SEARCH

Claims Examiner Resume Example

Resume Score: 80%

Love this resume?Build Your Own Now
CLAIMS EXAMINER
Professional Summary

Experienced Office Management and Administration Professional with 16 + years of experience optimizing productivity, efficiency and service quality across various environments. Highly dependable, ethical and reliable support specialist and leader that blends advanced organizational, technical and business acumen. Works effectively with cross-functional teams in ensuring operational and service excellence.

Skills
  • Program files maintenance
  • Multi-line phone proficiency
  • Office administration
  • Customer and client relations
  • Time management
  • 40 wpm typing speed
  • Data Entry
  • Business administration
  • Business correspondence
  • Knowledge of outlook,Word and Excel
  • Jurisdictional knowledge
  • Policy investigations
  • Multi tasking
Work History
Claims Examiner, 09/2011 to 05/2020
EAN Holdings LLC. – Fort Collins, CO
  • Consulted police and hospital records when needed
  • Conducted day-to-day administrative tasks to maintain information files and process paperwork
  • Ensured proper management of filed hazard and special hazard claims
  • Handled complaints and grievances using negotiating and problem-solving skills
  • Researched claims and incident information to deliver solutions and resolve problems
  • Examine damage claims and determine subrogatable parties
  • Review Enterprise contracts, review contract violations and state jurisdictions when applicable
  • Specialized in handling Corporate high dollar accounts
  • Handled account payments and provided information regarding outstanding balances
  • Executed billing tasks and recorded information in company databases
  • Produced large volumes of client invoices using Excel
Administrative Support Clerk, 02/2010 to 09/2011
EAN Holdings LLC. – Fort Collins, Colorado
  • Improved office operations by automating client correspondence, record tracking and data communications
  • Delivered expert clerical support by efficiently handling wide range of routine and special requirements
  • Improved customer satisfaction scores through application of superior conflict resolution and problem-solving skills
  • Managed electronic claim files and records for numerous clients and adhered to safety procedures to prevent breaches and data misuse
  • Kept physical files and digitized records organized for easy updating and retrieval by authorized team members
  • Performed background searches to obtain insurance and contact information for claimants and customers
  • Entered new data and updating electronic claim files from incoming correspondence
Phone Representative, 04/2009 to 02/2010
EAN Holdings LLC. – Fort Collins, CO
  • Responded to customer requests, offering excellent support and tailored recommendations to address needs
  • Forged and nurtured impactful relationships with customers to cultivate loyalty, boosting customer satisfaction ratings
  • Entered customer interaction details in AS400 to track requests, document problems and record solutions offered
  • Assisted customers by listening closely, finding solutions to problems and making recommendations based on extensive company knowledge
  • Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates
  • Directed incoming calls to internal personnel and departments, routing to best-qualified department
  • Maintained accurate and current customer account data with manual forms processing and digital information updates
  • Resolved dispute and discrepency issues over phone with customers daily
  • Developed highly empathetic client relationships and earned reputation for exceeding service standard goals
  • Called out to various insurance companies to file claims on policy holders
Guest Relations Specialist, 12/2005 to 01/2009
Ten Aveda Salon And Spa – Lovelland, Colorado
  • Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates
  • Trained staff on operating procedures and company services
  • Met all customer call guidelines including service levels, handle time and productivity
  • Communicated with vendors regarding back order availability, future inventory and special orders
  • Resolved customer issues over phone with customers daily
  • Welcomed, greeted and assisted guests in high-traffic store
  • Maintained up-to-date knowledge of product and service changes
  • Kept Salon and Spa areas clean, tidy and professional in appearance to maximize worker efficiency and promote customer engagement
  • Described and explained details about numerous products options to inform customers and guide purchasing decisions
  • Reached out to customers after completed sales to suggest additional service or product purchases and inquire about needs or concerns
  • Developed highly empathetic client relationships and earned reputation for exceeding service standard goals
  • Entered orders into Excel computer database system
  • Trained new personnel regarding company operations, policies and services
  • Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences
  • Implemented and developed customer service training processes
  • Assisted numerous customers daily by answering questions, responding to inquiries and handling telephone requests
  • Monitored cash drawers in multiple checkout stations and maintained adequate cash supply
  • Stocked merchandise each day, clearly labeling items, arranging according to size or color and preparing attractive displays
  • Maintained accurate and current customer account data with manual forms processing and digital information updates
  • Reviewed order data on daily basis to verify transactions and shipping dates
Education
Associate of Science: Science EducationFront Range Community College - Fort Collins
Associate of Science: Science EducationSalt Lake Community College - Salt Lake City
High School Diploma: 05/2003
Skyline High School - Salt Lake City, UT
Build Your Own Now

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

Companies Worked For:

  • EAN Holdings LLC.
  • Ten Aveda Salon And Spa

School Attended

  • Front Range Community College
  • Salt Lake Community College
  • Skyline High School

Job Titles Held:

  • Claims Examiner
  • Administrative Support Clerk
  • Phone Representative
  • Guest Relations Specialist

Degrees

  • Associate of Science : Science Education
    Associate of Science : Science Education
    High School Diploma : 05/2003

Similar Resumes

View All
Claims-Examiner-resume-sample

Claims Examiner

Blue Cross Blue Shield of Texas

Dallas, Texas