5 Amazing claims analyst Resume Examples (Updated 2023) + Skills & Job Descriptions

During your time working as a claims analyst, you have done it all. You keep close watch over liability claims, negotiate payments, review claims for reimbursement eligibility, and even monitor shipping and manufacturing costs to recoup losses. Despite the scope of your experience, recruiters still need to see a strong claims analyst resume. You must look at your current resume as a hiring manager. Scan it for six seconds to see if you included current key phrases, metrics, and standard resume formatting for your industry. Including each element better improves your chances of receiving interview requests. If you talk with experienced claims analysts and those who just completed a bachelor's degree program, you will realize that analysts from various backgrounds have a tough time hammering out a powerful submission. Examine our resume sample to gain a better idea of how to strengthen your current document. We also feature writing tips and templates to boost your chances of meeting with employers and landing the analyst job you desire.

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claims analyst: Resume Samples & Writing Guide

Professional Summary

A Claims Analyst with extensive experience in the insurance industry, providing insightful solutions to complex claims. Proven ability to develop effective strategies to resolve customer inquiries, reduce costs, and improve customer satisfaction.

Employment history

Senior Claims Analyst, Farmers Insurance Los Angeles, California

December 2011 – Present

Participate in audits and provide reports as needed
Respond to customer inquiries and provide customer service
Investigate and analyze complex claims and determine coverage and liability

Associate Claims Analyst, State Farm Bloomington, Illinois

July 2010 – November 2011

Review and interpret policy language to determine coverage and liability
Manage and monitor the progress of claims through resolution
Develop and implement procedures to ensure compliance with applicable laws and regulations

Junior Claims Analyst, State Farm Bloomington, Illinois

January 2009 – June 2010

Maintain up-to-date knowledge of claims-related laws and regulations
Participate in audits and provide reports as needed
Manage and monitor the progress of claims through resolution

Education

University of Pennsylvania, Philadelphia, Pennsylvania

Bachelor of Arts in Insurance and Financial Services, November, 2008

Skills

Relationship Management.

Adaptability

Accounting

Business Acumen

Insurance Claims Adjustment

Policy Knowledge

Claims Auditing

Data Entry

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Employment history

Jr. Claims Analyst, Allstate Northbrook, Illinois

January 2022 – October 2022

Manage and monitor the progress of claims through resolution
Prepare and maintain detailed claim files and records
Establish and maintain relationships with customers, agents, and other business partners

Education

Florida State University, Tallahassee, Florida

Doctor of Science in Insurance and Financial Services, November, 2021

Florida State University, Tallahassee, Florida

Bachelor of Science in Business Administration and Insurance, November, 2017

Skills

Teamwork

Analytical

Coaching

Innovation

HIPAA Compliance

Claims Resolution

Insurance Claims Processing

Medical Coding

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Professional Summary

A highly motivated and detail-oriented Claims Analyst with extensive knowledge of the insurance industry. Proven ability to analyze complex data and develop effective solutions to ensure efficient claims processing.

Employment history

Senior Claims Analyst, USAA San Antonio, Texas

April 2012 – Present

Investigate and analyze complex claims and determine coverage and liability
Manage and monitor the progress of claims through resolution
Review and interpret policy language to determine coverage and liability

Associate Claims Analyst, Liberty Mutual Boston, Massachusetts

April 2011 – March 2012

Manage and monitor the progress of claims through resolution
Monitor and analyze claim trends and make recommendations for improvement
Prepare and maintain detailed claim files and records

Junior Claims Analyst, MetLife New York, New York

September 2010 – March 2011

Establish and maintain relationships with customers, agents, and other business partners
Prepare and present reports on claims activity and trends
Analyze and process claim payments in accordance with policy guidelines

Education

Florida State University, Tallahassee, Florida

Doctor of Arts in Business Administration and Insurance, July, 2010

Florida State University, Tallahassee, Florida

Bachelor of Arts in Insurance and Financial Services, July, 2006

Skills

Creativity

Flexibility

Research

Communication

Claim Verification

Insurance Claims Adjustment

HIPAA Compliance

Medical Coding

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Professional Summary

A highly motivated Claims Analyst with a strong background in the insurance industry. Expertise in analyzing claims, identifying risks, and developing strategies to reduce losses.

