Claims Administrator Resume Sample
Billy Heathcote
92158 Millie Plains,
Los Angeles,
CA
+1 (555) 316 7541
Work Experience
Claims Administrator
05/2017
-
PRESENT
Philadelphia, PA
- Work closely with your Claims Lead and Team to investigate General Liability and “Fast Track” incidents by effectively executing claims handling practices in accordance with departmental standards and procedures. Resolve guest’s complaints, issues and claims in a fair and equitable manner always upholding Chuck E. Cheese’s and Peter Piper Pizza’s core values
- Willingness to commit to learning/studying to obtain a Texas Property/ Casualty or Multi Line adjuster’s license within 12 months of employment
- Responsible for developing and implementing overall freight claims management strategy to reduce the organizations claim exposure/liability
- Responsible for ensuring freight claim strategy is followed while continuously looking to identify and implement best practices. This includes updating policies as needed
- Determine what party is financially responsibility for claim through thorough investigation. This includes contacting origin shipper, carrier and destination receiver
- Responsible for negotiating favorable claim settlements terms for GFS
- Analyze root cause on large and/or repetitive claims to recommend and implement solutions to prevent recurring claims
- Monitor claims outstanding to accomplish turnaround goal and minimize backlogs
General Liability Claims Administrator
01/2014
-
12/2016
Boston, MA
- Three to five years experience in transportation, freight claims or accounting. Or an equivalent combination of education/training
- Knowledge of transportation claims environment, carriers & claim payment methods
- Make informed decisions and solve problems
- Detail oriented with an emphasis on quality & accuracy
- Excellent computation skills
- Working knowledge of Microsoft Word and Office software
- Perform quality investigations to ensure timely assessment of facts and liability by obtaining video/photos, interview statements, medical authorizations, records and expense documentation
- Interview and work with guests, Cast Members, Restaurant and District Managers, landlords, attorneys and vendors to help ensure complete and factual information is gathered on a timely basis
GAP Claims Administrator
04/2010
-
09/2013
New York, NY
- Utilize Origami (claims management system) to properly document claim files. Maintain accurate, complete and professional notes and claim file documentation. Manage assigned claims using a diary/task system and act with due diligence to manage case backlog
- Determine and set appropriate liability exposures. Set realistic reserves based on the facts of the case and anticipated outcome. Negotiate settlements with guests to reach an amicable resolution. Where needed, execute proper legal releases to ensure CEC is protected when settling General Liability claims
- Assist with the CRISIS HOTLINE on assigned weekends. This involves taking the DM’s call, determining whether Public Relations needs to be involved and communicating a summary of the incident to Senior Management via text
- Assist on projects assigned to the Company’s Internal Audit department
- Experience with General Liability and litigated claims end-to-end required
- Multi Line adjuster’s license required or obtained within first year
- Utilize the department claims system to ensure that medical data, case notes and pertinent claim activity is kept current and in accordance with internal workflow processes
Education
Strayer University - Anne Arundel Campus
2006 - 2010
Bachelor's Degree in Business
Professional Skills
- Excellent verbal and written communications skills and organizational skills
- Strong and accurate data entry, processing and administrative skills with basic mathematical skills
- Strong verbal (negotiating and presentation) and written communication skills
- Strong relationship building, communication and follow-up skills mandatory
- Evidence of strong computer and organizational skills
- Good organisational and prioritisation skills with the ability to manage a busy workload
- Strong customer service skills focused on the delivery of quality customer service
How to write Claims Administrator Resume
Claims Administrator role is responsible for customer, computer, basic, excel, telephony, communications, word, telecommunications, litigation, shipping.
