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claims specialist resume example with 9+ years of experience

Jessica Claire
, , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
Home: (555) 432-1000 - Cell: - resumesample@example.com - : - -
Summary

Caring and helpful Claims Specialist with Social Security with a Proven ability to manage a high caseload, navigate complex government systems, and provide compassionate support. Seeking a challenging new role that will allow me to use my skills to help others.

Skills
  • Customer Service
  • Verbal and Written Communication
  • Organizing and Prioritizing Work
  • Claims Processing
  • Friendly, Positive Attitude
  • Problem Resolution
  • Fluent in Spanish
  • Microsoft Office
Experience
08/2019 to Current
Claims Specialist Naphcare Port Orchard, WA,
  • Processed and reviewed incoming Social Security claims for completeness, accuracy, and timeliness; ensured all required documentation was included with the claim.
  • Performed quality control checks on documents submitted with claims such as medical records, pay stubs, etc., ensuring that they are complete before forwarding them to the appropriate department for further review/processing
  • Interview applicants to obtain information about their medical conditions, work history, and other factors that may be relevant to the claim.
  • Calculate retirement benefits based on employee contributions to the Social Security system.
  • Prepare detailed reports about claimants eligibility for benefits to include work history and a detailed earnings report.
  • Contact applicants to notify them of claim status updates, request additional information about a claim if needed, and answer any questions about their claim.
  • Process applications for New Social Security cards/numbers.
  • Contact medical providers to determine if an applicant is capable of managing their own funds.
  • Process annual work reviews and medical reviews to determine if eligibility towards the Disability program continues.
  • Maintained a working knowledge of Social Security regulations and policies as well as state-specific laws.
  • Communicated with other departments to establish action plans and manage open claims to closure.
  • Collaborated with co-workers to manage large volume of claims.
  • Collected over payments, processed receipts and informed claimants of outstanding balances.
  • Completed weekly and monthly reports summarizing activities.
  • Used active listening skills and supportive diction to cultivate client rapport and open communication while taking Retirement or Disability claims.
  • Achieved high levels of customer satisfaction through exceptional interpersonal skills and patience.
  • Processed and determined eligibility for the federal Medicare Part D Extra Help program.
  • Referred claimants to the states Social Services office after evaluating and determining eligibility for the Medicare Savings Program.
  • Work independently on an establish workload and meet established deadlines.
04/2018 to 08/2019
Operations Specialist Acv Auctions Reno, NV,
  • Guarded restricted areas to prevent unauthorized entry.
  • Upheld strong customer service standards while completing screenings.
  • Reviewed IDs and other paperwork to verify personal information and to check for fraudulent documents.
  • Coordinated and maintained smooth passenger traffic flow through airport security checkpoints.
  • Watched each individual to assess demeanor and look for suspicious behavior.
  • Completed thorough zone searches to check for physical tampering and restricted items.
  • Maintained operations compliance with FAA, TSA and airport regulations.
  • Responded to emergent situations regarding flight operations or medical issues to quickly identify concerns, provide support and transport personnel and passengers away from critical scenes.
07/2016 to 04/2018
Parking Supervisor Abm Cleveland, OH,
  • I oversaw the operations of the parking facility.
  • Ensured all transactions were handled to airport standards.
  • Responsible for monitoring, training & the continued development of the cashiers & LPR.
  • Delegated duties, assigned tasks & made sure all team members were accurately performing their duties.
  • Scheduled breaks, lunches & made sure all employees were at their assigned position.
  • Responsible for handing each cashier the daily petty cash.
  • Deposited daily parking revenue in an onsite Compu-Safe & made sure all paperwork was accurate.
  • Handled all Patron complaints to include lost tickets, unreadable tickets & lost receipts.
  • Assisted the Parking Manager with any task necessary.
  • Responded to information requests from superiors, providing specific documentation.
  • Supported accident investigations and prepared related paperwork.
10/2013 to 06/2016
Transportation Security Officer Securitas Security Services Usa, Inc. New Haven, CT,
  • As a TSO my primary duties and responsibilities were to identify obvious & hidden threats to air travelers, airport aircraft & neutralize them.
  • Performed the duties of a Lead & of a Supervisory TSO.
  • Trained & supervised new hires as an OJT mentor.
  • Scheduled my peers breaks & lunches & made sure all employees were at their assigned position.
  • Opened & closed the checkpoint, assigned roles & supervised that they performed according to SOP.
  • Oversaw the screening of baggage & passengers.
  • Developed incident reports for LEO & my superiors.
  • Checked employees while they entered restricted areas of the airport.
  • Patrolled the airfield perimeter, inspected fences, SIDA, looked for debris & reported anything out of the ordinary.
  • Awarded officer of the quarter in 2016, for providing excellent service & being a role model to my peers.
  • Verified vendors and cars that entered the Punta Gorda Airport during their annual airshow.
  • Excelled in a challenging, time-constrained environment.
  • Designated as back-up for Supervisor duties..
  • Completed routine and incident-related documentation.
Education and Training
Expected in 01/2012 to to
Bachelor of Arts: Psychosocial Human Services
Inter American University of Puerto Rico Aguadilla - Aguadilla, PR
GPA:
Expected in 05/2007 to to
High School Diploma:
Ramey School - Aguadilla, PR,
GPA:
Languages
English:
Native/ Bilingual
Negotiated:
Spanish:
Native/ Bilingual
Negotiated:

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Resume Overview

School Attended

  • Inter American University of Puerto Rico Aguadilla
  • Ramey School

Job Titles Held:

  • Claims Specialist
  • Operations Specialist
  • Parking Supervisor
  • Transportation Security Officer

Degrees

  • Bachelor of Arts
  • High School Diploma

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