5 Amazing claim examiner Resume Examples (Updated 2023) + Skills & Job Descriptions

claim examiner

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claim examiner: Resume Samples & Writing Guide

Employment history

Senior Claim Examiner, Allstate Northbrook, Illinois

February 2017 – Present

Determine the need for, and coordinate, independent investigations
Monitor and review claims for potential fraud
Make recommendations to management regarding claim handling techniques

Claim Examiner, Liberty Mutual Boston, Massachusetts

February 2016 – January 2017

Monitor and manage claim expenses to ensure they are within established guidelines
Analyze and evaluate claims information to determine coverage and liability
Provide customer service to claimants and other parties to the claim

Entry Level Claim Examiner, USAA San Antonio, Texas

August 2014 – January 2016

Participate in continuing education and training related to claims adjusting
Monitor and review claims for potential fraud
Negotiate settlements with claimants and other parties to the claim

Education

University of Wisconsin, Madison, Wisconsin

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

Skills

Data Analysis

Coaching

Interpersonal

Time Management

Policy Interpretation

Insurance Regulations

Risk Assessment

Insurance Policies

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Employment history

Lead Claim Examiner, Travelers Hartford, Connecticut

September 2015 – Present

Maintain accurate records and documentation of claims activities
Investigate, negotiate and resolve claims in accordance with company policies and procedures
Determine the need for, and coordinate, independent investigations

Claim Examiner, AIG New York, New York

March 2015 – August 2015

Monitor and manage claim expenses to ensure they are within established guidelines
Analyze and evaluate claims information to determine coverage and liability
Participate in continuing education and training related to claims adjusting

Jr. Claim Examiner, Allstate Northbrook, Illinois

August 2014 – February 2015

Monitor and manage claim expenses to ensure they are within established guidelines
Prepare reports and other documents related to the claims process
Make recommendations to management regarding claim handling techniques

Education

University of Texas, Austin, Texas

Bachelor of Arts in Business Administration and Insurance, July, 2014

Skills

Listening

Financial Management

Creativity

Training

Claim Reimbursement

Insurance Policies

Claim Resolution

Insurance Regulations

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Employment history

Lead Claim Examiner, Travelers Hartford, Connecticut

April 2023 – Present

Monitor and manage claim expenses to ensure they are within established guidelines
Monitor and review claims for potential fraud
Analyze and evaluate claims information to determine coverage and liability

Claim Examiner, Travelers Hartford, Connecticut

April 2022 – March 2023

Review and adjust claims to ensure accurate and timely payments
Determine the need for, and coordinate, independent investigations
Monitor and review claims for potential fraud

Junior Claim Examiner, State Farm Bloomington, Illinois

October 2020 – March 2022

Maintain accurate records and documentation of claims activities
Review and evaluate medical records and other documents to determine the extent of liability
Make recommendations for litigation when necessary

Education

Florida State University, Tallahassee, Florida

Doctor of Science in Risk Management, August, 2020

Florida State University, Tallahassee, Florida

Bachelor of Science in Insurance and Financial Services, August, 2016

Skills

Networking

Strategic Thinking

Decision Making

Accounting

Risk Assessment

Claim Investigation.

Policy Interpretation

Data Entry

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Employment history

Lead Claim Examiner, State Farm Bloomington, Illinois

March 2018 – Present

Determine the need for, and coordinate, independent investigations
Participate in continuing education and training related to claims adjusting
Monitor and review claims for potential fraud

Claim Examiner, Progressive Mayfield Village, Ohio

September 2016 – February 2018

Determine the need for, and coordinate, independent investigations
Review and adjust claims to ensure accurate and timely payments
Make recommendations to management regarding claim handling techniques

Entry Level Claim Examiner, USAA San Antonio, Texas

September 2015 – August 2016

Negotiate settlements with claimants and other parties to the claim
Investigate, negotiate and resolve claims in accordance with company policies and procedures
Prepare reports and other documents related to the claims process

Education

University of Wisconsin, Madison, Wisconsin

Master of Science in Risk Management, July, 2015

University of Wisconsin, Madison, Wisconsin

Bachelor of Science in Accounting and Insurance, July, 2011

Skills

Networking

Project Management

Innovation

Public Speaking

Claim Auditing

Data Entry

Claim Coding

Claim Processing

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Employment history

Senior Claim Examiner, Travelers Hartford, Connecticut

April 2017 – Present

Monitor and review claims for potential fraud
Monitor and manage claim expenses to ensure they are within established guidelines
Negotiate settlements with claimants and other parties to the claim

Associate Claim Examiner, MetLife New York, New York

November 2015 – March 2017

Negotiate settlements with claimants and other parties to the claim
Monitor and review claims for potential fraud
Review and adjust claims to ensure accurate and timely payments