To write great resume for claims administrator job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Claims Administrator Resume
The section contact information is important in your claims administrator resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Claims Administrator Resume
The section work experience is an essential part of your claims administrator resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous claims administrator responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular claims administrator position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Claims Administrator resume experience can include:
- Demonstrates excellent public relations knowledge and skills
- Exhibit excellent communications skills, both verbal and written
- Strong level of interpersonal skills
- Highly effective organizational, interpersonal and communication skills
- Good numeracy and literacy skills required
- To prioritise and manage workload effectively
Education on a Claims Administrator Resume
Make sure to make education a priority on your claims administrator resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your claims administrator experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Claims Administrator Resume
When listing skills on your claims administrator resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical claims administrator skills:
- Good planning and organisational/time management skills
- Critical thinking and effective communication skills
- Prior experience working in a customer service or call center environment
- Technical skills to include working knowledge of MS office suite
- Basic selling skills—establishes relationships with customers
- Exceptional customer focus with great relationship building skills
List of Typical Experience For a Claims Administrator Resume
1
Experience For General Liability Claims Administrator Resume
- Work effectively within a team environment by assisting fellow team members, sharing information and supporting the team to achieve its targets
- Time management skills is required
- Establish and maintain processes and systems/ databases for tracking and reporting claim experience for loss prevention initiatives
- Assisting with invoicing and other financial processes
- Answering general telephone queries and directing calls
2
Experience For LMI Claims Administrator Resume
- Escalate issues related to missing / incomplete claims documents
- Coordinate with the Mail Room the mailing of letters, forms and cheques
- Daily incoming email count and allocation
- Acquire and maintain Epic certification in “Epic Resolute Claims” for Physician or Hospital Billing
- Work with Epic and the IS Department for claims and claim status troubleshooting
- Receive, sort and distribute incoming electronic correspondence within agreed timeframes
3
Experience For GAP Claims Administrator Resume
- Report claims to Companies insurance company and within 24 hours of receiving claim
- Provide complete documentation of claim event, including accident report and witness statements, to the insurance company
- Coordinates with DMS short term disability and/or workers’ compensation team members to ensure best possible outcomes
- Counsels and educates employees and managers on leave process
- Maintains partnerships and works collaboratively with managers, Legal, HR, EAP and Employee Health
- In accordance with the UH Temporary Alternative Duty policy, coordinates temporary accommodations through placement in alternative duty assignments throughout the organization
- Manages all claims to ensure compliance with the Family Medical Leave Act, American’s with Disability Act and applicable UH policies
- Maintains claim database for general reports
- Interacts with the third-party adjusters, as needed
4
Experience For Senior Claims Administrator Resume
- Interacts with claimants to obtain completed paperwork for all settlements
- Interacts with sites to obtain completed paperwork for all incidents
- Reviews, handles, and distributes all claims and insurance documents and correspondence
- Follow up that all relevant claim documents are received from Credit Controllers
- Possess ability to work in cooperation with others as a team leader to achieve desired results
5
Experience For Junior Claims Administrator Resume
- Answer telephone calls and emails from employees and HR of Mercer’s broking clients on topics including claim status, rejection reasons, benefit coverage and claim submission procedures
- Strong knowledge of general business and administrative practices
- Provide peer review for other colleagues’ enquiry responses
- Claims are in insurance categories of medical, travel, disability income, personal accident, life, etc
- Generates and maintains claims records, reports, and logs for assigned claims unit. Submits completed information to appropriate personnel or bureaus.
