Claims Specialist Resume Example

Love this resume?

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

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • Home: (555) 432-1000
  • Cell:
Professional Summary

Business-minded Claim Specialist with exemplary skills in customer service, time management and service coordination. Bringing over 3 years of related experience combined with superior morale and productivity abilities. Pursuing similar position with expanding career growth and advancement.

  • Claims Adjustments
  • Customer Service
  • Claims Processing
  • Negotiation Skills
  • Customer Billing
  • Claims Knowledge
Work History
Claims Specialist, 02/2018 to Current
Devoted HealthDenver, CO,
  • Followed up with customers on unresolved issues
  • Addressed average of 700 customer inquiries and complaints yearly
  • Reviewed new files to determine current status of injury claim and to develop plan of action
  • Delivered exceptional customer service to policyholder's by communicating important information and patiently listening to all issues
  • Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials
  • Visited customer locations to evaluate damage and provided cost estimates for remediation
  • Documented all information gathered field and uploaded data to company database for efficient processing using Excel
  • Negotiated new and renewal production goals with business development manager
  • Analyzed sales volume, retention and loss ratio trends to identify areas for improvement
  • Inspect photos,fabric rolls, defects
  • Contributed ideas and offered constructive feedback at weekly sales and training meetings
  • Process Credits for each approved claim
Direct Support Professional Caregiver, 05/2017 to 02/2018
Bethesda Lutheran HomesSan Francisco, CA,
  • Creating and Managing Fitness Programs within AHRC of Nassau for all clients
  • Organized and led client groups per time period in subjects related to physical and emotional health to ensure long-term patient well-being
  • Ensured HIPAA compliance
  • Provided on-call care at all times of day and night
  • Trained new staff on quality control procedures as per OPWDD standards
  • Assisted clients with daily functions
  • Extensive experience working in homes and day habilitation programs with disabled children and adults
  • Monitored fluid intake and output levels
  • Provided all daily living tasks to enhance quality of life for clients
  • Assisted client residents with bathing, dressing, feeding, lifting and transferring
  • Provided coaching and mentoring to clients to enhance individual development
  • Assisted patients with daily hygiene tasks, including bathing, dressing, dental care and grooming
Security & Fire Safety Manager, 08/2015 to 05/2017
KrogerGreeley, CO,
  • Detected suspicious activities and watched for criminal acts and rule infractions
  • Monitored and authorized entrance and departure of vehicles, cargo trucks and visitors
  • Monitored and authorized entrance and departure of employees and visitors
  • Circulated among visitors, patrons and employees to preserve order and protect property
  • Wrote reports on property damage, theft, presence of unauthorized persons and unusual occurrences
  • Monitored and reported suspicious activities to local authorities
  • Operated detecting devices to screen individuals and prevent passage of prohibited articles into restricted areas
  • Warned offenders about rule infractions and violations and verbally evicted violators from premises
  • Denied entrance to any building to unauthorized persons
  • Monitored central alarm system for fire, intrusion, and duress alarms and responded when needed
  • Secured all doors in each office and main building after hours
  • Inspected equipment, structures and materials to identify all cause of errors and defects
  • Completed in-depth searches of 150 individuals and baggage to check for devices, weapons and other prohibited items
  • Maintained safety by quickly responding to alarms and investigating disturbances
Deli Assistant Manager, 01/2014 to 08/2016
Cino's Hot BagelsCity, STATE,
  • Oversaw all POS systems
  • Answered telephone calls and responded to inquiries
  • Assigned patrons to tables suitable for their needs and according to rotation
  • Assisted in maintaining preparation and service areas in sanitary conditions
  • Checked temperatures of freezers, refrigerators, and heating equipment to ensure proper functioning
  • Cleaned and inspected galley equipment, kitchen appliances, and work areas
  • Cleaned and organized eating, service, and kitchen areas
  • Cleaned and sterilized equipment and facilities
  • Cleaned garbage cans with water or steam
  • Trained kitchen staff on proper use of equipment, food handling, and portion sizing
  • Worked stations including pizza, omelet, soup, salad, sandwich, and dessert at a busy cafeteria
  • Greeted each customer with friendly eye contact
  • Helped with preparation, set-up, and service for catering events
  • Maintained friendly and professional customer interactions
  • Scheduled over 25 employees by assigning shifts
  • Assisted restaurant ownership with pricing by providing information about ingredient costs and correct portioning
  • Established and enforced standards of personnel performance and service to provide customers with consistent and positive experiences
High School Diploma: , Expected in 2010
Christ the King Regional High School - Middle Village, NY,
  • CPR Certified
  • Approved Medication Administration Personnel (AMAP) Certified
  • SCIP-R Certified
  • FO1 Fire Safety Certification
  • FO3 Fire Safety Certification

Managed a successful ERP transition

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
  • Christ the King Regional High School
Job Titles Held:
  • Claims Specialist
  • Direct Support Professional Caregiver
  • Security & Fire Safety Manager
  • Deli Assistant Manager
  • High School Diploma

Similar Resume

View All
Claims Specialist
Claims Specialist
Claims Specialist