to discuss accounts’ status and reimbursement process to ensure account resolution.
  • Utilized spreadsheets to track sales figures, branch growth, and income for the branch.
04/2018 to 04/2019
Market Research Analyst Intern Taylor Corp Golden Valley, MN,
  • Utilized statistical analysis to track client industry and market trends and needs.
  • Created dense reports and spreadsheets to portray market insights and future opportunities.
  • Assisted with Coordination of projects, including B2B events and trade shows.
  • Assisted in making contact with potential buyers and distributors.
09/2014 to 03/2015
Assistant Manager Education Realty Trust Inc. Fullerton, CA,
  • Delegated daily tasks to team members to optimize group productivity.
  • Reviewed and analyzed KPIs daily and worked with store manager to ensure performance and support.
  • Assisted with bookkeeping activities, including cash report, cash counts, ledgers, and bill payment as necessary or as requested.
  • Oversaw daily, weekly, and monthly audits of inventory to ensure accuracy and project demand.
    Secured revenue, by accurately monitoring transactions and deposits to eliminate discrepancies.
Skills
  • Research and Data Analysis
  • Issue and conflict resolution
  • General ledger journal entry
  • Financial modeling
  • Advanced computer proficiency (both PC and Mac)
  • Account reconciliation
  • Multitasking
  • Financial records analysis
  • Deadline-driven
  • Key Performance Indicators (KPIs)
Certifications

Accounting Technology Specialist, Broward College - Dec 2016

Business Specialist, Broward College - June 2017

Bloomberg Market Concepts Certification, Barry University - March 2019

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Resume Overview

School Attended

  • Barry University
  • Broward College

Job Titles Held:

  • Claims Adjudicator
  • Management Trainee
  • Market Research Analyst Intern
  • Assistant Manager

Degrees

  • Bachelor of Science
  • Associate of Arts

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