Claims Processor resume examples

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Skillful Claims Processor resume

Christopher Rendon
Summary

Goal-oriented customer service professional dedicated to high levels of client satisfaction, excelling at prioritizing, multitasking, and strategic thinking.

Professional Experience
Service Representative|LPL Financial - San Diego, CA|01/2018 - Current
  • Communicates directly with AXA Financial Advisors and clients via phone/email to ensure complex situations, and processing is executed within service level agreements. 
  • Corresponds with internal departments to ensure operational tasks are completed. 
  • Adheres to compliance/risk procedures and exhibits detailed attention to policies while maintaining focus on investors' best interests. 
  • Peer coach for all new hire classes (10 employees) for 4-6 weeks per class. 
  • Responsible for scheduling new hires, providing feedback to management, and evaluating daily and weekly performances. 
  • Cross-trained across all skill sets resulting in working with AXA's top producers within the first year. 
  • One of three representative selected for a dedicated team to manage critical incidents. 
Front Desk Representative|Sweat - Dallas, Texas|07/2015 - 07/2017
  • Delivered an exceptional level of service to clients through adopting feedback, resulting in client retention and increased memberships. 
  • Promoted services, programs, and classes to members and guests.
  • Delegated incoming calls to appropriate staff members. 
  • Trained new employees.


Agency Resource Technician|State Farm - Irving, Texas|05/2013 - 05/2015
  • Delivered customer support to an average of 30 agents a day via phone and email.
  • Corresponded with management team to determine solutions to problems and ensure changes were made to improve agent satisfaction.
  • Resolved policy issues and shared benefits of new technology.
  • Cross-trained and provided back-up for other customer service representatives which reduced call volume by 20 percent. 
  • Consistently exceeded service team goals. 


Auto Claim Representative|State Farm - Austin, Texas|11/2012 - 05/2013
  • Determined liability for new automotive claims within state mandated initial contact laws resulting in a 30 percent decrease of claims not transferring to a critical contact pool . 
  • Detailed coverage's, liability, and reasons for denial of claims to policyholder's, attorneys and third-party providers.
  • Coordinated estimates, repair proposals, and rental services to support claim processing and policyholder needs.
  • Negotiated final claim settlements.
Auto Claims Processor|State Farm - Austin, Texas|03/2012 - 11/2012
  • Completed a 3 month training program resulting in obtaining a state adjuster license.
  • Interviewed claimants, named insured's, and witnesses for pertinent claim information.
  • Analyzed first reports of loss and underlying file material to determine claim validity.
  • Provided exemplary service resulting in a promotion 3 months after obtaining my state adjuster license.


Education
Texas State University|| San Marcos, Texas||USA|2009 Bachelor of Arts: General Studies

Minor in Mass communication, Psychology, and Fashion Merchandising.

El Centro College|| Dallas, Texas|USA Nursing

Courses in Licensed vocational nursing.

3.7 GPA


Licenses

California Property & Casualty, and Life Only Agent: #OL99206. Current.

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Popular Claims Processor resume designs

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Job-winning Claims Processor resume

Samantha N. Marshall
Summary
Organized, independent worker with strong time management skills. Detail-oriented and able to learn new tasks quickly and effectively.
Skills
  • Cooperative team member
  • Outstanding interpersonal skills
  • Strong verbal communication
  • Energetic and organized
  • Microsoft Office, Excel, PowerPoint proficiency
  • Collaborative team member
  • Self motivated
  • Independent worker
Experience
March 2017
to
August 2017
Lava Cantina The Colony, TX Hostess

Located items requested by customers. Assisted co-workers. Assisted diners with seating as needed. Checked patrons' identification to ensure that they met minimum age requirements for consumption of alcoholic beverages. Greeted guests and sat them at tables or in waiting areas. Informed patrons of establishment specialties and features.

