Insurance Specialist Resume Sample

Updated on: June 19, 2021

The job of an insurance specialist requires an individual to examine health insurance claims to determine claim holders’ or providers’ need for payments.

It is a challenging position that requires a lot of investigation into insurance coverage and billing statements.

Applicants who wish to apply for this position need to portray an acute understanding of the workings of insurance companies and the types of claims when they write their resumes.

Insurance specialists process medical insurance claims to decipher the need for paying out insurance claims. They monitor delinquent accounts and perform some collection duties. They also identify denied claims, perform reconciliation of records and resubmit rejected claims to payers.

If you are preparing your application for an Insurance Specialist job, the following resume sample will help you to build a useful job application package.

Sample Resume for Insurance Specialist Position

Solomon Craig
376 Coolpoint Road
Indianapolis, IN 66663
(000) 999-9999


Focused and results-driven Insurance Specialist with 12+ years’ dedicated experience in the insurance industry. Highly qualified in reviewing, analyzing, and interpreting insurance policies. Hands-on experience in monitoring and managing the disbursement of payments. In-depth knowledge of initiating and overseeing insurance coverage directives. Proficient in submitting and resubmitting claims and suggesting action plans to eliminate denials.

• Delinquent accounts monitoring
• Customer service
• Denied claims identification
• Service activity monitoring
• Electronic workflow completion
• Front desk assistance

• Managed payment of a particularly difficult claim after it was denied three times
• Set up a system that monitors delinquent accounts automatically thereby reducing research time
• Increased the client base of the company by 15% in three months using diverse business solicitation methods
• Successfully obtained underwriting approval for coverage for a particularly tricky to pass insurance policy


Insurance Specialist
Kaleida Health, Indianapolis, IN                   
2008 – Present
• Ensure resolution of submitted claims in a time-efficient manner
• Handle billing-related activities focused on medical specialties
• Ensure that appropriate coding is managed to maximize efficiency
• Verify patient insurance information
• Resubmit claims when denied or edited
• Determine the appropriateness of payers
• Post payments to accounts and maintain records
• Train newly hired insurance representatives

Insurance Representative
HCR Home Care – Rochester, NY               
2006 – 2008
• Assessed clients’ insurance needs by conferring with them
• Formulated insurance plans to help meet clients’ coverage needs
• Approached potential clients by using different mediums such as telephone and mail
• Assisted existing clients with questions and problems
• Assessed clients’ financial position in order to manage an appropriate coverage plan
• Ensured timely payment of claims

Associate’s Degree in Accounting
Rochester City College, Rochester, NY – 2005

• Exceptional knowledge of insurance follow-up procedures
• Ability to analyze and resolve problems effectively
• Effective written and oral communication skills