Jr. Claim Examiner, USAA San Antonio, Texas

April 2015 – October 2015

Maintain accurate records and documentation of claims activities
Monitor and manage claim expenses to ensure they are within established guidelines
Participate in continuing education and training related to claims adjusting

Education

University of Texas, Austin, Texas

Master of Science in Accounting and Insurance, March, 2015

University of Texas, Austin, Texas

Bachelor of Science in Risk Management, March, 2011

Skills

Public Speaking

Customer Service

Coaching

Communication

Claim Resolution

Claim System Maintenance

Insurance Policies

Claim Validation

Use This claim examiner Resume Template

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claim examiner Job Skills

For an claim examiner 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
Data Analysis
Claim Investigation
Claim Processing
Insurance Regulations
Insurance Policies
Claim Adjustment
Risk Assessment
Quality Control
Claim Validation
Claim Auditing
Claim Resolution
Policy Interpretation
Claim Documentation
Claim Reimbursement
Claim Verification
Claim System Maintenance
Claim Monitoring
Claim Coding
Claim Investigation.

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 claim examiner 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

Lead Claim Examiner, State Farm Bloomington, Illinois

October 2018 – Present

Mointor and reviw cliams for potential fraud
Reviw and evaulate medical records and other documents to determin the extent of liabillity
Comunicate with cliamants, insures, agants, witneses, and other partys to the cliam.

Claim Examiner, MetLife New York, New York

April 2017 – September 2018

Maintain accurrate records and documentation of claims activities
Monitor and manage cliam expenses too ensure they are within established guidelines
Provide custoemr service too claimants and other parties too the claim.

Jr. Claim Examiner, Travelers Hartford, Connecticut

October 2016 – March 2017

Proivde customer service to claimants and other parties too the claim
Investigate, negociate and reslove claims in acordance with company policies and proceduers
Determine the need for, and coordinte, indepedent investigations.

Education

University of Illinois, Urbana, Illinois

Bachelor of Science in Business Administration and Insurance, August, 2016

Skills

Public Speaking

Social Media

Reliability

Organization

Risk Assessment

Data Analysis

Claim Investigation.

Quality Control

Avoid Spelling Mistakes and Include your Contact Information

Missing contact information prevents recruiters from understanding you're the best fit for the position.

Key Insights

Make sure you're not missing contact information on your resume. That should include your full name, telephone number and email address.
Make sure to use a professional email address as part of your contact information.
Highlight your contact information and double check that everything is accurate to help recruiters get in touch with you.

How to Optimize Your claim examiner 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

Lead Claim Examiner, State Farm Bloomington, Illinois

September 2019 – May 2022

Communicate with claimants, insureds, agents, witnesses, and other parties to the claim
Review and adjust claims to ensure accurate and timely payments
Determine the need for, and coordinate, independent investigations

Claim Examiner, State Farm Bloomington, Illinois

April 2018 – September 2019

Maintain accurate records and documentation of claims activities
Participate in continuing education and training related to claims adjusting
Monitor and review claims for potential fraud

Junior Claim Examiner, Travelers Hartford, Connecticut

October 2016 – March 2018

Education

Ohio State University, Columbus, Ohio

Insurance Agency Management, September, 2016

Skills

Supervisory

Strategic Thinking

Organization

Negotiation

Policy Interpretation

Claim Monitoring

Claim Resolution

Claim Reimbursement

Unexplained Year Gaps and Missing Job Experiences are a No-no

Gaps in your resume can prevent recruiters from hiring you if you don't explain them.

Key Insights

It's okay to have gaps in your work experience but always offer a valid explanation instead of just hiding it.
Use the gap to talk about positive attributes or additional skills you've learned.
Be honest and straightforward about the gap and explain it using a professional summary.

claim examiner Cover Letter Example

A cover letter can be a valuable addition to your job application when applying for an claim examiner 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 Claim Examiner
USAA
San Antonio, Texas

Greetings USAA Recruitment Team

I am excited to apply for the Senior Claim Examiner role at USAA. As a highly skilled Claim Examiner, I am confident that I have the necessary experience and abilities to make a valuable contribution to your organization.

As someone who has faced challenges in various areas of my life and has overcome them, I am confident in my ability to adapt and thrive in any environment. I have developed a reputation for being a collaborative team player and an effective problem solver, which has been instrumental in my career's success. With my experience and passion for Insurance, I am excited to apply my skills to this role and contribute to your organization's growth and success.

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

Sincerely,
Tony Quinn
730-194-6343
tonyquinn@zoho.com

Tony Quinn

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