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insurance claims processor resume example with 1+ years of experience

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Jessica Claire
Montgomery Street, San Francisco, CA 94105 (555) 432-1000, resumesample@example.com
Professional Summary
– Benefits and Retirement professional with experience working on Defined Contribution/Benefit plans for both corporate human resources and investment management firms that demand strong organizational, technical and interpersonal skills. Very effective communicator and team leader with proven ability to build long-term relationships with individuals at all levels. Possess a strong business acumen with intellectual curiosity. Knowledgeable of industry updates, recent legislations and changes.  Emphasis and focus on delivering excellent quality to the customers and clients’ needs.
Skills
  • Benefits administration
  • Employee coaching
  • Records maintenance
  • Diverse Background
  • Self Motivated
  • Team Player
  • Detail Oriented
  • Professional
Work History
02/2014 to 07/2014 Insurance Claims Processor Department Of Commerce | Lakeland, FL,
  • Repriced UB-04 and HICFA claims according to pre-negotiated PPO discounts and applied network discounts.
  • Assisted Health Solutions department with transition to new processing systems by clearing back logged claims by deadlines.
  • Corresponded directly with insurance and 3rd party providers to resolve client issues and confirm in and out of network provider updates.
  • Controlled, filed and scanned all incoming and outgoing documents for Health Solutions office. 
11/2012 to 07/2013 Trade Specialist Mercer Company | City, STATE,
  • Serviced over 200 Defined Contribution client plans and participants.
  • Applied business expertise and finance acumen to advise employees of Fortune 100 companies and investment firms on asset selection strategies and investment options.
  • Processed loans and paperless distributions for all DC 401, 405B, 457 plans on platform, deferral changes, online enrollments.
  • Ensured participants abide by regulatory guidelines. ERISA and DOL compliance.
06/2012 to 11/2012 Benefits Specialist/ HR Consultant Mercer Company | City, STATE,
  • Provided health benefits consultative servicing through a wide network of client teams.
  • Administered open enrollment; mediated between health plan representative and employee benefits.
  • Educated Employees about Group Health benefits, vision, dental and group retiree health insurance.
  • Maintained employee benefit records through secure online date terminal/work station.
Education
Expected in 2001 to to Bachelor of Arts | Mass Comunications Loyola University, New Orleans, LA GPA:
  • Continuing education in Business Administration
  • Student government representative
Expected in 1997 to to Certificate of excellence in Comunications | Xaiver University, New Orleans, LA GPA:
Expected in 1996 to to High School Diploma | St. Marys Academy, New Orleans, LA GPA:
Affiliations
Daughters of Zion    Board Member

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Resume Overview

School Attended

  • Loyola University
  • Xaiver University
  • St. Marys Academy

Job Titles Held:

  • Insurance Claims Processor
  • Trade Specialist
  • Benefits Specialist/ HR Consultant

Degrees

  • Bachelor of Arts
  • Certificate of excellence in Comunications
  • High School Diploma

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