- Support print and mail requests from remote employees
- Self-starter with demonstrated ability to prioritize own work and ability to research/problem solve and make decisions both independently and collaboratively within a fast-paced team environment
6
Experience For Claims Administrator, Strata Resume
- Daily incoming post count and allocation
- Quickly gain the ability to navigate Ultera, CHESS, Life Support and GWEW claim systems
- Responds to all email and phone inquiries within 24 hours
- Proficient with Windows and Microsoft application ( MS Excel, MS Word, MS Power Point)
- Complete vehicle uplifts on a daily basis
7
Experience For Trade Claims Administrator Resume
- Complete salvage returns payments
- Work with assigned Epic claims representative on custom changes, fixes and Epic upgrades, as well as new enhancements
- Maintain Epic Reflections/Text settings including Claim Definition Files (CDFs), master file settings as needed (ie. PIN, NPI & Group numbers) and electronic payer identification codes. (cpids/payor ids)
- Create and maintain custom programming points for electronic and paper claims and for electronic remittances
- Create, maintain and monitor Claim Edit Workqueues (CEWQs) and rules, including split runs
8
Experience For Asbestos Claims Administrator Resume
- Test Epic system upgrades as they relate to claims submission and claim status
- Investigation into complex claims
- Ad hoc logistical management
- Process non-complex claims to agreed Gallagher Bassett & client standards
- Provide professional, and client focused claims service
- Process workflow items within agreed timeframes
- Review of new STD documents
9
Experience For Group Claims Administrator Resume
- Sets up new STD claims in Ultera and CHESS claim systems
- Assignment of Eligibility Tasks to the appropriate claims examiner based on pre-determined criteria
- Identify complex diagnoses and to label these claims accordingly
- Monitors and reports on new claim inventory levels
- Able to meet production goals on a consistent basis
- Maintain a high level of accuracy and identify errors for correction
- Can effectively communicate the claim status or request information from employees, employers, or doctors, and can accurately address any questions or concerns with confidence
- Establishes excellent relationship with claim organization
- Responds to all e-mail and phone inquiries within 24 hours
10
Experience For HOA Claims Administrator Resume
- Responds to correction emails within required turnaround time
- Maintains high levels of customer service with internal and external customers
- Willingness to cross-train on all Front End operations responsibilities
- Proficient with Lotus Notes, Windows and Microsoft application ( MS Excel, MS Word, MS Power Point)
- Develop systems to support the in-take, evaluation, investigation, documentation, communication and tracking of liability claims. Perform exposure/ coverage determination, cost estimation, and case management. Coordinate claims management from notification to close
- Engage division and corporate management in minimizing exposure to claims and reducing the financial loss resulting from claims made against the division. Identify, develop, and implement risk control/prevention actions to reduce risk and minimize exposure to liability claims
List of Typical Skills For a Claims Administrator Resume
1
Skills For General Liability Claims Administrator Resume
- Effectively prioritize assignments and handle multiple projects/assignments
- Intermediate - Advanced MS Excel skills and experience with MS Access
- Excellent communication and customer service skills; and
- Prior experience handling general liability claims required
- Demonstrate good understanding of claims procedures, products and services
- Good ability to build solid working relationships with customers and advisers as well as wider AMP teams
- Experience in FMCG and related Claims Admintrative experience
- Customer / Hotline service skills
- Prior disability or critical illness claims experience
2
Skills For LMI Claims Administrator Resume
- Knowledge of general business and organisational skills
- Computer skills with a high level of accuracy and attention to detail
- European language skills are desirable but not essential
- Effectively present information and respond to questions quickly and thoroughly
- Analytical skills would be an advantage
- Managing tasks and able to handle pressure of deadlines and changing priorities
- Solid working knowledge of Microsoft Packages – Excel, Word, Outlook etc and ability to use applications in a Windows environment
- Experience working within the telecommunications industry would be highly advantageous
- Previous experience processing claims or data entry
3
Skills For GAP Claims Administrator Resume
- Experience working in services related insurance claims (especially medical)
- Experience working in services related insurance claims (especially medical) or customer service contact center
- Experience handling insurance claims
- Claims experience working with workers’ compensation, general liability, automobile, and property insurance
- Proven ability to make the right decisions on legal liability; damage assessment and assessing the need for investigation
- Those with experience working specifically in transportation are highly desired
4
Skills For Senior Claims Administrator Resume
- Quick to pick up new tasks and strong attention to detail
- Some multi-line insurance carrier experience
- Some related experience in the Pest control industry or a field service organization
