Claims Service Representative Resume Example

Love this resume?

By clicking Build Your Own Now, you agree to our Terms of Use and Privacy Policy

Jessica Claire
  • , , 100 Montgomery St. 10th Floor
  • H: (555) 432-1000
  • C:
  • Date of Birth:
  • India:
  • :
  • single:
Professional Summary

Hardworking Claims Service Representative bringing 22 years of experience meeting customer needs. Skilled at researching and analyzing claim errors/issues, meeting productivity targets. Offering experience, reliability, teamwork, and enthusiasm for any opportunity.

  • Excellent work ethic
  • Extensive work experience, in multiple functions.
  • Work Independently
  • I am a great resource for others.
  • Account management
  • Computer proficiency
  • Teamwork
  • Good listening skills
  • Adaptability
  • Customer Service
  • Responsible
Work History
Claims Service Representative, 09/1999 to Current
Utica National Insurance Group Duluth, GA,
  • Research, identify and obtain information needed to help process claims or resolve claim issues (I.E. Executive, Restricts, MSSC, Adjustments)
  • Ensure proper benefits are applied to every claim
  • Apply knowledge of customer service requirements to process claim appropriately
  • Identify and apply knowledge of new plans/customers to process their claims correctly
  • Resolve or address new or unusual claims errors/issues as they arise, applying appropriate knowledge or prior experience'
  • Communicate and collaborate with internal business partners to resolve claims errors/issues
  • Document and Communicate status of claims as needed
  • Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
  • Participated in continuous improvement by generating suggestions, engaging in problem-solving activities to support teamwork.
  • Used critical thinking to break down problems, evaluate solutions and make decisions
  • Use appropriate systems/platforms/applications to process claims
  • Navigate system tools and screens efficiently and effectively
  • Use appropriate documentation, reference materials and or websites to ensure that claims are processed accurately and efficiently
  • Achieve applicable performance metrics
Business Owner/Operator, 08/1998 to 08/2001
Bmi Hospitality Management Everett, WA,
  • Put together realistic budgets based upon costs and fees for effectively operating business.
  • Oversaw end-to-end business processes to maintain proficiency and profitability.
  • Monitored staff performance, providing final-say assessment over all inquiries.
  • Served as primary point-of-contact with suppliers and contractors to achieve inventory expectations.
  • Learned and remained updated on statutory requirements and regulations.
  • Kept all building areas and equipment functional and well-organized to promote business performance.
  • Applied human resources expertise to optimize hiring, training and performance.
  • Trained and developed team members throughout 3-year business history.
  • Reconciled daily sales, returns and financial reports
  • Oversaw business budget planning and administration, accounting functions, purchasing and bi-weekly payroll to handle financial needs.
Bar Manager, 08/1993 to 08/1998
O'Leary's Tavern City, STATE,
  • Implemented quality control initiatives while creating house-made cocktails, juice and preparations to reduce downtime and increase revenue.
  • Took customer orders and capitalized on opportunities to sell special beverage and food options.
  • Managed bar inventory, restocked supplies and placed orders for spirits, beer, wines and mixers.
  • Maintained secure cash drawers, promptly resolving discrepancies for accuracy.
  • Increased profits with enhanced inventory oversight and strategic pricing adjustments.
  • Closed out cash register with 100% accuracy and prepared cashier report.
  • Handled escalated customer concerns with speed and knowledgeable support to achieve optimal satisfaction and maintain long-term loyalty.
  • Checked ID cards and verified bar guests were of legal age.
  • Followed all safety requirements for alcohol service and maintained network of available ride services for inebriated customers.
  • Kept facility compliant with health codes, sanitation requirements and license regulations, alleviating potentially heavy fines.
  • Assisted servers with specialty drinks orders by preparing on-demand items without delay.
  • Reduced health risks and safety hazards by preparing beverage products consistently while creating cleaning schedules, restocking items and sanitizing equipment to adhere to health department standards.
  • Kept alcoholic beverages well-stocked and organized to meet expected demands.
  • Polished glassware, bussed tables and removed debris to keep customer areas fresh and clean.
No Degree: Nursing, Expected in
Schenectady Community College - Schenectady, NY,
High School Diploma: , Expected in 06/1990
Linton High School - Schenectady, NY,

Available Upon Request

By clicking Build Your Own Now, you agree to our Terms of Use and Privacy Policy

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:


Resume Strength

  • Formatting
  • Length
  • Personalization
  • Strong Summary
  • Target Job
  • Typos

Resume Overview

School Attended
  • Schenectady Community College
  • Linton High School
Job Titles Held:
  • Claims Service Representative
  • Business Owner/Operator
  • Bar Manager
  • No Degree
  • High School Diploma