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Claims Representative Resume Example

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CLAIMS REPRESENTATIVE
Summary

Multi-faceted, results-focused, educated, professional, with in-depth knowledge of sales, negotiation, proactive marketing, account management and training, with exceptional organization, time management and multi-tasking abilities. Follows directives and employs all necessary steps to excel in high-pressure situations. Committed to addressing customer concerns with speed, accuracy and professionalism.

Highlights
  • MS Office proficient
  • Customer Relationship Management software (CRM)
  • Strong organizational skills
  • Detail-oriented
  • Analytical
  • Self-motivated
  • High customer service standards




  • Complex problem solver
  • Skilled negotiator
  • Cold calling
  • Complaint handling and resolution
  • Case management
  • Staff development
  • Supervision and training
Accomplishments

Recipient of Team Manager Discretionary Award for devotion to excellence in job performance. Multiple Global Recognition Awards for excellent customer service. Winner of the Founders Day award for exceeding weekly sales. Qualified for Fast Start award for exceeding sales target set by headquarters. Streamlined, and managed, case flow for the team I supervised and trained, which resulted in a 35% reduction of caseloads.

Experience
Claims RepresentativeAthene Holding LtdNew York , NY
Case Manager/Jury ConsultantEmc Insurance Group Inc.Overland Park , KS
  • Met with clients and other legal professionals to discuss case details.
  • Conducted client interviews and client intake
  • Corresponded daily with clients, insurance adjusters, doctors and attorneys
  • Investigated and negotiated claims, in order to settle, by applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to the client getting a fair and adequate settlement.
  • Interpreted and relayed legal information in a clear format for clients.
  • Mentored and supervised 3 assistants.
  • During the litigation process, assisted attorney, by evaluating medical records, interviewing clients, claimants, witnesses, doctors, medical specialists, or employers, to gather additional information needed
  • Composed and typed routine letters of correspondence.
  • Analyzed law sources, including statutes, recorded judicial decisions, legal articles, constitutions and legal codes..
  • Organized legal memoranda and client correspondence.
  • Collected data to prepare and draft settlement package for clients.
  • Assist in selection of jury members and interviewed jury member at the conclusion of trial.
  • Built and organized self motivational library for usage in the firm.
Senior Claims AdjusterLeidos Holdings Inc.Swedesboro , NJ
Independent Agent02/2014 to CurrentCommunity Solutions, Inc.Secaucus , NJ
  • Promote agency products to customers in person, on the telephone and in writing.
  • Present and clearly explain insurance policy options to clients based on their needs and goals.
  • Research coverage and premium options and supply clients with the best coverage available.
  • Present account proposals in a professional and timely manner.
  • Promote client retention through high-quality service and follow through.
  • Process applications, payments, corrections, endorsements and cancellations.
  • Pursue continuing education and training programs to continue professional development.
  • Generated new accounts by implementing effective networking and content marketing strategies.
Customer Relationship Manager03/2010 to 05/2013Bank Of America Home LoansCity , STATE
  • Conducted client interviews, setup and maintained case files, for homes in default, requiring loan modifications, or short-sale/deed in lieu.
  • Processed all assigned cases according to company and client service level agreements.
  • Corresponded daily with clients, attorneys, and foreclosure specialists,
  • Composed and typed routine letters of correspondence.
  • Provided accurate and appropriate information in response to customer inquiries.
  • Maintained up-to-date records at all times.
  • Developed effective relationships with all call center departments through clear communication.
  • Ran reports and supplied data to fulfill customer report requirements.
  • Monitored and reviewed all incoming and outgoing documents for accuracy and timeliness..
  • Built customer loyalty by following up with borrowers on constant basis..
  • Provided accurate and appropriate information in response to customer inquiries.
  • Demonstrated mastery of customer service call script within specified Time frames.
  • Maintained up-to-date records at all times.
Case Manager Supervisor01/2008 to 03/2010Jewish Vocational Services For The Department Of Social Services GAINCity , STATE
  • Trained, mentored and supervised, a team of 14 employees.
  • Increased team productivity by 40%, by identifying inefficiencies in existing methods, and implementing improvements. .
  • Recommended changes to existing methods to increase the accuracy, efficiency and responsiveness of the department.
  • Reviewed, and approved, files submitted for payments to clients.
  • Provided detailed weekly and monthly departmental reports and updates to senior management.
  • Interviewed clients individually and with families to determine what services would best address their needs.
  • Communicated with public social and welfare agencies to obtain and provide information.
  • Maintained thorough case history records and wrote detailed reports.
  • Managed caseloads and acted as an advocate for client rights.
  • Motivate, encourage and support participants in successfully completing each step of the program.
Case Manager/Jury Consultant06/1999 to 12/2005R. Rex Parris Law FirmCity , STATE
  • Met with clients and other legal professionals to discuss case details.
  • Conducted client interviews and client intake
  • Corresponded daily with clients, insurance adjusters, doctors and attorneys
  • Investigated and negotiated claims, in order to settle, by applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to the client getting a fair and adequate settlement.
  • Interpreted and relayed legal information in a clear format for clients.
  • Mentored and supervised 3 assistants.
  • During the litigation process, assisted attorney, by evaluating medical records, interviewing clients, claimants, witnesses, doctors, medical specialists, or employers, to gather additional information needed
  • Composed and typed routine letters of correspondence.
  • Analyzed law sources, including statutes, recorded judicial decisions, legal articles, constitutions and legal codes..
  • Organized legal memoranda and client correspondence.
  • Collected data to prepare and draft settlement package for clients.
  • Assist in selection of jury members by reviewing potential jury applications, attending jury selection, and then interviewing jury members at the conclusion of trial, to assist with future jury selections.
  • Built and organized self motivational library for usage in the firm.
Education
Bachelor of Arts: PhilosophyUCLACity, State

Philosophy

Skills

Attention to Detail, Coaching, Mentoring, Excellent customer service, Detailed documentation, filing, Human relations, Negotiation, Excel, Outlook, Word, Word Perfect, Quality assurance, Supervisory

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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.

How this resume score could be improved?

Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:

80Good
Resume Strength
  • Completeness
  • Formatting
  • Word choice
  • Measurable results
  • Clear contact info

Resume Overview

School Attended

  • UCLA

Job Titles Held:

  • Claims Representative
  • Case Manager/Jury Consultant
  • Senior Claims Adjuster
  • Independent Agent
  • Customer Relationship Manager
  • Case Manager Supervisor

Degrees

  • Bachelor of Arts : Philosophy

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