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Insurance Claims Specialist Resume Example

Resume Score: 80%

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INSURANCE CLAIMS SPECIALIST
Summary

Proficient Claims Associate skilled in handling high volumes of [Type] claims. Processes adjustments based on identifiable liability and compensability. Supports work of senior team members by organizing documentation and assisting on complex cases.

Skills
  • Documentation skills
  • Reporting abilities
  • Regulatory compliance understanding
  • Account management expertise
  • Customer service
  • Team building
  • Problem resolution
  • Inventory management
Experience
Mutual of Omaha | Omaha, NEInsurance Claims Specialist01/2000 - 01/2001
  • Determined liability, compensability and benefits due on each claim.
  • Stayed current on industry trends and changes and participated in professional development opportunities to strengthen product and service knowledge.
  • Fostered relationships with customers to expand customer base and enhance loyalty and retention.
  • Recognized by management for providing exceptional customer service.
  • Monitored reports to identify claims issues and worked with adjusters to resolve problems.
  • Demonstrated self-reliance by meeting and exceeding workflow needs.
  • Provided excellent service and attention to customers when face-to-face or through phone conversations.
  • Improved customer satisfaction by finding creative solutions to problems.
  • Improved operations by working with team members and customers to find workable solutions.
Immanuel Hospital and All Clinics (Floater) | Omaha, NECertified Medical Assistant06/1994 - 10/1996
  • Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate effective treatment.
  • Assessed, documented and monitored vital signs for more than [Number] patients per day.
  • Assisted with diagnostic testing by collecting and packaging biological specimens for internal and laboratory analyses.
  • Used [Type] software to process patient payments and update accounts.
  • Prepared treatment rooms for patients, including cleaning surfaces and restocking supplies.
  • Organized charts, documents and supplies to maintain team efficiency.
  • Administered rapid tests such as [Type] and [Type] to help clinical staff assess conditions.
  • Contributed to efficient office operations by triaging patients by severity of medical complaint.
  • Completed basic physical assessments of [Type] and [Type] patients to provide optimal care.
  • Contacted pharmacies to submit and refill patients' prescriptions.
  • Performed preliminary physical tests, such as taking blood pressure, weight and temperature, accurately recording results in patient history summary.
  • Transmitted physician's orders to patients, counseling on execution and addressing follow-up questions.
  • Monitored medical supply levels to confirm sufficient stock, promptly placing replenishment orders before depletion.
  • Educated patients about medications, procedures and physician's instructions.
  • Verified appointment times with patients, preparing charts, pre-admission and consent forms.
  • Secured patient information and maintained patient confidence by completing and safeguarding medical records.
  • Interviewed patients to verify information, record medical history and confirm purpose of visit.
  • Led patients to exam rooms, answered general questions and prepared patients for physician by explaining process.
  • Recorded vital signs and medical history for 20 patients each day.
  • Scheduled appointments for patients via phone and in person.
Creighton Family Physicians | Omaha, NECertified Medical Assistant10/1991 - 07/1995
  • Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate effective treatment.
  • Assessed, documented and monitored vital signs for more than [Number] patients per day.
  • Assisted with diagnostic testing by collecting and packaging biological specimens for internal and laboratory analyses.
  • Prepared treatment rooms for patients, including cleaning surfaces and restocking supplies.
  • Administered rapid tests such as Diabetes and pregnancy to help clinical staff assess conditions.
  • Contributed to efficient office operations by triaging patients by severity of medical complaint.
  • Completed basic physical assessments of Existing and New patients to provide optimal care.
  • Contacted pharmacies to submit and refill patients' prescriptions.
  • Performed preliminary physical tests, such as taking blood pressure, weight and temperature, accurately recording results in patient history summary.
  • Transmitted physician's orders to patients, counseling on execution and addressing follow-up questions.
  • Monitored medical supply levels to confirm sufficient stock, promptly placing replenishment orders before depletion.
  • Educated patients about medications, procedures and physician's instructions.
  • Verified appointment times with patients, preparing charts, pre-admission and consent forms.
  • Secured patient information and maintained patient confidence by completing and safeguarding medical records.
  • Interviewed patients to verify information, record medical history and confirm purpose of visit.
  • Led patients to exam rooms, answered general questions and prepared patients for physician by explaining process.
  • Collected forms, copied insurance cards and coordinated patient information for billing and insurance processing.
  • Recorded vital signs and medical history for 20 patients each day.
  • Scheduled appointments for patients via phone and in person.
Education and Training
Omaha College Of Health Careers | Omaha, NESome College (No Degree) in Medical Assisting
  • Completed professional development in medicine
  • Ranked in Top 5% of class
  • 3.8 GPA
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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.

Resume Overview

Companies Worked For:

  • Mutual of Omaha
  • Immanuel Hospital and All Clinics (Floater)
  • Creighton Family Physicians

School Attended

  • Omaha College Of Health Careers

Job Titles Held:

  • Insurance Claims Specialist
  • Certified Medical Assistant

Degrees

  • Some College (No Degree) in Medical Assisting

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