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

In a competitive job market, you need to make sure you stand out over the other applicants. Since your claims processor resume is typically your first introduction to the hiring manager, it needs to be top-notch. One way to make it effective is to include relevant, job-specific qualifications such as customer service, risk assessment and mitigation, communication, time management, claims software, records management, damage assessment, and multi-tasking skills. An employer usually spends a short amount of time glancing over each resume, so you need to grab attention right away. You can do this by incorporating terms from the job description and formatting the information so it is easy to read quickly. If you are unsure as to what a good resume should look like, look at our resume sample library, which includes resumes written by our professional writers. They have also put together industry-specific qualifications and skills that most hiring managers are looking for.

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claims processor: Resume Samples & Writing Guide

Employment history

Chief Claims Processor, MetLife New York, New York

October 2018 – Present

Investigate and analyze complex claims to determine the extent of the company's liability
Calculate claim settlements and process payments
Prepare reports and maintain claim information in the system

Associate Claims Processor, USAA San Antonio, Texas

April 2018 – September 2018

Ensure compliance with company policies and procedures
Calculate claim settlements and process payments
Investigate and analyze complex claims to determine the extent of the company's liability

Jr. Claims Processor, Travelers Hartford, Connecticut

April 2017 – March 2018

Respond to inquiries from claimants and other parties
Prepare claim documents and update claim files
Calculate claim settlements and process payments

Education

University of Texas, Austin, Texas

Master of Science in Risk Management, February, 2017

University of Texas, Austin, Texas

Bachelor of Science in Insurance and Financial Services, February, 2013

Skills

Critical Thinking

Professionalism

Communication

Documentation

Insurance Claims Processing

Claim Reporting

Claim Verification

Claim Settlement Negotiation

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Employment history

Senior Claims Processor, USAA San Antonio, Texas

July 2021 – Present

Follow up on claims to ensure all parties are satisfied with the resolution
Investigate and analyze complex claims to determine the extent of the company's liability
Provide customer service and answer questions regarding claim status

Claims Processor, Travelers Hartford, Connecticut

January 2021 – June 2021

Negotiate settlements with claimants
Prepare claim documents and update claim files
Investigate and analyze complex claims to determine the extent of the company's liability

Jr. Claims Processor, Progressive Mayfield Village, Ohio

July 2019 – December 2020

Respond to inquiries from claimants and other parties
Prepare reports and maintain claim information in the system
Review and process insurance claims in accordance with established guidelines

Education

University of California, Berkeley, California

Insurance Business, June, 2019

Skills

Strategic Thinking

Technical

Problem Solving

Collaboration

Claim Payment Processing

Claim Form Preparation

Claim Verification

Claim Resolution

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Professional Summary

A highly organized and detail-oriented Claims Processor with extensive experience in the insurance industry. Possesses excellent problem-solving skills and a proven track record of successfully managing a high volume of claims.

Employment history

Chief Claims Processor, USAA San Antonio, Texas

April 2012 – Present

Follow up on claims to ensure all parties are satisfied with the resolution
Respond to inquiries from claimants and other parties
Prepare claim documents and update claim files

Associate Claims Processor, Travelers Hartford, Connecticut

April 2011 – March 2012

Resolve discrepancies between claims and policy provisions
Negotiate settlements with claimants
Stay up to date with changes in the insurance industry

Jr. Claims Processor, Allstate Northbrook, Illinois

September 2010 – March 2011

Calculate claim settlements and process payments
Prepare claim documents and update claim files
Prepare reports and maintain claim information in the system

Education

Florida State University, Tallahassee, Florida

Bachelor of Science in Business Administration and Insurance, August, 2010

Skills

Professionalism

Relationship Management.

Conflict Resolution

Interpersonal

Claim Authorization

Claim Reporting

Claim Re-evaluation

Insurance Regulations

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Employment history

Senior Claims Processor, Allstate Northbrook, Illinois

March 2019 – Present

Maintain accurate records and documentation of claim activities
Investigate and analyze complex claims to determine the extent of the company's liability
Calculate claim settlements and process payments

Claims Processor, Progressive Mayfield Village, Ohio

September 2018 – February 2019

Communicate with claimants and other parties involved in the claim process
Respond to inquiries from claimants and other parties
Investigate and analyze complex claims to determine the extent of the company's liability

Entry Level Claims Processor, Nationwide Columbus, Ohio

February 2018 – August 2018

Monitor claim status and ensure timely resolution
Investigate and analyze complex claims to determine the extent of the company's liability
Maintain accurate records and documentation of claim activities

Education

Florida State University, Tallahassee, Florida

Insurance Underwriting, December, 2017

Skills

Listening

Reporting

Technical

Reliability

Data Entry

Claim Settlement Negotiation

Insurance Regulations

Medical Terminology

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Professional Summary

Experienced Claims Processor with a proven track record of accurately and efficiently processing insurance claims. Highly organized and detail-oriented with excellent communication skills.

