claims specialist resume example with 2+ years of experience
JessicaClaire
, , 609 Johnson Ave., 49204, Tulsa, OK100 Montgomery St. 10th Floor
H: (555) 432-1000
C:
resumesample@example.com
Date of Birth:
India:
:
single:
:
Summary
Dedicated Customer service Associate talented at processing high volumes of error-free transactions and meeting departmental goals. Offers 5 years of experience in customer service, retention and problem resolution. Smoothly manages conversational flow and diffuses difficult customer situations.
Skills
Settlement determinations
Coverage assessments
Documentation review
Documentation skills
Account management expertise
Reporting abilities
Regulatory compliance understanding
Analytical
MS Office
Data management
Time management
Work ethic
Planning
Working collaboratively
Computer skills
Decision-making
Supervision
Troubleshooting
Schedule management
Quality control
Patient relations
Team contribution
Reliable and trustworthy
Customer service
Cash register operation
Security understanding
Courteous and professional demeanor
Payment methods
Guest and client satisfaction
Communication
Collaboration
People skills
Friendly, positive attitude
Problem resolution
Project planning
Organizational skills
Schedule mastery
Transportation solution development
System implementation
Route management
Process optimization
In-store support
Freight operations
Courteous demeanor
Product organization
Call Center Operations
Office equipment proficiency
Shipping and receiving understanding
Adaptive team player
Problem-solving abilities
Store maintenance
Customer relations
Senior leadership support
Technologically savvy
Retail sales customer service
Business development understanding
Quality assurance controls
Inbound and Outbound Calling
Promotional support
Stockroom procedures
Materials transport
Project management abilities
High-energy attitude
Data evaluation
Conflict mediation
Sales expertise
Experience
Claims Specialist, 06/2020 - 08/2020 Markel Corporation – Plano, TX,
Provided quality customer service to all 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 effective service times for all parties.
Verified details with policyholders and requested additional information.
Supported efficient handling of complex claims and followed up on open, denied or suspended claims to complete required line items.
Researched and reviewed information to determine validity of insurance claims and contacted companies and customers about decisions.
Reviewed documentation and accounts to gain full picture.
Assessed policy coverage and pulled contracts for review.
Determined liability, compensability and benefits due on each claim.
Monitored reports to identify claims issues and worked with adjusters to resolve problems.
Acted as intermediary between insurance companies and customers, including researching and assessing information to determine validity of claims.
Processed high volumes of bodily injury claims efficiently while working in fast-paced environment.
Consulted with field support team, including claim manager, quality control, file review, team lead and adjusters to receive support specific to assigned claim.
Researched coverage and premium options and supplied clients with best coverage available for individual needs.
Negotiated settlements for uncomplicated claims in accordance with actual company liability.
Oversaw regulatory and strategic initiatives to ensure accuracy of medical claims.
Investigated and analyzed requirements to improve timeliness of reports to customers.
Managed asset recoveries for claims, including salvage and subrogation.
Tracked and reported on patterns of claims and repeat offenders to help eliminate system abuse.
Promoted agency products to customers in person, by telephone and in writing.
Homestead Museum Volunteer, 03/2019 - 10/2019 Dean Health – North Fond Du Lac, WI,
Tracked attendance, supervised volunteers and greeted guests at all museum events.
Provided knowledgeable service when answering questions and greeted all customers with friendly demeanor.
Directed guests to correct location by documented ticket seats and answered questions about facility amenities.
Responded to guest questions about current facility events and future offerings.
Complied with health and sanitation practices and procedures.
Processed admission payments and provided tickets.
Provided client service by distributing programs, answering patron's questions and selling tickets and merchandise.
Helped patrons to assigned seats by giving directions and leading way with flashlight while lights were dimmed.
Determined authenticity and applicability of presented tickets.
Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
Worked closely with team members to deliver project requirements, develop solutions and meet deadlines.
Prioritized and organized tasks to efficiently accomplish service goals.
Juggled multiple projects and tasks to ensure high quality and timely delivery.
