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claim specialist: Resume Samples & Writing Guide

Andrew Wilson 540 Ridgeview Drive, Selah, WA 98942
wilsonandrew77@hotmail.com
727-432-7119

Employment history

Senior Claim Specialist, Progressive Mayfield Village, Ohio
September 2015 – Present
  • Recommend changes to existing claims policies and procedures
  • Prepare claim reports and review for accuracy
  • Liaise with external vendors, service providers, and other stakeholders
Associate Claim Specialist, State Farm Bloomington, Illinois
September 2014 – August 2015
  • Negotiate settlements with claimants
  • Prepare claim reports and review for accuracy
  • Provide customer service and maintain customer relationships
Jr. Claim Specialist, Travelers Hartford, Connecticut
September 2013 – August 2014
  • Liaise with external vendors, service providers, and other stakeholders
  • Analyze claims data to identify trends and areas of improvement
  • Monitor claims to ensure timely and accurate resolution

Education

University of Washington, Seattle, Washington
Doctor of Arts in Insurance and Accounting, August, 2013
University of Washington, Seattle, Washington
Bachelor of Arts in Insurance and Accounting, August, 2009

Skills

Social Media
Stress Management
Listening
Planning
Microsoft Office
Claim Reimbursement
Regulatory Compliance
Data Analysis

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Paul Quinn 979 Valley View Drive, St. Bonaventure, NY 14760
paulquinn@icloud.com
676-187-1118

Professional Summary

 Highly experienced Claim Specialist with an in-depth understanding of insurance policies and procedures. Proven track record of accurately assessing and resolving complex claims in a timely manner. 

Employment history

Chief Claim Specialist, Farmers Insurance Los Angeles, California
June 2010 – Present
  • Ensure compliance with applicable laws and regulations
  • Recommend changes to existing claims policies and procedures
  • Review and process claims according to established guidelines
Associate Claim Specialist, Travelers Hartford, Connecticut
December 2009 – May 2010
  • Assist in the development of new claims procedures and processes
  • Negotiate settlements with claimants
  • Investigate and analyze complex claims
Jr. Claim Specialist, Progressive Mayfield Village, Ohio
December 2008 – November 2009
  • Investigate and analyze complex claims
  • Prepare claim reports and review for accuracy
  • Evaluate and process claims for payment

Education

University of Illinois, Urbana, Illinois
Insurance Brokerage, October, 2008

Skills

Relationship Management.
Flexibility
Technical
Negotiation
Medical Billing
Claim Processing
Microsoft Office
Claim Investigation
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Owen Anderson 96 Summerwood Drive, East Williston, FL 32696
andersonowen@protonmail.com
800-424-3630

Employment history

Chief Claim Specialist, Liberty Mutual Boston, Massachusetts
September 2016 – Present
  • Analyze claims data to identify trends and areas of improvement
  • Assist in the development of new claims procedures and processes
  • Review and process claims according to established guidelines
Associate Claim Specialist, Farmers Insurance Los Angeles, California
March 2016 – August 2016
  • Resolve customer inquiries and complaints
  • Negotiate settlements with claimants
  • Evaluate and process claims for payment
Junior Claim Specialist, State Farm Bloomington, Illinois
March 2015 – February 2016
  • Investigate and analyze complex claims
  • Provide customer service and maintain customer relationships
  • Negotiate settlements with claimants

Education

University of Pennsylvania, Philadelphia, Pennsylvania
Bachelor of Business Administration in Insurance, January, 2015

Skills

Planning
Problem Solving
Risk Management
Documentation
Litigation
Subrogation
Communication
HIPAA Compliance
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Yvette Turner 263 Highland Drive, Belle Rive, IL 62810
yvetteturner93@outlook.com
836-850-9818

Employment history

Senior Claim Specialist, Nationwide Columbus, Ohio
February 2016 – Present
  • Provide customer service and maintain customer relationships
  • Liaise with external vendors, service providers, and other stakeholders
  • Monitor claims to ensure timely and accurate resolution
Associate Claim Specialist, Farmers Insurance Los Angeles, California
March 2015 – February 2016
  • Ensure compliance with applicable laws and regulations
  • Review and process claims according to established guidelines
  • Liaise with external vendors, service providers, and other stakeholders
Jr. Claim Specialist, Allstate Northbrook, Illinois
March 2014 – February 2015
  • Review and process claims according to established guidelines
  • Ensure compliance with applicable laws and regulations
  • Provide customer service and maintain customer relationships

Education

University of Wisconsin, Madison, Wisconsin
Doctor of Science in Risk Management, January, 2014
University of Wisconsin, Madison, Wisconsin
Bachelor of Science in Accounting and Insurance, January, 2010

Skills

Training
Quality Assurance
Teamwork
Time Management
Subrogation
Claim Auditing
Claim Processing
Data Entry
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Abe Irving 388 Mountain Road, Freeburg, PA 17827
abe-irving@aol.com
785-700-4243

Employment history

Senior Claim Specialist, MetLife New York, New York
May 2021 – Present
  • Recommend changes to existing claims policies and procedures
  • Analyze claims data to identify trends and areas of improvement
  • Assist in the development of new claims procedures and processes
Claim Specialist, State Farm Bloomington, Illinois
November 2019 – April 2021
  • Liaise with external vendors, service providers, and other stakeholders
  • Prepare claim reports and review for accuracy
  • Ensure compliance with applicable laws and regulations
Junior Claim Specialist, Allstate Northbrook, Illinois
June 2018 – November 2019
  • Liaise with external vendors, service providers, and other stakeholders
  • Analyze claims data to identify trends and areas of improvement
  • Prepare claim reports and review for accuracy

