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Claims Adjustment Representative Resume Example

Resume Score: 90%

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CLAIMS ADJUSTMENT REPRESENTATIVE
Summary
Proven track record in processing, customer service, and management. Passionate commitment to Work, great disposition, and upbeat attitude. Positive and enthusiastic individual with excellent leadership skills and professional attention to detail. Task-oriented with high performance standards; skilled at Problem mediation and resolution while upholding company standards. Highly motivated, results-oriented, Resourceful, focused and collaborative professional who consistently sets benchmark for excellence.
Highlights
  • Strong organizational skills
  • Active listening skills
  • Seasoned in conflict resolution
  • Sharp problem solver
  • Customer service expert
  • Adaptive team player
  • Claims file management processes
  • Strong interpersonal and communication skills
  • Self-directed
  • Analytical
Experience
Claims Adjustment Representative03/2015 to CurrentCompany NameCity, State

•Perform all types of complex adjustments including closed, denied, and simple adjustments

•Meet Quality and Productivity requirements

•Ensure Provider Satisfaction through Maintaining accurate documentation in ORS

•Provide assistance to Providers with status updates and follow-up work needed for resolving and closing issues

•Identify and resolve anticipated Provider issues to prevent future calls

•Maintain proficiency in all technical applications (technical skills and system knowledge)

•Comply with all current policies and procedures



Credit Specialist07/2014 to 03/2015Company NameCity, State
  • Analyze credit data and financial statements to determine the degree of risk involved in Extending credit or.
  • lending money.
  • Confer with credit association and other business representatives to Exchange credit information.
  • Generate financial ratios, using computer programs, to evaluate customers' Financial status.
Fraud Specialist01/2014 to 07/2014Company NameCity, State
  • Monitor fraud detection reports and queues.
  • Review accounts initially opened and those high- risk Transactions referred for review.
  • Give advice on identifying fraudulent activities done using the credit card and Handling the person involved.
  • Make calls to financial institutions to verify that the billing information of the Customer is valid.
  • Call up the customer and verify his or her order.
  • In cases of fraud counsel the victim on which financial institutions he or she should contact and on how to restore good credit standing.
Customer Service Manager01/2010 to 01/2014Company NameCity, State
  • Ensure compliance with the Company's procedures regarding Customer Satisfaction Cards (CSC's) and Competition Ads.
  • Correct register errors when necessary/required.
  • Complete at least 10 daily Register audits.
  • Approve checks and bankcards when necessary/required.
  • Monitor and maintain all front end cash levels and cash fund.
  • Provide proper change needed for Cashiers.
  • Consistently attend/conduct Cashier Training sessions to ensure each front end Associate is knowledgeable regarding current Communications/directions.
  • Train Associates on how to improve scanning accuracy and productivity.
  • Ensure Registers are prepared for opening and closing each day.
  • Follow Company guidelines concerning refund, check, bankcard and Associate discount purchase approvals.
  • Co-ordinate schedules, Ensure an adequate number of Cashiers are on registers to provide excellent Customer Service.Co-ordinate lunch/break schedules for Cashiers, People Greeter, Layaway and Courtesy Desk Associates.
Accounting Associate08/2007 to 01/2010Company NameCity, State
  • Comply with all Company policies and procedures.
  • Process register bags, which includes Separating cash, coupons, and other media and processing coins.
  • Prepare all deposits, which include using teller Mate to weigh and enter currency into the computer.
  • Verify, reconcile and finalize end of day business transactions into the system.
  • Identify, record, and track register and office long and short.
  • Communicate shortages per company guidelines and management.
  • Monitor area for signs of shrink and potential security risks and inform Management and Loss Prevention.
  • Prepare, organize, and separate various reports and logs.
  • Demonstrate Attention to detail when reviewing reports, and any financial transactions.
  • Prioritize work assignments and Complete duties within established work routines, procedures and time lines.
  • Research and challenge all Charge backs.
Education
HIGH SCHOOL DIPLOMA2006Vincent High SchoolCity, State, US
Skills

10-Key, Account Management, Active Learning, Calendaring, Client Relations, Computer Proficiency, Coordination, Creative Problem Solving, Critical Thinking, Customer Needs Assessment, Customer Service, Data Collection, Data Entry, Documentation, Email, Management Support, Internet Research, Report Transcription, Research, Scheduling, Spreadsheets, Telephone Skills, Time Management, Typing, Vendor Management, Writing, Letters and Memos, Microsoft Excel, Microsoft Office Suite, Microsoft Outlook, Microsoft PowerPoint, Microsoft Word, Organizational Skills

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DISCLAIMER

Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.

Resume Overview

School Attended

  • Vincent High School

Job Titles Held:

  • Claims Adjustment Representative
  • Credit Specialist
  • Fraud Specialist
  • Customer Service Manager
  • Accounting Associate

Degrees

  • HIGH SCHOOL DIPLOMA 2006

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