Claims Specialist resume examples

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Skillful Claims Specialist resume

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Lisa Mann
Professional Background

Caring Nursing Assistant with excellent communication skills and 7 years expertise in quality Geriatric care. Experience in both assisted living environment and private duty caregiving. 

Skill Highlights
  • Medical terminology knowledge
  • Proficient in ADL's and vitals
  • Drug administration trained
  • Cpr Certified
  • Patient/family focused
  • Trained in catheter/colostomy care
  • Charting knowledge
  • Body mechanics competency
Professional Experience
07/2017 - 11/2018 Liability Claims Adjuster Elephant Inusrance Co | Richmond, VA

Telephone liability claims adjuster in call center environment. Investigated claims, determined losses and reported findings. Investigated any potentially fraudulent claims with a focus on thoroughness, quality and cost control. Managed a caseload of 150 monthly claims. Recommended settlement offers and negotiated payment arrangements.

01/2016 - 06/2017 Caregiver Public Partnerships | Fredericksburg, VA

Provided in home care to a elderly adult female with vision and hearing impairments. Assisted with meal preparation, ensure medications taken properly,  medical appointments transport, grocery shopping, and companionship. Communicate concerns to assigned family members.

10/2016 - 03/2017 Care Manager Greenfield's Senior Living | Stafford, VA

Worked 3rd shift in Assisted Living Community specializing in Geriatric care, including locked Alzheimer's unit.  Worked to improve patient outlook and daily living through compassionate care. Assisted with activities of daily living (ADL), including personal hygiene, feeding, ambulation and household maintenance. Took and recorded patients' temperature, pulse and blood pressure.

09/2015 - 10/2016 Personal Care Aide Brookdale | Fredericksburg, VA
Personal Care Aide in an 100+ bed community. Assisted with ADL's according to Aide assignment sheets. Became lead care associate of 3 full time and 4 part time associates on 3rd shift. Trained on 1st and 2nd shift procedures to fill in as needed. Reported resident changes to charge nurse and family members. Experienced with AL and Alzheimer's unit. Use of pager system to respond to resident needs promptly.
05/2016 - 09/2016 Private Duty Caregiver Private Duty - Mullen | Spostylvania, VA Provided care for a non-ambulatory elderly male. Used hoyer lift for transport. Provided respite relief for spouse as needed. Provided am care which included bathing, dressing, shaving, skin care, transport from bed to wheelchair to reclining chair. Provided pm care which included transport from reclining chair to wheelchair to bed as well as oral care and bowel incontinence. Provide foley catheter care. Assisted with care until patients passing in September.
03/2005 - 05/2015 Liability Claims Adjuster Geico | Fredericksburg, VA Telephone Liability Claims Adjuster for MD/DC. Investigated liability and coverage disputes, settled 1st party injury claims and 3rd party minor injury claims. Team contribution that achieved 100 % telephone audits 2009-2010. Chairman's Club recipient 4 times during 6 year eligibility. Promoted 5 times in 10 year tenure with company. Department lead with 49 quality SIU referrals in 2010 out of approximately 200 adjusters.
09/2001 - 09/2004 Nursing Assistant/Med Tech Wilburn Gardens | Fredericksburg, VA Nursing assistant in 100 bed Assisted Living Community. Primary shift was 3rd shift but assisted on 2nd shift as needed. Responsible for assisting residents with ADL's. Communicated with staff, residents, family members. Maintained and updated staff assignment sheets based on resident care plans. Completed 2 day Med Tech course and passed medications primarily 3rd shift but assisted on 2nd shift as needed. Observed, charted, and reported resident changes. Initiated resident emergency transport when required. Resident charting as required by community and state guidelines.
Education and Training
Nurse Aide Program
Mary Washington Hospital | Fredericksburg, VA 2001 Completed 6 week Nurse Aide Program
Nursing Education
Germanna Community College | Frederickburg, VA 1998-2014 Completed 76 credits, focus on nursing

Certificate of completion of Mary Washington Hospital Nurse Aide Program 

Health Care Provider BLS Certification

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Job-winning Claims Specialist resume

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Decorated former federal agentProven leader who has consistently demonstrated the ability to remain calm in times of crisis and perform at a high level under stress.  Positive thinker and team-oriented.  Excellent writer with strong interpersonal skills and active listening skills who communicates effectively with individuals from diverse backgrounds. 