Employment history

Senior Claims Analyst, USAA San Antonio, Texas

November 2012 – Present

Maintain up-to-date knowledge of claims-related laws and regulations
Manage and monitor the progress of claims through resolution
Investigate and analyze complex claims and determine coverage and liability

Associate Claims Analyst, Nationwide Columbus, Ohio

June 2011 – October 2012

Analyze and process claim payments in accordance with policy guidelines
Prepare and maintain detailed claim files and records
Establish and maintain relationships with customers, agents, and other business partners

Junior Claims Analyst, USAA San Antonio, Texas

November 2010 – May 2011

Manage and monitor the progress of claims through resolution
Review and interpret policy language to determine coverage and liability
Participate in audits and provide reports as needed

Education

University of Michigan, Ann Arbor, Michigan

Risk Management, October, 2010

Skills

Analytical

Self-Motivation

Risk Management

Problem Solving

Claims Documentation

Claims System Troubleshooting

Claims Resolution

Claims Analysis

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Employment history

Chief Claims Analyst, USAA San Antonio, Texas

February 2022 – Present

Prepare and maintain detailed claim files and records
Utilize knowledge of medical terminology, legal terminology, and insurance coverage to evaluate claims
Monitor and analyze claim trends and make recommendations for improvement

Associate Claims Analyst, Farmers Insurance Los Angeles, California

September 2020 – January 2022

Prepare and maintain detailed claim files and records
Analyze and process claim payments in accordance with policy guidelines
Maintain up-to-date knowledge of claims-related laws and regulations

Junior Claims Analyst, Allstate Northbrook, Illinois

February 2020 – August 2020

Manage and monitor the progress of claims through resolution
Negotiate settlements of claims with customers and other parties
Analyze and process claim payments in accordance with policy guidelines

Education

University of Texas, Austin, Texas

Master of Science in Insurance, December, 2019

University of Texas, Austin, Texas

Bachelor of Science in Insurance and Financial Services, December, 2015

Skills

Written Communication

Reporting

Technical

Conflict Resolution

Medical Terminology

Claims System Maintenance

Technical Writing

Microsoft Office

Use This claims analyst Resume Template

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claims analyst Job Descriptions; Explained

If you're applying for an claims analyst position, it's important to tailor your resume to the specific job requirements in order to differentiate yourself from other candidates. Including accurate and relevant information that directly aligns with the job description can greatly increase your chances of securing an interview with potential employers.

When crafting your resume, be sure to use action verbs and a clear, concise format to highlight your relevant skills and experience. Remember, the job description is your first opportunity to make an impression on recruiters, so pay close attention to the details and make sure you're presenting yourself in the best possible light.

claims analyst

Handle auto claims involving damage to vehicle, or liability claims involving third party vehicle or third party bodily injury from liability situations, such as motor vehicle accidents.
Policy interpretation, investigate a loss, deciding the policy covers the loss.
Examine claim and provide decisions accurately.
Inspect vehicle damage to determine degree of damages.
Examine photographs and statements.
Consult with car manufacture, police, and field surveyor for expert evaluation.
Verify overall coverage during the point of accident.

claims analyst

Analysis of Claim data to find reason behind deviation from expected result of different claim parameters.
Coordinating with fraud and actuary team and creating Fraud Risk Model for claim department.
Making Board meeting ppt for National Manager based on data analysis.
Finding Magma Ranking within 30 days settlement quarterly based on NL-24 and 25 data uploaded by companies on IRDAI website.
Coordinating with IT department to resolve system issues.

claims analyst

Ensures accurate review of claims document like LOA, hospital bills/SOA concurrent review form, physicians report, original OR for use in processing claims.
Reviews and match the endorsed document againts the actual encoded data in the system.
Evaluates claims and adjudicates claims to ensure claims are according to benefits plan, coverage and policies and standards.
Accurately evaluates and process Out-patient and In-patient claim reimbursement and non-reimbursement, received from various providers and meet the required quota.

