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Claims Specialist Resume Example

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Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
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.

Skills
  • 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
Education
High School Diploma: , Expected in 2010
Christ the King Regional High School - Middle Village, NY,
GPA:
Certifications
  • CPR Certified
  • Approved Medication Administration Personnel (AMAP) Certified
  • SCIP-R Certified
  • FO1 Fire Safety Certification
  • FO3 Fire Safety Certification
Accomplishments

Managed a successful ERP transition

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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
Degrees
  • High School Diploma

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