insurance claims specialist resume example with 11+ years of experience
JessicaClaire
, , 100 Montgomery St. 10th Floor(555) 432-1000, resumesample@example.com
Summary
Proficient Claims Associate skilled in handling high volumes of 300 claims. Processes adjustments based on identifiable liability and compensability. Supports work of senior team members by organizing documentation and assisting on complex cases.
Skills
Customer Service
Teamwork and Collaboration
Attention to Detail
Problem-Solving
Time Management
Organizing and Prioritizing Work
Critical Thinking
Verbal and Written Communication
Decision Making
Active Listening
Appointment Scheduling
Documentation Review
Microsoft Office
Data Entry
Recordkeeping Organization
Settlement Determinations
Insurance Claim Forms Review
Eligibility Determination
Accident Investigations
Document Control
Coverage Assessments
Claim Amount Calculations
Payment and Investigation Escalations
Coverage Determination
New Policies Processing
Client Interviews
Information Verification
10-key Touch
Policy Modifications and Updates
Policy and Procedure Explanations
Regulatory Compliance Adherence
Service Referrals
Financial Transactions
Proofreading and Editing
Cancellation Notifications
Billing Software
Account Management Software
Small Claims Payouts
Insurance Carrier Applications
Policy Reinstatement Approvals
Large-Sum Computations
Google Suite
Premium Collection
Experience
01/2021 to 09/2022Insurance Claims SpecialistYamaha Motor Corp | Bridgeport, AL,
Supported efficient handling of complex claims and followed up on open, denied or suspended claims to complete required line items.
Determined liability, compensability and benefits due on each claim.
Processed Insurance claims daily and expertly handled as many as 100 files with impeccable quality.
Monitored reports to identify claims issues and worked with adjusters to resolve problems.
Researched and reviewed information to determine validity of insurance claims and contacted companies and customers about decisions.
Communicated with other departments to establish action plans and manage open claims to closure.
Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.
Planned and conducted investigations of claims to confirm coverage and compensability.
Documented specific claims by completing and recording forms, reports and logs.
02/2018 to 12/2021Deli ManagerSprouts Farmers Market | Tucson, AZ,
Maximized customer satisfaction scores by training employees well and implementing strong customer relations standards.
Reduced costs by controlling portion sizes and eliminating all types of waste.
Reconciled daily transactions, balanced cash registers and deposited restaurant's earnings at bank.
Priced and ordered food products, kitchen equipment and food service supplies.
Prepared and led food service training programs to teach staff various tasks.
Reduced food waste by overseeing and planning ingredients, anticipated customers and popularity of items.
Created effective marketing promotions to improve business.
Delegated work to staff, setting priorities and goals.
Trained front-of-house staff on restaurant policies and procedures, guest service techniques and communication skills to promote positive experiences.
Consistently maintained high levels of cleanliness, organization, storage and sanitation of food and beverage products to ensure quality.
Used proper cleaning supplies and methods to disinfect counters where raw meat, poultry, fish and eggs had been prepared.
Oversaw inventory and ordered ingredients to restock freezers, fridges and pantry.
Cleaned and sanitized kitchen equipment, utensils and work stations.
Observed food safety and sanitation protocols to reduce germ spread.
Prepared variety of foods according to exact instructions and recipe specifications.
01/2016 to 08/2019Dispatch SupervisorMenzies Aviation | Ontario, CA,
Monitored attendance and productivity for employees by maintaining accurate and updated records.
Mentored, trained and managed team of [50] employees and offered insight and direction, helping boost overall performance.
Compiled presentations based upon analysis of project and vendor data and distributed to internal stakeholders.
Monitored dispatch board and adjusted call priorities regularly based on caller needs.
Tracked changes in computer system to keep records current and accurate.
Kept detailed and updated records of calls in physical and electronic databases.
Managed daily delivery and work schedules to maximize coverage.
Reviewed routes, daily traffic and weather conditions to adjust plans, meeting daily requirements and service needs.
Answered customer requests with information about product availability, shipping information and status updates.
Scheduled loads according to priority and available equipment.
Communicated with individuals within inbound call center setting to complete dispatch support for 300 calls.
Worked closely with transportation supervisor to dispatch and assign loads.
Leveraged GPS devices and computer programs to plan routes, update customers or advise drivers about upcoming issues.
03/2011 to 01/2016General ManagerDonatos | London, OH,
Delivered exceptional client experiences through hands-on leadership of associates and managers.
Built and maintained loyal, long-term customer relationships through effective account management.
Designed sales and service strategies to improve revenue and retention.
Managed inventory levels and conducted corrective action planning to minimize long-term costs.
Created schedules and monitored payroll to remain within budget.
Complied with company policies and government regulations to prevent and detect rule violations and protect organization from fines and lawsuits.
Trained employees on duties, policies and procedures.
Conducted employee evaluations to provide adequate feedback and recognize quality performance.
Guided management and supervisory staff to promote smooth operations.
Developed service and sales strategies to improve retention and revenue.
Taught alertness and security tactics to reduce theft and losses.
Led employee evaluations with constructive feedback to boost performance.
Recruited, trained and empowered employees to achieve key performance indicators.
Recruited, interviewed and hired qualified staff for open positions.
Supervised employees through planning, assignments and direction.
Administered employee discipline through verbal and written warnings.
Enhanced operational performance by developing effective business strategies, systems and procedures.
Education and Training
Expected in 06/2004 to to Associate of Science | Computer And Information SciencesHenry Ford College, Dearborn, MIGPA:
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