claims analyst

Acting liason for General Motors customers and suppliers in investigating and claim that may result in asset loss
Oversaw return and exchange processes from customer to supplier
Took corrective action in the case of accidents and delays to minimize extra expenses
Gathered, logged and monitored all shipping data
Analyzed and reviewed claims for accuracy, completeness, eligibility and detailed research in verifying claims
Monitored claims from start to finish making decision to determine reimbursement in a timely manner

claims analyst

Process and adjust claims.
Transfer to correct department when necessary.
Knowledge of ICD-10 codes.
Daily use of 10-Key.
Knowledge of Dual monitors.
Proficient in hotkeys.

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claims analyst Job Skills

For an claims analyst position, your job skills are a key factor in demonstrating your value to the company and showing recruiters that you're the ight fit for the role. It's important to be specific when highlighting your skills and ensure that they are directly aligned with the job requirements, as this can greatly improve your chances of being hired. By showcasing your relevant skills and experience, you can make a compelling case for why you're the best candidate for the job.

How to include technical skills in your resume:

Technical skills are a set of specialized abilities and knowledge required to perform a particular job effectively. Some examples of technical skills are data analysis, project management, software proficiency, and programming languages, to name a few.

Add the technical skills that will get hired in your career field with our simple-to-use resume builder. Select your desired resume template, once you reach the skills section of the builder, manually write in the skill or simply click on "Add more skills". This will automatically generate the best skills for your career field, choose your skill level, and hit "Save & Next."

Data Entry
Insurance Claims Processing
Insurance Claims Adjustment
Claim Investigations
Claims Resolution
Claims Auditing
Claims Negotiation
Claims Documentation
Claims System Maintenance
Claims System Troubleshooting
Claims Analysis
Claim Verification
Medical Coding
Medical Terminology
HIPAA Compliance
Regulatory Compliance
Policy Knowledge
Technical Writing
Data Analysis
Data Mining
Microsoft Office

How to include soft skills in your resume:

Soft skills are non-technical skills that relate to how you work and that can be used in any job. Including soft skills such as time management, creative thinking, teamwork, and conflict resolution demonstrate your problem-solving abilities and show that you navigate challenges and changes in the workplace efficiently.

Add competitive soft skills to make your resume stand-out to recruiters! Simply select your preferred resume template in the skills section, enter the skills manually or use the "Add more skills" option. Our resume builder will generate the most relevant soft skills for your career path. Choose your proficiency level for each skill, and then click "Save & Next" to proceed to the next section.

Communication
Interpersonal
Leadership
Time Management
Problem Solving
Decision Making
Critical Thinking
Creativity
Adaptability
Teamwork
Organization
Planning
Public Speaking
Negotiation
Conflict Resolution
Research
Analytical
Attention to Detail
Self-Motivation
Stress Management
Collaboration
Coaching
Mentoring
Listening
Networking
Strategic Thinking
Negotiation
Emotional Intelligence
Adaptability
Flexibility
Reliability
Professionalism
Computer Literacy
Technical
Data Analysis
Project Management
Customer Service
Presentation
Written Communication
Social Media
Troubleshooting
Quality Assurance
Collaboration
Supervisory
Risk Management
Database Management
Training
Innovation
Documentation
Accounting
Financial Management
Visualization
Reporting
Business Acumen
Process Improvement
Documentation
Relationship Management.

How to Improve Your claims analyst Resume

Navigating resume pitfalls can mean the difference between landing an interview or not. Missing job descriptions or unexplained work history gaps can cause recruiters to hesitate. Let's not even talk about the impact of bad grammar, and forgetting your contact info could leave your potential employer hanging. Aim to be comprehensive, concise, and accurate.

