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claims service specialist resume example with 16+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
  • :
Summary

Experienced in processing Auto and home owner claims in high-volume environments. Successful at managing complete claims process with minimal direction. Conversational skills in English . Capable Claims Representative adept at claims investigations, information review and settlement management. Positive and reliable professional with a detail-oriented and systematic approach. Bringing 6 years of related experience. Dedicated team player adept at managing customer service and claims processing for policyholders. Looking for a long-term position with a growth-oriented company. Dedicated employee known for punctuality, pursuing employment options where good customer service and positive attitude will make a difference.

Skills
  • Documentation research
  • Coverage determination
  • Settlement agreements
  • Policy knowledge
  • Reporting abilities
  • Documentation skills
  • Insurance terminology
Experience
Claims Service Specialist, 10/2015 - Current
Bayada Home Health Care Brooklyn, NY,
  • Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers.
  • Delivered quality customer service to assigned, insured and claimants throughout entire claims lifecycle to promote service times.
  • Verified details with policyholders and requested additional information.
  • Reviewed documentation and accounts to gain full picture.
  • Consulted with field support team, claim manager and other entities to receive support specific to assigned claim.
  • Assessed policy coverage and pulled contracts for review.
  • Verified policy holder data, including age, contact number and physical address.
  • Complied with confidentiality regulations in handling customer information.
  • Corresponded with insurance customers and agents to obtain or relay information on account status changes.
  • Processed claims for payment or forwarded to appropriate personnel for further investigation
  • Assisted new policyholders with processing claims.
Direct Care Worker, 11/2012 - 10/2022
Supportive Concepts For Families Reading, PA,
  • Made beds, swept floors and sanitized surfaces to support activities of daily living.
  • Maintained daily living standards by assisting clients with personal hygiene needs.
  • Helped clients with personal needs from exercise to bathing and personal grooming.
  • Supervised medication administration, personal hygiene and other activities of daily living.
  • Followed care plan and directions to administer medications.
  • Engaged with patients and families to provide emotional support and daily living instruction.
  • Developed strong and trusting rapport with patients to facilitate smooth, quality care.
  • Transported patients to medical, dental and personal care appointments.
  • Laundered clothing and bedding to prevent infection.
  • Aided with mobility and independence for disabled individuals and continually monitored safety.
  • Coordinated doctor appointments, exercise, recreation and family visits to maintain schedule.
Direct Care Staff Member, 11/2008 - 11/2012
Giant Eagle, Inc. Upper Arlington, OH,
  • Documented client progress and services performed, reporting changes in client condition to manager or supervisor.
  • Cared for individuals or families during periods of illness or convalescence, providing companionship, personal care or help in adjusting to new lifestyles.
  • Entertained or read aloud to patients to improve mental health and alertness.
  • Administered medications or treatments as directed by physician or nurse.
  • Made beds, swept floors and sanitized surfaces to support activities of daily living.
  • Maintained daily living standards by assisting clients with personal hygiene needs.
  • Helped clients with personal needs from exercise to bathing and personal grooming.
  • Followed care plan and directions to administer medications.
  • Aided with mobility and independence for disabled individuals and continually monitored safety.
  • Cultivated relationships with residents to support happiness and emotional well-being.
Overnight Stock Associate, 03/2006 - 11/2008
Walmart City, STATE,
  • Stocked, arranged and organized merchandise during late shift in store that stayed open overnight.
  • Cleaned and straightened warehouse, store aisles and shelves for ease of product accessibility, safety and loss prevention.
  • Identified stock needs, replaced outdated stock and assembled products.
  • Constructed and stocked new displays, designed and assembled end caps and removed and discarded outdated displays.
  • Assisted customers upon request in finding products or checked in warehouse for unstocked items.
  • Received, unloaded and documented incoming stock in warehouse and staged merchandise for easy retrievability.
  • Demonstrated expertise in knowing product locations, resulting in maximum satisfaction for searching customers.
  • Routed warehoused and incoming merchandise to proper store departments and locations.
  • Removed product from boxes and placed on shelves according to merchandising guidelines.
  • Picked up boxes and related trash from sales floor.
  • Stocked pallets throughout shift to keep warehouse clean, maintained and organized.
  • Disposed of expired and overripe items to eliminate health risks.
  • Assessed floor displays to restock merchandise.
  • Checked shelves in department to determine replenishment needs.
  • Secured products during transport to prevent damage.
Education and Training
High School Diploma: , Expected in 06/2005
-
Rosemount High School - Rosemount, MN,
GPA:
Status -

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Resume Overview

School Attended

  • Rosemount High School

Job Titles Held:

  • Claims Service Specialist
  • Direct Care Worker
  • Direct Care Staff Member
  • Overnight Stock Associate

Degrees

  • High School Diploma

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