Claims Assistant Resume Sample

Updated on: April 16, 2021

In order to write a professional resume for a claims assistant position, you have to thoroughly assess your professional skills, abilities, and experiences. Then, write this information a logical way under different headings such as summary, skills, and experience.

Once you have done this, your resume should look something like the following:

Sample Resume for Claims Assistant Position

Tracy Oliver
900 N Morgan Street
Decatur, IL 96210
(000) 847-8547
tracyoliver @ email .com


CLAIMS ASSISTANT
Highly Energetic and determined to exceed the expectations of the employer.

Performance Summary
6 years of hands-on experience in investigating rejected claims and processing payments with 4 years specifically in the role of claims assistant. Ensured timely and accurate administration and processing of claims in accordance with the organization’s mission and vision. Documented success in preparing documents to help evaluate and report on specific claims, producing and maintaining spreadsheets and databases to enhance data presentation and analysis.

CORE COMPETENCIES
✓ Claims Summaries
✓ Broker Liaison
✓ Claims Processing
✓ Bills Review
✓ Payment Authorizations
✓ Error Handling
✓ Disability Rates Determination
✓ Reports Review
✓ Follow-up
✓ Case Compensability
✓ Records Research
✓ Financial Reserves Setting

SELECTED ACHIEVEMENTS

Process Improvement
Implemented a novel follow-up process, which guaranteed a high rate of success in getting rejected claims paid.

Discrepancy Management
Decreased the chances of data discrepancy by 65% by introducing a foolproof system to handle the first claim filing process.

Research
Successfully implemented a series of research initiatives which led to efficacious procurement of claims data.

Follow-up
Developed a claims follow-up system which increased the chances of paid claims by 75%.

PROFESSIONAL EXPERIENCE

Claims Assistant
KePro, Decatur, IL
| 2013 – Present
• Make determinations regarding compensability or liability on routine cases
• Authorize treatment and initiate other activities on claims, including contact with external adjusters
• Set financial reserves for cases and determine temporary disability rates
• Review injury reports to determine the possibility for third party liabilities
• Prepare documentation to help them evaluate and report on specific claims
• Produce and maintain spreadsheets and databases to enhance data presentation, analysis and storage
• Provide assistance with the necessary auditing and reviewing of internal and external claim files
• Prepare claims summaries and provide immediate responses to reinsurance queries

Claims Aide
Medix, Decatur, IL
| 2010 – 2013
• Assisted claims managers in sorting out unpaid claims and preparing documentation for evaluation purposes
• Liaised with service providers and brokers to support the effective management of unpaid claims
• Assisted in the review of claims and provide support in auditing and reviewing assigned claims
• Mailed claim checks, filing and processing claims into the company’s system
• Set diary dates for periodic review of case files and assisted in determining which case files can be closed

EDUCATION
High School Diploma | 2009
Decatur High School, Decatur, IL

TECHNOLOGY SKILLS
• Claims Processing Software: Virtual Benefits Administrator
• MS Word, Outlook, and Excel
• Computer Navigation
• Data entry, analysis, and organization