Employment history

Chief Claims Analyst, Liberty Mutual Boston, Massachusetts

January 2010 – May 2022

Develop and implement procedures to ensure compliance with applicable laws and regulations
Establish and maintain relationships with customers, agents, and other business partners
Manage and monitor the progress of claims through resolution

Claims Analyst, USAA San Antonio, Texas

July 2008 – December 2009

Negotiate settlements of claims with customers and other parties
Analyze and process claim payments in accordance with policy guidelines
Establish and maintain relationships with customers, agents, and other business partners

Jr. Claims Analyst, State Farm Bloomington, Illinois

July 2007 – June 2008

Investigate and analyze complex claims and determine coverage and liability
Analyze and process claim payments in accordance with policy guidelines
Respond to customer inquiries and provide customer service

Education

Ohio State University, Columbus, Ohio

Bachelor of Arts in Insurance and Financial Services, May, 2007

Skills

Research

Networking

Professionalism

Organization

Claims Negotiation

Microsoft Office

Data Entry

Medical Terminology

Provide your Contact Information and Address Year Gaps

Always explain any gaps in your work history to your advantage.

Key Insights

Employers want to know what you've accomplished, so make sure to explain any gaps using a professional summary.
Adding extra details and context to explain why you have a gap in your work history shows employers you are a good fit for the position.

How to Optimize Your claims analyst Resume

Keep an eye out for these resume traps. Neglecting to detail your job roles or explain gaps in your career can lead to unnecessary doubts. Grammar blunders can reflect negatively on you, and without contact information, how can employers reach you? Be meticulous and complete.

Professional Summary

A highly motivated Claims Analyst with extensive experience in the insurance field. Skilled in identifying and resolving complex claims issues, ensuring accurate and timely processing of claims, and providing excellent customer service.

Employment history

Senior Claims Analyst, State Farm Bloomington, Illinois

October 2014 – Present

Participate in audits, and provide report's as needed.
Analyze, and process claim payment's in accordance with policy guideline's.
Manage, and monitor the progress of claim's through resolution.

Claims Analyst, Travelers Hartford, Connecticut

May 2013 – September 2014

Maintian up-to-date knowledge of claims-related laws and regulations
Negotiate settlements of claims with customers and other partys
Developed and implement procedures to ensure compliance with applicable laws and regulatiosn

Entry Level Claims Analyst, Progressive Mayfield Village, Ohio

October 2012 – April 2013

"I went to the store and bought some apples"
I went too the store, an bought some apples.

Education

University of California, Berkeley, California

Insurance Law, September, 2012

Skills

Negotiation

Adaptability

Training

Innovation

Claims System Troubleshooting

Claims System Maintenance

Insurance Claims Adjustment

Microsoft Office

Include Job Descriptions and Avoid Bad Grammar

Avoid sending a wrong first impression by proofreading your resume.

Key Insights

Spelling and typos are the most common mistakes recruiters see in resumes and by simply avoiding them you can move ahead on the hiring process.
Before submitting your resume, double check to avoid typos.

claims analyst Cover Letter Example

A cover letter can be a valuable addition to your job application when applying for an claims analyst position. Cover letters provide a concise summary of your qualifications, skills, and experience, also it also gives you an opportunity to explain why you're the best fit for the job. Crafting a cover letter that showcases your relevant experience and enthusiasm for the Accounts Payable role can significantly improve your chances of securing an interview.

Senior Claims Analyst
Allstate
Northbrook, Illinois

To the Recruitment Team at Allstate

As a Claims Analyst with a proven track record of success in Insurance, I am excited to apply for the Senior Claims Analyst position at Allstate. I believe that my skills and expertise would make a valuable contribution to your team.

Growing up, I always had a fascination with Actuarial Science. As I pursued my education and gained experience in this field, I realized that this was where I could make the most impact. I have had the opportunity to work on things throughout my career like personal projects and voluntary work, which have developed in me a deep understanding of the challenges and opportunities in this field. I am excited to bring my passion and expertise to the role at and help your organization achieve its goals.

I am elated about the opportunity to join a team that shares my passion for this field, and values collaboration and innovation. I am confident that together we can overcome whatever tests and challenges are put on our way.

Kind regards,
Stanley Fox
787-805-0758
fox_stanley@yahoo.com

Stanley Fox

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