Employment history

Lead Claims Processor, USAA San Antonio, Texas

January 2012 – Present

Resolve discrepancies between claims and policy provisions
Communicate with claimants and other parties involved in the claim process
Monitor claim status and ensure timely resolution

Associate Claims Processor, AIG New York, New York

January 2011 – December 2011

Prepare reports and maintain claim information in the system
Ensure compliance with company policies and procedures
Negotiate settlements with claimants

Junior Claims Processor, Travelers Hartford, Connecticut

January 2010 – December 2010

Communicate with claimants and other parties involved in the claim process
Provide customer service and answer questions regarding claim status
Respond to inquiries from claimants and other parties

Education

Ohio State University, Columbus, Ohio

Master of Science in Insurance, December, 2009

Ohio State University, Columbus, Ohio

Bachelor of Science in Insurance, December, 2005

Skills

Adaptability

Documentation

Business Acumen

Adaptability

Claim Denial Analysis

Claim Appeals

Claim Reimbursement

Claim Form Preparation

Use This claims processor Resume Template

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claims processor Job Descriptions; Explained

If you're applying for an claims processor 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 processor

Demonstrates telephone customer service skills and empathizes with customers and claimants.
Organizes and prioritizes work to assure accuracy and productivity targets are met.
Effectively works independently and as a team.
Documents and preserves all verbal and written communication in the claims system.
Establishes and maintains accurate loss and expense reserves.
Conducts investigation into claims.
Submits payments to vendors weekly and properly controls claims expenses.

claims processor

Investigation and proccesing of claims
Recommends Approval/Rejection of claims
Develop company-client favorable business relationship
Processed and audited manual paper claims for Workers Compensation clients

claims processor

Process medical claims for the sate of TN, FL, LA, KS
Use citrx and Facets
Production 122-160 day
Reached out to pharmacies to verify missing required information to process claims

claims processor / collection specialist

Processed professional (1500) and facility (UB04) claim reimbursement according to managed care contracts
Contacted payers to follow-up on claim and payment status
Maintains compliance with applicable Department of Insurance regulations.
Keeps direct supervisor informed of significant developments in all assigned claims.

claims processor

Reviewed and processed medical claims and collected information as needed to insure swift and accurate payments to providers
Responds to any inquiries from Brokers/Agents, insureds, claimants, attorneys, outside business partners and internal staff in a timely, thorough and accurate manner.
Assign claims, pay vendors, process payments and denials.
Responds to insureds requests, questions, and review estimates

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claims processor Job Skills

For an claims processor 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
Medical Terminology
Insurance Regulations
Data Analysis
Claims Adjustment
Claim Investigation
Claim Form Preparation
Claim Verification
Claim Payment Processing
Claim Denial Analysis
Claim Re-evaluation
Claim Auditing
Claim Authorization
Claim Reimbursement
Claim Documentation
Claim Settlement Negotiation
Claim Reporting
Claim Appeals
Claim Resolution
Claim System Maintenance.

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 processor 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 Processor, Nationwide Columbus, Ohio

November 2019 – Present

Monitor claim status and ensure timely resolution
Respond to inquiries from claimants and other parties
Review and process insurance claims in accordance with established guidelines

Associate Claims Processor, Travelers Hartford, Connecticut

May 2019 – October 2019

Negotiate settlements with claimants
Monitor claim status and ensure timely resolution
Calculate claim settlements and process payments

Entry Level Claims Processor, AIG New York, New York

May 2018 – April 2019

Education

University of Illinois, Urbana, Illinois

Master of Science in Business Administration and Insurance, March, 2018

University of Illinois, Urbana, Illinois

Bachelor of Arts in Insurance and Risk Management, March, 2014

Skills

Research

Documentation

Process Improvement

Leadership

Claim Settlement Negotiation

Insurance Regulations

Claim Reporting

Claim Verification

Include your Contact Information and Job Descriptions

Missing job descriptions lessens your chances of getting hired.

Key Insights

Employers want to know what you've accomplished, so make sure to include descriptions for all of your previous jobs.
Keep job descriptions short but don't just list your jobs.
Never copy-paste a job description to post on your resume. Get inspired and use tools to help you write customized descriptions.

How to Optimize Your claims processor 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.

Employment history

Senior Claims Processor, Nationwide Columbus, Ohio

June 2019 – May 2022

Comunicate with cliamants nd othe parties involed in the cliam process
Reslove discrepencies between cliams and policy provisionss
Stay up to dat with changes in the insurace industry

Associate Claims Processor, AIG New York, New York

June 2018 – May 2019

Calculate claim settlemens and process payments
Monitor cliam status and ensure timely resolutin
Provide custmer service and answer questions regardng cliam status

Entry Level Claims Processor, Travelers Hartford, Connecticut

June 2017 – May 2018

Folow up on claims to ensuer all party's are satisfide with the resolusion
Prepare claim document's and update claim file's
Respond to inquirie's from claimant's and other party's

Education

Georgia State University, Atlanta, Georgia

Bachelor of Arts in Insurance and Financial Services, April, 2017

Skills

Documentation

Reporting

Training

Teamwork

Claim Auditing

Medical Terminology

Claim Resolution

Claim Documentation

Correct Grammar and Address Gap Years in Your Resume

Don't leave unexplained gaps in your work history.

Key Insights

When explaining gaps in your employment section, start by being honest.
Elaborate on the gap and show that you never stopped learning.
Explain and elaborate any gap in your work history by highlighting new skills.

claims processor Cover Letter Example

A cover letter can be a valuable addition to your job application when applying for an claims processor 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.

Chief Claims Processor
Progressive
Mayfield Village, Ohio

Esteemed Progressive Hiring Team

I am writing to express my interest in the Chief Claims Processor role at Progressive. As a Claims Processor with 6 years of experience, I am confident that I possess the necessary skills and qualifications to excel in this position.

Growing up, I always had a fascination with Business Development. 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.

Thank you for considering my application for the Chief Claims Processor role. I am looking forward to a future where we work together to drive this organization's success.

Looking forward to hearing from you,
Cecil Foster
934-699-6882
cecil_foster@aol.com

Cecil Foster

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Showcase your most significant accomplishments and qualifications with this cover letter.
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