Health Insurance Specialist Resume Sample

Insurance provides us with a great peace of mind especially in the event of an illness or an accident. However, most of us do not review our insurance contracts carefully which is why it can become quite difficult to understand the coverage we are provided with. This is where health insurance specialists help us by providing us information on our insurance rights.

Candidates who depict deep knowledge of the insurance world in their resumes are more likely to be called in for an interview. This is why it is important to portray your knowledge of claims handling when writing a resume.


Health Insurance Specialist Resume Sample


Christopher James

911 Wheat Road, Maumelle, AR 53990
(999) 999-9999, Email

PERSONAL PROFILE: Highly motivated and accomplished insurance specialist with a solid track record of performance in insurance reviews. Key strengths include ability to meet and exceed targets, a knack for managing on-time projects and the ability to maintain productivity levels

• Advanced knowledge of insured and self-funded healthcare products
• Effective analytic skills aimed at providing judicious claims settlements
• Deep understanding of maintaining meaningful relationships with clients and insurance companies
• Strong knowledge of communicating insurance claims education to clients
• In depth knowledge of medical terminology aimed at providing accurate information to clients and insurance companies


Arkansas Insurance Company, Maumelle, AR | March 2011 – Present
Insurance Specialist

• Confer with clients to determine their needs for insurance claiming
• Review clients’ documentation to understand diagnosis and procedures
• Verify claims and determine insurance eligibility
• Post medical charges, payments and adjustments
• Provide clients with insurance and benefits information
• Detect and correct coding errors and manage appropriate modifications
• Provide insurance compliance information to clients
• Submit claims for payment purposes
• Resubmit denied claims and determine reason for denial

Key Contributions
• Integrated an extremely complex insurance system with key insurance companies’ database that engendered easy clients’ claims information
• Revamped the company’s client database by incorporating online services for remote clients

ABC Healthcare, Austin, TX | Jan 2005 – Mar 2011
Insurance Agent

• Contacted clients through cold calling procedures
• Provided information on insurance policies and their benefits
• Met with clients to provide them with benefits information on a one-to-one basis
• Developed a base for long term business relationships with clients
• Determined clients’ particular and individual insurance needs
• Devised plans to meet clients’ insurance needs

Key Contributions
• Wrote a handbook on insurance claims benefits for new clients
• Streamlined the company’ records management system thereby ensuring easy and timely retrieval

Texas State University, Austin, TX – 2005
Bachelor of Science in Health Management

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