- Excellent knowledge or Microsoft Word, Microsoft Excel, and other office software
- Experience using the following applicants: Microsoft Word, Excel and PowerPoint, SharePoint and SIMS records
- Crucial Calls training or experience
- Proficient in computer software in Word, Excel, and PowerPoint programs and experience in manufacturing related systems
5
Skills For Junior Claims Administrator Resume
- Mortgage or loan default services, foreclosure, Claims Administration, Investor Reporting experience
- Strong knowledge in the areas of Claims Administration, Investor Reporting, or Default Management
- Decision making abilities that demonstrate focus on the customer and a recognition of business objectives
- Prioritize work against our KPI’s and TAT’s; manage multiple demands
- Experience with Chess and Phoenix
- A positive attitude, good work ethics, and honesty
- Good command of spoken Chinese and English
6
Skills For Claims Administrator, Strata Resume
- Claims administration and lodgement experience essential
- Experience within a busy office environment
- Is able to multi-task, prioritise and work to deadlines
- Professional GL claims experience required
- Organize and prioritize workload is essential
- Establishes excellent relationship with claim organization, maintains high levels of customer service with internal and external customers
- Completing £3 cheques and V84 slips on daily basis and being responsible for sending these to DVLA on a weekly basis
- Managing the entire technical claims administration process including, the management of the Claims Inbox and preparing electronic claim files for assessment
7
Skills For Trade Claims Administrator Resume
- Reviewing and responding to customer inquiries into claim analysis and/or associated costs via phone or electronic communications
- Interpreting policy wordings an reviewing individual circumstances
- Reporting and providing claims statistics to key stakeholders when required
- Assessing liability and informing the file handler a new claim has been raised and confirm to them the details of the claim
- Contributing to ensuring the Unit’s Key Performance Targets are met and that own objectives are achieved
- Being responsible for sending document bags to Copart on a weekly basis
- Maintaining and ensuring data integrity of claims assessment information on internal systems
8
Skills For Asbestos Claims Administrator Resume
- Ensuring that the company’s administration standards and time service requirements are applied to the handling of all claims received
- Drawing and collating of technical claims assessment data
- Understanding of principles of insurance policies and claims
- Ensuring that all allocated work is handled within the Key Performance Targets of the Claims Department
- Following agreed internal and external processes, policies and procedures to ensure quality and service standards are met and leakage minimised
- Allocating total losses on a daily basis
- Providing administrative support to the team of 5 in Melbourne
- Distributing claims to be assessed to Claims Consultants
9
Skills For Group Claims Administrator Resume
- Liaising with Operations, Valuations and Finance to ensure that the data utilised, reported on and supplied are correct
- Interacting with Clients on various technical claims assessment aspects such as assessment requirements and responses
- Handles various administrative functions including but not limited to; special mailings, filing, collating, faxing, printing files, etc
- A understanding of claims fraud practices and procedures and a broader understanding of claims fraud identification techniques across all lines of business
- Develops customer relationships to promote improved material handling, disposition of material, claim administration and understanding of agreements
- Assist customers with questions on filing warranty claims, shipping, analysis and payment of claims that have been processed
10
Skills For HOA Claims Administrator Resume
- Data compilation and processing using Microsoft Excel
- Take a pro-active and results orientated approach to claims handling, whilst making claimants feel valued
- Help Disability Services team through busy tax season by picking up additional tasks, assisting team members in day to day tasks
- Comply with all Health and Safety requirements, including reporting all accidents, near accidents and hazards
- Awareness of industry practices surrounding claims fraud and the affiliated legislation and legal obligations
- An understanding of workings of relevant fraud related legislation
- An understanding of broader industry anti-fraud services and initiatives
- The ability to be a self-starter and ‘hit the ground running’ from the outset
- Assure continuing technician communication of current warranty product analysis
List of Typical Responsibilities For a Claims Administrator Resume
1
Responsibilities For General Liability Claims Administrator Resume
- Coordinate and communicate claim notification and findings to safety, operations, finance, administration, risk management and law departments. Obtain necessary documentation, records, statements, and regulations and investigate scope of claim/ incident
- Strong analytical skills and ability to solve complex problems in an independent way
- Care for details, critical mind set and good organisational skills
- Good communication skills and ability/willingness to build network
- Strong computer skills- Word, Excel, PowerPoint, SAP, and JDE
- Strong interpersonal oral and written communication skills required
