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claims processor: Resume Samples & Writing Guide

Cecil Foster

216 Mountain Road, Victoria, TX 77902
[email protected]
934-699-6882

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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Todd Ellis

714 Greenbriar St., Mountlake Terrace, WA 98043
[email protected]
808-621-9569

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

Gus Hawkins

939 Woodview Drive, Sierra City, CA 96125
[email protected]
805-786-9725

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

Neil Yates

113 Cypress Road, Winfield, AL 35594
[email protected]
720-091-0970

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

Jonathan Coleman

663 Laurelwood Drive, Damon, TX 77430
[email protected]
657-389-1282

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

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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.

1

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.
2

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
3

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
4

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.
5

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

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.

Cal Campbell

88 Pine Valley Avenue, Valley Head, WV 26294

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.

Marcus Yates

993 Laurelwood Drive, Silver Lake, KS 66539
[email protected]
972-879-1635

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.



Cecil
Foster

[email protected]
934-699-6882
216 Mountain Road, Victoria, TX
77902

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
[email protected]

Cecil Foster






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Build your Resume in 15 minutes

Give yourself the best chance of standing out from the competition!

Create an awesome resume that meets the expectations of potential employers with our selection of professional, field-tested resume templates.