LiveCareer-Resume

claims adjuster resume example with 9 years of experience

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

Organized and motivated employee eager to apply time management and organizational skills in various environments. Seeking entry-level opportunities to expand skills while facilitating company growth. Outgoing and friendly with strong drive to succeed.

Skills
  • Property Claims
  • Rules of Evidence
  • Property Adjusting
  • Liability Determination
  • Relationship Building
  • Coverage Assessment
  • Information Confidentiality
  • Verbal and Written Communication
  • Conflict Resolution
  • Property Damage Assessment
  • Case Presentation
  • Complex Problem Solving
  • Claims Evaluation
  • Legal Documentation and Reporting
  • Decision Making
  • Client Interviewing
  • Critical Thinking
  • Claims Processing
  • File and Record Management
  • Settlement Negotiations
  • Active Listening
  • Claims File Management Processes
  • Loading and Unloading
  • Container Tagging and Marking
  • Material Handling
  • Inventory Organization
  • Data Entry
  • OSHA Compliance
  • Willing to Learn
  • Storage Area Maintenance
  • Adaptable to Changing Needs
Experience
Claims Adjuster, 08/2019 to Current
Snap-On ToolsNewark, NJ,
  • Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
  • Negotiated and settled claims according to information presented through reports, research and data verification.
  • Recommended settlement offers and negotiated payment arrangements.
  • Investigated questionable claims to determine payment authorization.
  • Obtained necessary information to complete proper evaluation of injury claims.
  • Reviewed data to verify validity of claims and determine case management actions.
  • Coordinated benefits while applying applicable deductibles, co-insurance and out-of-pocket costs.
  • Drafted statement of loss to summarize damages, payments and underlying policy coverage.
  • Completed required investigations on referred files within established timeframes.
  • Identified and obtained evidence to ascertain claim value.
  • Conducted witness interviews to assist claim information gathering process.
  • Identified and collected evidence and determined value to specific claim to properly assess conditions.
  • Gathered information from various third parties to determine claim acceptability.
  • Reduced loss ratios through fair and prompt processing of claims.
  • Interviewed claimants, medical specialists and employers to determine pertinent claim information.
  • Communicated with personnel and legal counsel on claims involving litigation.
  • Kept up-to-date on changes in regulations for deductibles and collections.
Pharmacy Technician, 11/2014 to 02/2019
State Of North CarolinaRutherfordton, NC,
  • Teamed with peers, technicians and pharmacists to prioritize and complete orders.
  • Created new customer profiles and updated demographics, allergies and new medications in pharmacy computer systems.
  • Interpreted and processed medication orders under supervision of pharmacist.
  • Assisted pharmacist with clearing high volume of prescriptions and responded to customer questions.
  • Inspected medication storage locations to monitor drug expiration dates and supply adequate inventory.
  • Received and verified daily incoming drug inventories, reported discrepancies and logged items into inventory system.
  • Refilled medications, offered insight into over-the-counter products and verified insurance benefits.
  • Prepared prescription transfers to other pharmacies.
  • Maintained pharmacological practices by checking drug inventory, stocking medications and monitoring supplies.
  • Leveraged database to confirm validity of prescriptions, patient data and drug side effects.
  • Flagged potential side effects and allergies to prescribed medications for patients.
  • Verified prescriptions and drug labels, documents and packages.
  • Maintained strict patient confidentiality to adhere to HIPAA regulations and avoid data compromises.
  • Promoted supplement and nutritional products to maximize sales and customer wellness.
  • Maintained clean and organized pharmacy shelving and work areas.
  • Verified patients' identities at pickup to prevent sale of wrong medications.
  • Managed inventories, rotated stock, removed expired or damaged drug products and resolved discrepancies in drug counts.
  • Performed wide range of pharmacy operations with strong commitment to accuracy, efficiency and service quality.
  • Efficiently processed cash register transactions for new and refilled prescription orders.
  • Completed and filed patient paperwork, updating records in system with insurance carrier changes and allergy information.
  • Prepared prescription labels, promoting accuracy in medication administration and dosing.
  • Adhered to regulatory guidelines for workplace safety and customer confidentiality.
  • Worked with insurance companies to process claims, resolve problems and obtain payments.
  • Established and updated patient profiles, medications and insurance details.
  • Prepared pricing and instruction labels for placement on prescriptions.
  • Consulted with customers via telephone or in-person to assist with navigating pharmacy systems and completing requests.
  • Compiled customer demographic, allergy and medical history background.
  • Closely inspected medications to determine accuracy of identities, strengths and purities.
  • Processed prescription transfer requests from competitors.
  • Verified labeled prescriptions using 8-point check system to maintain accuracy and efficiency.
  • Requested scripts from doctors and verified insurance and coding.
Sales Associate, 07/2012 to 02/2014
Chico's Fas, Inc.South Windsor, CT,
  • Collected payments and provided accurate change.
  • Completed daily recovery tasks to keep areas clean and neat for maximum productivity.
  • Helped customers find specific products, answered questions and offered product advice.
  • Trained new team members in cash register operation, stock procedures and customer services.
  • Arranged new merchandise with signage and appealing displays to encourage customer sales and move overstock items.
  • Sold various products by explaining unique features and educating customers on proper application or usage.
  • Built and maintained relationships with peers and upper management to drive team success.
  • Maintained knowledge of current promotions, exchange guidelines, payment policies and security practices.
  • Retained product, service and company policy knowledge to serve as resource for both coworkers and customers.
  • Answered product questions with up-to-date knowledge of sales and promotions.
  • Engaged customers in friendly, professional dialogue to determine needs.
  • Developed trusting relationships with customers by making personal connections.
  • Answered incoming telephone calls to provide store, products and services information.
  • Assisted teammates with sales-processing tasks to meet daily sales goals.
  • Assessed customer needs to provide assistance and information on product features.
  • Received and displayed product shipments on store retail shelves upon delivery.
  • Adhered to company initiatives and achieved established goals.
Education and Training
High School Diploma: , Expected in 05/2012 to Auburndale Senior High School - Auburndale, FL
GPA:
: Criminal Justice, Expected in to Florida Southern College - Lakeland, FL
GPA:
Certifications
  • Licensed Claims Adjuster - 2019-Current
,

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Resume Overview

School Attended

  • Auburndale Senior High School
  • Florida Southern College

Job Titles Held:

  • Claims Adjuster
  • Pharmacy Technician
  • Sales Associate

Degrees

  • High School Diploma
  • Some College (No Degree)

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