LITIGATION SOLUTIONS Springfield, MO Claims and Surveillance Investigator 02/2014 to Current
  • Licensed private investigator.
  • Investigated home invasions, automobile accidents, workplace accidents, and general liability claims.
  • Conducted surveillance of insurance fraud suspects and covertly obtained video evidence of them.
  • Prepared detailed investigative reports.
  • Administered recorded statements.
JOHN HARTMAN BAIL BONDS Springfield, MO Fugitive Recovery Agent/Bail Agent 07/2012 to Current
  • As an independent contractor, built a solid, reputable business from scratch.
  • Managed a large caseload of adult offenders from arrest to case adjudication.
  • Conducted undercover surveillance to determine the whereabouts of fugitives.
  • Investigated and analyzed court documents, criminal histories, arrest records, and applicant backgrounds.
  • Served arrest warrants to subjects who failed to appear for scheduled court hearings.
  • Conducted in-depth interviews and prepared detailed, accurate reports.
  • Developed and utilized a network of confidential informants.
  • Established and maintained effective working relationships with individuals from diverse cultural and socioeconomic backgrounds.
UNITED STATES MARSHALS SERVICE Tucson, AZ 06/2010 to 06/2012
  • Reviewed records, gathered evidence, and traced and arrested individuals named in criminal warrants.
  • Acted as the primary law enforcement officer in federal court proceedings.
  • Organized, planned, and led surveillance operations.
  • Escorted federal prisoners to their court appearances.
  • Protected federal judges, attorneys, federal witnesses, jurors, and other members of the federal judiciary.
  • Managed prisoner transportation systems.
Border Patrol Tucson, AZ Prosecutions Officer 04/2008 to 04/2009
  • Investigated drug smuggling and human smuggling cases.
  • Presented cases to the U.S.
  • Attorney's Office for criminal prosecution.
  • Prepared criminal complaints Presented and swore to criminal complaints before the U.S.
  • Magistrate.
  • Presented cases to the Grand Jury.
  • Testified before the Grand Jury weekly.
  • Acted as the case agent at criminal trials, providing evidence and testimony.
UNITED STATES BORDER PATROL Sonoita, AZ U.S. Border Patrol Agent 03/2004 to 06/2010
  • Arrested subjects attempting to smuggle illegal narcotics and/or illegal entrants into the United States.
  • Conducted strategic, covert surveillance operations to intercept and arrest immigrant/narcotics smugglers.
  • Responded to underground sensors, independently determined if an illegal incursion into the U.S.
  • had been made, and , if an incursion had been made, tracked and arrested those persons who activated the sensors, oftentimes over a distance of several miles, over rugged terrain, and in extreme heat.
  • Managed and led small special operations units.
  • Gathered and disseminated intelligence regarding illegal entrant/drug smuggling traffic patterns.
  • Organized, planned, and led special operations projects designed to target high drug trafficking areas.
Field Training Officer
  • U.S.
  • Marshals Service Academy's Outstanding Graduate Award (Class 009) U.S.
  • Border Patrol Academy Physical Techniques (PT) Instructor U.S.
  • Border Patrol Agent of the Month (June 2006-Sonoita Station) National Recruiter (Border Patrol) Oral Hiring Board Interviewer (Border Patrol) Defense Tactics and Intermediate Use of Force Instructor (Border Patrol) (FTO) (Border Patrol).
Education and Training
U.S. Border Patrol Academy, Federal Law Enforcement Training Center Criminal Investigator Training Program (CITP), Federal Law Enforcement Training Center U.S. Marshals Service Academy, Federal Law Enforcement Training Center Detecting Deception and Eliciting Responses (DDER), Federal Law Enforcement Traininng Center
Attorney, Case management, Oral, Hiring, Instructor, Insurance, Law Enforcement, Office, network, Recruiter, Report writing, strategic, transportation, video, warrants

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Experienced Claims Specialist resume

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Versed in all aspects of art creation, youth leadership , administration and customer service. Looking to contribute my skills and passion to make a positive impact in my work environment while servicing the community and learning more about art direction.

August 2019
Kids Creative New York, NY Dance Instructor
  • Help with coordination and administration of complete dance program.
  • Provide individual instruction to students and directed dance performances
  • Develop guides and course materials focused on reinforcing lecture information and helping students learn.
  • Managecurriculum development and daily facility operations in alignment with the organization's objectives.
  • Build positive relationships with students, parents, colleagues and administrators.
  • Establish objectives for all lessons and projects.
June 2019
Groove With Me Inc. New York, NY Dance Instructor

• Instruct girls ages 7 - 14 hip hop and modern dance.

•Teach dance history , creative expression , improv and freestyle

August 2017
H&M Columbus, OH Sales Coach
  • Welcome each customer and offer assistance in the form of excellent customer service
  • Implement proper garment care, garment replenishment , process new shipmen, retain product knowledge and store appearance
  • Assist with setting departments according to HM standards
  • Role model for new hires to ask questions and lean on for help. I create training plans for my trainees , provide hands on training for the role and provide feedback
June 2018
May 2019
Crunch Fitness Hilliard Hilliard, OH Shift Supervisor
  • Welcomed members, scanned member cards, provided answers to questions, clean gym , keep up with fitness knowledge, sign up new members and book personal training sessions
  • Trained newly hired front desk associates on company policies, cleaning procedures and customer service techniques. Handled scheduling, shift coverage and any other concerns with all staff during third shift
  • Professionally dealt with any member escalations and passed them on to the general manager when needed
August 2017
May 2019
York Risk Services Group Inc. Dublin, OH Claims Specialist
  • Managed a case load of 400 employees for Johns Hopkins Hospital, handling FMLA , Medical , Military and other leave types
  • Performed data entry, claim review , processing and decision making
  • Corresponded with HR and employees via email, by phone and US mail
September 2016
August 2017
Garden City Group Dublin, OH Project Administrator
  • Performed data entry, document review, intake , mail sorting and managed internal email inbox's
Education and Training
Capital University Bexley, OH French
Fort Hayes Arts And Academic High School Columbus, OH High School Diploma
  • I was selected by Mrs. China White ( Dance Theatre of Harlem, The Wiz) to be apart of the two year pre- professional dance program

English- Native; French - Fluent ; Spanish- Conversational