September 2016
to
October 2017
Blaze Pizza The Colony, TX Pizza Maker Served fresh, hot food with a smile in a timely manner. Accurately measured ingredients required for specific food items. Carefully maintained sanitation, health and safety standards in all work areas.
May 2016
to
August 2017
Careington Frisco, TX Intern

Worked independently and as part of a team to finish scanning cred files. Documented names into their files. Worked with multiple departments to help complete various projects. Projects included scanning files, researching referrals to help create prospect lists.

September 2015
to
June 2016
Culver's The Colony, TX Cashier Up-sold additional menu items, beverages and desserts to increase restaurant profits. Took necessary steps to meet customer needs and effectively resolve food or service issues. Recorded customer orders and repeated them back in a clear, understandable manner. Promptly reported complaints to a member of the management team.
August 2017
to
November 2018
Careington International Corporation Frisco, TX Claims Processor
  • Prepared necessary paperwork to process discount plan claims.
  • Managed over 80-90 claims each day.
November 2018
to
Current
Careington International Corporation Frisco, TX Member Service Representative
  • Performed in-depth research to answer more complex questions.
  • Built customer confidence by actively listening to their concerns and giving appropriate feedback.
  • Informed customers about sales and promotions in a friendly and engaging manner.
  • Educated customers on product and service offerings.
Education and Training
2017
The Colony High School The Colony, TX, USA High School Diploma Member of Cougar Crew (flag runner), bible study, Journey To Dream, and travel club. Did outstanding work in English class with my outstanding written and communication skills.
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Top Claims Processor skills

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Experienced Claims Processor resume

Anthony Flores
Professional Summary
To obtain a full time position that will utilize my skills and educational background while allowing the opportunity for advancement. Motivated customer service specialist with over 8 years experience in a fast-paced, team-based environment.
Work History
10/2016 to 10/2017
Payroll/Coordinator Edison Home Health Care New York, United States
  • Maintain payroll information by collecting, calculating and entering data
  • Resolve payroll discrepancies by collecting and analyzing information
  • Communicate with various departments to process pay information and handle questions from supervisors and employees regarding paychecks, time cards and other payroll related issues
  • Follow-up with patients and ensure that the Home Health Aide is satisfying the patients with all their needs
  • Responsible for updating all digital file while making sure that all necessary hard copy documents are present
  • Responsible for maintaining and updating the existing patient files
11/2015 to 10/2016
Member Services Associate Fidelis Care - New York City Regional Office New York, United States
  • Assist members in adjusting their insurance preferences
  • Track, file and input all technical documentation under a high pressure environment
  • Answer any inquiries pertaining to a member benefit and health plan
  • Assist in issue resolution to ensure member satisfaction
  • Politely assisted customers in person and via telephone
  • Ensured superior customer experience by addressing customer concerns, demonstrating empathy and resolving problems on the spot
  • Directed calls to appropriate individuals and departments
07/2013 to 11/2015
Claims Processor LogistiCare Solutions, LLC New York, United States
  • Identify and resolve problems with billing invoice forms
  • Arrange travel for patient hospital discharge
  • Confirm all enrollee New York City Medicaid eligibility using Epaces
  • Assist with Fraud and Abuse department
  • Schedule, modify and cancel reservations as requested
  • Comply with all HIPAA regulations
03/2011 to 07/2013
Customer Service Representative Access-A-Ride Long Island City, NY
  • Process travel scheduling and cancellation request
  • Arrange travel authorizations and accommodations
  • Verify locations of drivers to assist customers with estimated time of arrival of vehicles
  • Defused volatile customer situations calmly and courteously
  • Referred unresolved customer grievances to designated departments for further investigation
Affiliations
Hearts To Hands In Needs, Inc.
02/2017-Present
Skills
  • Dexterous in IDX & Eagle
  • Proficient In Microsoft Office
  • Data Entry
  • Proficient in Facets & Salesforce
  • Fluent in Spanish
  • Exceptional communication skills
  • Efficient Multi-tasker
  • Adroit in ePaces and Insurance Verification
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