Education

University of Wisconsin, Madison, Wisconsin
Bachelor of Science in Risk Management, April, 2018

Skills

Emotional Intelligence
Risk Management
Strategic Thinking
Financial Management
Insurance Verification
Regulatory Compliance
Microsoft Office
Claim Denial Management
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claim specialist Job Descriptions; Explained

If you're applying for an claim specialist 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

claim specialist

  • Investigates, evaluates, negotiates, and settles auto claims in an assigned area.
  • Verifies coverage, legal liability and extent of damage to persons and property
  • Uses various electronic resources for claim handling 
  • Applies knowledge of policies, procedures, laws, statutes and insurance regulations when determining coverage, liability, and property damage
  • Interview or correspond with claimants, witnesses, police, or other relevant parties to determine claim settlement, denial, or review.Examine claims forms and other records to determine insurance coverage.
2

claim specialist

  • Resolved complex, severe exposure claims, using high service oriented file handling.
  • Maintained claim files such as records of settled claims and an inventory of claims requiring detailed analysis.
  • Investigated, evaluated and settled claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
  • Managed pivot table projects which contain provider claim discrepancies on CMS 1500 and UB-04 forms, in a timely manner resolution complete.
  • Created Policies and Procedures for Claims review
3

claim specialist

  • Responsible for overseeing and tracking customer inquiries at the executive level.  
  • Supported field managers with reviewing and managing independent adjuster handled claim files.  
  • Assigned to Phase I MI IPM teamCreated and wrote requirements to interface software CPS currently uses to work in IPM. 
  • Data mined Excel spreadsheets to find trends and to summarize results. 
4

claim specialist

  • Guide policyholder on how to proceed with a claim. 
  • Analyse a claim to establish whether it satisfies the conditions or not. 
  • Uphold relationships and communication with insurance companies and clients.
  • Negotiate and ensure fair settlement of valid claims.

claim specialist Job Skills

For an claim specialist 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 Verification
  • Claim Processing
  • Claim Investigation
  • Claim Adjustment
  • Documentation Review
  • Regulatory Compliance
  • Claim Auditing
  • Claim Reimbursement
  • Claim Denial Management
  • Medical Terminology
  • HIPAA Compliance
  • Medical Billing
  • Medical Coding
  • Subrogation
  • Auditing
  • Litigation
  • Data Analysis
  • Microsoft Office
  • Communication

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 specialist 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.

Fred Young 55 Pinecrest Drive, Georgetown, DE 19947
fredyoung54@zoho.com
831-612-0561

Employment history

Jr. Claim Specialist, Farmers Insurance Los Angeles, California
August 2021 – May 2022

    Education

    University of Texas, Austin, Texas
    Bachelor of Arts in Insurance and Financial Services, June, 2021

    Skills

    Professionalism
    Problem Solving
    Networking
    Leadership
    Medical Terminology
    Litigation
    HIPAA Compliance
    Data Entry

    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.

    How to Optimize Your claim specialist 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.

    Dale Daniels 215 Hickory Hill Road, Hoodsport, WA 98548

    Employment history

    Lead Claim Specialist, Allstate Northbrook, Illinois
    April 2016 – Present
    • Anaylze cliams data to identfy trends and areas of improvent
    • Communcate with cliamants, adjusters, and other insurance personel
    • Assit in the devlopment of new claims procedurs and proccesses
    Associate Claim Specialist, Nationwide Columbus, Ohio
    November 2014 – March 2016
    • Maintain inaccurate records and documentation of claims
    • Monitor clames to ensure timely and inaccurate resolution
    • Ensure complience with applicable laws and regulations
    Junior Claim Specialist, USAA San Antonio, Texas
    April 2014 – October 2014
    • Communicate with claimants, adjusters, and other insurance personel
    • Resolve customer inquirys and complaints
    • Analize claims data to identify trends and areas of improvment

    Education

    University of Pennsylvania, Philadelphia, Pennsylvania
    Master of Science in Accounting and Insurance, March, 2014
    University of Pennsylvania, Philadelphia, Pennsylvania
    Bachelor of Arts in Insurance and Risk Management, March, 2010

    Skills

    Quality Assurance
    Supervisory
    Negotiation
    Strategic Thinking
    HIPAA Compliance
    Claim Reimbursement
    Microsoft Office
    Medical Terminology

    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.

    claim specialist Cover Letter Example

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



    Andrew
    Wilson     wilsonandrew77@hotmail.com
    727-432-7119
    540 Ridgeview Drive, Selah, WA
    98942

    Senior Claim Specialist
    Allstate
    Northbrook, Illinois

    Greetings Allstate Recruitment Team


    I am a highly motivated Claim Specialist with 10 years of experience in Insurance. I am excited to submit my application for the Senior Claim Specialist position at Allstate, where I believe my skills and expertise would be an excellent fit.


    As someone who has always been curious and eager to learn, I have pursued my education and gained experience in areas like Fraud Detection to develop my skills in my work. This experience has given me the opportunity to lead major projects and provide my input in diverse areas, which have helped me gain a deeper understanding of the industry. I am excited to bring my passion and expertise to the role at this company and work towards achieving your organization's goals.


    Thank you for considering my application for the Senior Claim Specialist position. I hope you will allow me to show you what I am capable of bringing to your organization and how we can work together to make an impact on the industry.


    Kind regards,
    Andrew Wilson
    727-432-7119
    wilsonandrew77@hotmail.com

    Andrew Wilson






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