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Claims Adjuster Resume Example

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CLAIMS ADJUSTER
Summary
Focused and dedicated insurance professional motivated to succeed in a fast-paced and deadline-driven professional environment. Comprehensive knowledge of claims adjustments with special knowledge of health claims.
Accomplishments
  • Medical terminology knowledge Complaint handling and resolution
  • Detailed Oriented Excellent Written and Verbal Communication Skills
  • Quality and Customer Centric Oriented Analytical with Good Decision Making Skills
Experience
Claims Adjuster
April 2013 to CurrentCombined Insurance － Chicago, ILAccurately process claims under supplemental A&H. Key data into online processing system. Determine eligibility by evaluating claim submission and comparing to policy benefits. Interviewing claimants, medical specialists and employers to determine pertinent claim information. Manage pending files. Create claim related correspondence. Provide customer service to policyholders, agents, and doctors answering questions both in writing and by phone. Conduct telephone assessments for continuing disability claims. Assist in preparation of SIU cases and preliminary investigation of suspected fraud. Meet department standards for time service and quality.
Life Claims Adjuster/Portal Editor/Customer Service Representative
November 2011 to April 2013Smart Resources, Inc － Chicago, ILConducted research to determine the validity of Life Claims. Requested additional information from policyholders as necessary to finalize claims. Manged pending claim files. Created claim related correspondence. Managed the editorial content for Clients Daily News Summary for internal distribution. Tagged and categorized content in specialized database. Created summaries for selected articles. Provided accurate and appropriate information in response to customer inquiries. Addressed customer service inquiries in a timely and accurate fashion.
Account Coordinator
July 2011 to October 2011Ventures Unlimited － Chicago, ILScouted locations for markets and obtained approvals for tour stops. Provided on-site support during sampling activations. Coordinated travel arrangements for executives and staff. Prepared expense reports for executives. Handled the processing and payment of invoices.
Front Desk Coordinator
March 2010 to July 2011Kimberly Coleman Salon － Chicago, ILMeticulously entered client and service information when booking appointments. Clearly communicated with each technician regarding any schedule changes. Suggested and sold salon services and retail products to customers. Verified end-of-day reports against credit and cash profits and executed all daily opening and closing procedures. Spearheaded the creation of social media program and social media content.
Project Coordinator
April 2009 to December 2009Commonground Marketing － Chicago, ILProcessed payroll for contractors and brand ambassadors for activations. Tracked activation costs against budgets and estimates. Prepared purchase orders and expense reports. Managed all vendors payments for events, Reviewed, investigated and corrected errors and inconsistencies in financial entries, documents and reports. Provided on-site support during sampling activations including set-up and tear down.
Project Administrator
January 2006 to January 2009OPPIDANusa － Chicago, ILAssigned projects and tasks to employees based on their territory and/or lender. Accurately provided status information on project progress to bank lenders through inspection reports. Entered completed report information into specialized database for tracking. Acted as a liaison between inspectors, borrowers, and developers on a daily basis. Created accounts receivable invoices using Quickbooks software.
Administrative Assistant
December 2004 to January 2006Whitehall Jewellers Inc － Chicago, ILProvided administrative support to three Vice Presidents. Utilized specialized database to provide weekly updates for in-store contests and bonus programs. Maintained store manager and assistant manager company directories. Set-up and created merchant number accounts for new stores. Created real estate correspondence and construction contracts and routed through the signature process.
Education
Bachelor of Arts : Public CommunicationsDePaul University － Chicago, IL, USBachelor of Arts: Public Communications DePaul University - Chicago, IL, USA
Certifications
Medical terminology
Skills
Database, Correspondence, Credit, Claims, Customer Service, Receptionist, Retail Sales, Invoices, Accounts Receivable, Basis, Inspection, Liaison, Progress, Quickbooks, Territory, Answering, Benefits, Cases, Disability, Interviewing, Telephone, Clients, Customer Inquiries, Customer Service Representative, Cash, Closing, Front Desk, Retail, Retail Marketing, Accounts For, Administrative Assistant, Administrative Support, Construction Contracts, Contracts, Real Estate, Sampling, Budgets, Payments, Payroll, Project Coordinator, Purchase Orders, Adjustments, Excellent Written, Excellent Written And Verbal Communication Skills, Medical Terminology, Office Medical, Written And Verbal, Arrangements, Travel Arrangements
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Resume Overview

Companies Worked For:

  • Combined Insurance
  • Smart Resources, Inc
  • Ventures Unlimited
  • Kimberly Coleman Salon
  • Commonground Marketing
  • OPPIDANusa
  • Whitehall Jewellers Inc

School Attended

  • DePaul University

Job Titles Held:

  • Claims Adjuster
  • Life Claims Adjuster/Portal Editor/Customer Service Representative
  • Account Coordinator
  • Front Desk Coordinator
  • Project Coordinator
  • Project Administrator
  • Administrative Assistant

Degrees

  • Bachelor of Arts : Public Communications

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