Guidelines

Thoroughly assessing your professional skills, abilities and competencies is the first step to producing an effective resume for claims assistant position.

It is imperative to take stock of what you have to offer to an employer before you begin to write your resume.

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

 

 

 

Claims Assistant Resume Sample

 

 

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 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.

Effectively liaise with service providers and brokers to support the effective management of claims. Ability to audit and review both internal and external claim files and associated data.

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 fool proof system to handle 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

KePro, Decatur, IL | 2013 – Present
Claims Assistant

• 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 determine 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

Medix, Decatur, IL | 2010 – 2013
Claims Intern

• 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