Demonstrated self-reliance by meeting and exceeding workflow needs.
Demonstrated leadership by making improvements to work processes and helping to train others.
Provided excellent service and attention to customers when face-to-face or through phone conversations.
Improved operations by working with team members and customers to find workable solutions.
Motivated and encouraged team members to communicate more openly and constructively with each other.
Food Service Associate, 10/2017 - 01/2018 Rbc Bearings – Plymouth, IN,
Followed all procedures regarding food safety to properly handle and preserve food.
Received, checked and arranged food orders for in-store and carry out customers.
Assembled, cooked, stored and disposed of food using proper handling, labeling and safety techniques and maintained proper food temperature during preparation and service.
Prepared, apportioned and served beverages, salads and desserts for regular and therapeutic diets according to planned menus and production sheets.
Assisted cook with meal preparing and serving, delivered food and trays, washed dishes and sanitized kitchen and serving areas according to health standards.
Maintained dining and food service areas to maximize safety and cleanliness.
Supported serving staff in delivering accurate and well-presented food orders.
Mentored and trained new team members, helping to build confidence and demonstrate proper ways to complete job tasks.
Stocked ingredients, monitored inventory, helped track expenses, supported menu planning and maintained food service equipment in proper operating condition.
Responded to visitor questions and concerns with friendly, knowledgeable service.
Welcomed and thanked guests to demonstrate appreciation for patronage.
Responded to customer questions effectively, explained preparation style for menu items and helped in entrée selections.
Provided exceptional service that reflected restaurant standards and core values.
Assembled and served meals according to specific guest requirements.
Restocked napkins, plates and silverware as well as beverages and condiments.
Demonstrated proficient knowledge of menus, services and promotions offered to assist customers and team members.
Helped with special events, banquets and catering functions, including dining room setup and takedown, food preparation and direct customer service.
Discussed menu options with guests, took orders and provided kitchen with special dietary information.
Served attractive, appetizing meals and deployed accepted tasting techniques to confirm quality, taste and palatability prior to service.
Set tables for upcoming meal according to food service guidelines manual.
Collaborated with kitchen team to bus and set tables, prep food and stock salad bar.
Created food displays according to established standards and replaced dated products with fresh.
Supervised numerous service areas throughout establishment and restocked napkins, silverware and condiments to keep supplies from running low.
Maintained presence throughout meals to assist guests with additional food and beverage requests as needed.
Delivered exemplary service and support to customers during restaurant events, including fundraisers and bridal showers.
Oversaw inventory in buffet and reported replacement needs to kitchen management.
Customer Service, 01/2015 - 09/2016 Miami Dade College Bookstore – City, STATE,
Organized store by returning all merchandise to its proper place and restocked displays.
Stocked shelves and supplies and organized displays to focus customer attention on specific items.
Unboxed new merchandise and restocked shelves in appealing and organized arrangements to promote items.
Performed floor moves, merchandising, display maintenance and housekeeping to keep sales areas well-stocked, organized and current.
Recommended merchandise to customers based on needs and preferences.
Educated customers on product and service offerings.
Escorted customers to products and pointed out complementary items to boost store sales.
Stayed up to date on store promotions, payment policies and security practices.
Recommended optimal merchandise based on customer needs and desires.
Maintained visually appealing and effective displays for entire store to drive sustained revenue and move target products.
Helped customers sign up for loyalty programs and submitted completed paperwork.
Demonstrated products to customers, discussed features and redirected objections to capture sales.
Observed customer behaviors to identify security threats and escalate concerns to supervisors.
Met or exceeded upselling, donation and credit card sign-up targets on consistent basis by leveraging excellent communication and interpersonal strengths.
Mixed and matched paints according to customer specifications.
Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
Worked closely with team members to deliver project requirements, develop solutions and meet deadlines.
Education and Training
GED: , Expected in 06/2016 - Miami Dade College - Kendall, Fl, GPA: Status -
Associate of Arts: Anthropology, Expected in 04/2021 - Miami Dade College - Kendall, Fl, GPA: Status -
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