- Effectively handle high levels of inbound and outbound calls and emails including Broker inquiries
2
Responsibilities For LMI Claims Administrator Resume
- Proficient in both verbal and written communication to effectively communicate with internal and external customers/partners and vendors
- Established math skills with the ability to perform basic calculations quickly
- Prior retail or customer service experience required
- Claims experience and/or relevant experience
- Communicate with distribution centers on the arrival of damage goods; generate timely investigations and claims filing
- Experience working with an administration and customer service environment
3
Responsibilities For GAP Claims Administrator Resume
- Regional FlexSave claims administration and processing a consistently high volume of claims with strong accuracy
- Participate in evaluation, testing and validation of new release functionality, as it relates to claims
- Experience in fields associated with claims such as communications, legal, insurance, customer service or similar fields
- Industry experience is an asset
- Answer inbound calls and emails from advisors and clients and continuously learn about customers, their priorities and their expectations
- Coordinates preservation of all physical evidence related to claims
4
Responsibilities For Senior Claims Administrator Resume
- Able to multitask, prioritize and adapt to meet deadlines
- Receiving, sorting, distributing incoming and outgoing mail and faxes within agreed time frames
- Generating, sending and assessing appropriate correspondence to follow up on claims, specifically the weekly compensation entitlement
- Inputting new claims and updating existing claims data on the claims management system
- Responding to/managing calls from both our clients and carriers with claim related questions
5
Responsibilities For Junior Claims Administrator Resume
- Gaining a thorough understanding of the impact the operations area has on the other departments within RGA
- Maintaining filing system; and
- Managing of department email inboxes using Microsoft Outlook
- Liaising with our claims handlers and vendors to ensure timely payments. Managing all monthly vendor payments in line with company policy
- Managing our filling system
- Scanning and logging paperwork as required
- Setting up and paying supplier invoices
6
Responsibilities For Claims Administrator, Strata Resume
- Scanning and electronic filing of claims
- Creating new claims onto designated claims handling platforms
- Ordering stationery and ensuring stock is replenished as required
- Supporting the claims assessment teams through general administration and payments
- Obtaining status updates from the adjuster/carriers and circulate details to all parties involved
- Processing non-complex claims to agreed standards
7
Responsibilities For Trade Claims Administrator Resume
- Scanning of documents as appropriate
- Screening theft documents
- Acting as a liaison for associates, case manager, and insurers
- Reporting into Excel
- Assisting with diaries where directed by the Claims Manager
- Assist the Senior Claims Administrator in the handling of litigated claims including gathering information for discovery
8
Responsibilities For Asbestos Claims Administrator Resume
- Supports adjusters by researching and gathering necessary documentation for claims
- Assists supervisors by running reports to audit files and by maintaining a weekly file of claims assigned, closed and reopened
- Ensures incoming and outgoing mail is distributed promptly and accurately
- To produce and maintain accurate and complete documentation /correspondence using standard templates, writing clearly, concisely and professionally
- Provide general administrative support to the Case Managers and wider department as required, including chasers, photocopying etc
- Follow up on pending and difficult claims cases to ensure proper processing
9
Responsibilities For Group Claims Administrator Resume
- Absolute understanding of Epic Hyperspace and Text relationships that pertain to electronic and paper claims generation and processing
- Assist in configuring and testing the Epic system to meet Nemours needs
- Maintains flexibility in a changing, high speed & demanding team environment
- Build rapport with customers and advisers through understanding their needs and to positively influence the outcome of the customer/adviser contact
- Take ownership of complex issues from the initial query through to its resolution while managing customer expectations
- Proactive and confident approach to problem solving
- Report and administer claims in accordance with policies and reporting requirement
- Communicate claim reporting processes and requirements to Leadership Team
10
Responsibilities For HOA Claims Administrator Resume
- Provides guidance and assistance to customers/employees regarding basic claim inquiries
- Completes state wage forms after requesting needed information from Payroll
- Maintains and updates data files, operation manuals and other training materials
- Supports adjusters by updating claims files with correspondence and notes
- Indexes all new files, requesting further information from other insurance companies as required
- Proficient in desktop applications including Excel, Word, PowerPoint, Project and SQL
- Monitor and finalize damage estimate for claim processing
- Ensure the integrity of the operations of the claims department through accurate and timely processing of data
- Reconcile payments entered into Operations Claims database to ensure accuracy of reporting
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