Claims Analyst Resume Sample
Freddie Mayert
1499 Goldner Extension,
Detroit,
MI
+1 (555) 186 5168
Work Experience
Senior Claims Analyst
04/2017
-
PRESENT
Chicago, IL
- Values. Demonstrates in word and action the Y’s core values of caring, honesty, respect, and responsibility and a commitment to the Y’s mission, in all matters at all times
- Inclusion. Values all people for their unique talents, and takes an active role in promoting practices that support diversity, inclusion, and cultural competence
- Relationships. Builds authentic relationships in the service of enhancing individual and team performance to support the Y's work
- Communication. Listens and expresses self effectively and in a manner that reflects a true understanding of the needs of the audience
- Quality Results. Demonstrates and fosters a strong commitment to achieving goals in a manner that provides quality experiences
- Change Capacity. Leads self and others through change by navigating ambiguity appropriately and adapting well to new situations, obstacles, and opportunities
- Emotional Maturity. Demonstrates effective interpersonal skills
- Self-Development. Is dedicated to the improvement of own capabilities and demonstrates this through the continual expansion of knowledge and skills
Claims Analyst
07/2014
-
02/2017
Los Angeles, CA
- Problem solve and work on own initiative
- Reinforce the culture and core values of DLG Insurance through appropriate behaviours and actions
- Be aware of and comply on an ongoing basis with the rules and requirements of the Financial Services Authority (FSA) and any other legal/regulatory/risk management frameworks
- To take responsibility for own development to maximise personal contribution to the team
- Formulates and applies analytical reports using the company’s database to develop and interpret information that assists in developing test cases
- Experience in Claims or Call Center
- Manage Liability and Workers Compensation claims, including working with TPA’s, Attorney’s and Insurance Companies. Facilitate reports to support reserve increases and settlement approvals for such claims
Junior Claims Analyst
03/2009
-
04/2014
Chicago, IL
- Actively engages in lean process design by participating in the identification and elimination of non value add activity
- Analyse MI data to inform the relevant stakeholders across Claims of performance, interpreting and presenting findings as appropriate
- Undertake statistical and probability analysis to identify trends and improvement opportunities by key driver across the business
- Support strategic Claims initiatives and provide robust management information and analysis to enable robust decision making. Work with Claims Operational Management in order to design and implement fit-for-purpose reporting containing relevant, accurate, timely and commercially-focussed lead and lag key performance Indicators
- To continuously seek to improve the quality of MI provided to the business, and to support, prioritise, and challenge ad hoc requests from the business. Work with the business to educate and shape the MI request in order to better meet objectives, and reinforce a culture of working in partnership by keeping stakeholders informed and updated
- To adopt a creative approach to resolving complex problems in mining and manipulation of data, identify alternative non-standard mechanisms and approaches to achieve the desired output
- Where possible, identify process improvements and/or efficiencies in order to contribute to the profitability of DLG Insurance
- Develop statistical techniques & models that can be utilised by the wider team and analyst community in order to drive business benefit
Education
Strayer University - Anne Arundel Campus
2004 - 2009
Bachelor's Degree in Business
Professional Skills
- Demonstrate a strong passion to provide an excellent customer service experience
- Demonstrated claim trend analysis skills, including development of management-level scorecards and reports
- Meet deadlines / strong time management skills
- Excellent written and oral communications skills in English; French is an asset; and
- Excellent written and verbal communication and organization skills, ability to work with all levels of management
- Professional writing skills, including abilities in editing and proofing and in use of correct sentence structure and grammar
- Proven experience in challenging existing process(es) in a professional manner and developing unique solutions
How to write Claims Analyst Resume
Claims Analyst role is responsible for computer, analytical, software, microsoft, negotiation, excel, organizational, interpersonal, communications, analysis.
To write great resume for claims analyst job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Claims Analyst Resume
The section contact information is important in your claims analyst 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 Analyst Resume
The section work experience is an essential part of your claims analyst 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 analyst 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 analyst position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Claims Analyst resume experience can include:
- Work closely with Legal, Operations and Insurance Agent to review insurance, certificates and related contract language for the approval or denial of Newpark’s vendors
- Excellent analytical and technical skills, along with strong communication, time management, interpersonal, and problem solving abilities
- Utilizing strong communications skills
- Effective negotiation skills when managing and negotiating in house claims or claims tendered to the Company's insurance carriers
- Strong adjusting, negotiation and communication skills desirable
- Motivated, proactive, research and detail oriented. Strong analytic and problem solving skills. Ability to work independently
Education on a Claims Analyst Resume
Make sure to make education a priority on your claims analyst resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your claims analyst 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 Analyst Resume
When listing skills on your claims analyst 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 analyst skills:
- Applied Learning: Quickly gains knowledge, understanding and skills and actively participates in learning experiences. Applies knowledge and skills
- Strong planning, organizational skills, possess proficient analytical, problem solving and decision-making skills
- Effective oral and written communication skills, and human relation skills
- Strong interpersonal skills to effectively function in a team environment, as well as the ability to work independently
- Strong verbal and written communication skills and analytical skills required
- Solid 3 to 5 years of experience technical Reinsurance Claims skills, seasoned in the handling of Reinsurance claims (mainly P&C, Marine and Engineering)
List of Typical Experience For a Claims Analyst Resume
1
Experience For Senior Claims Analyst Resume
- Excellent organizational skills and the ability to effectively prioritize taskse of urgency
- Strong knowledge of Microsoft Office with excellent Excel skills
- Excellent verbal and written communication skills, accurate with details and a demonstrated ability to handle a variety of tasks in an organized manner
- Exceptional and proven time management and organisational skills
- Excellent organization and analytical skills are essential
2
Experience For Warranty Claims Analyst Resume
- Utilize industry experience to effectively probe likely areas of problems and work with team to suggest measures to mitigate risks on future projects
- Flexible team player with effective interpersonal skills
- Excellent organizational, verbal, written communication skills
- Strong written and verbal communication skills; fluency in French an asset
- Proficient with PC computer skills including spreadsheet and word processing programs
- Advanced IT skills, including a detailed knowledge of a broad range of Microsoft Software / SAS, SQL and Visual Basic
- Client-facing position; need customer service and phone skills
- Advanced ability to apply teamwork and cooperation skills with CFSC/CISC and outsourced companies’ employees in order to accomplish given tasks
- Basic problem solving skills associated with software application
3
Experience For Senior Casualty Claims Analyst Resume
- Sharp critical thinking skills with sound judgment
- Prior experience processing 1st dollar health insurance claims
- Prior experience handling Specific Stop Loss claims
- Demonstrated experience successfully interacting across lines of business, in a team environment
- Prior experience with data profiling software is required, specifically
4
Experience For GAP Claims Analyst Resume
- Multi-task and coordinate information and resources efficiently and effectively
- Reports complaints effectively in line with the company’s complaints procedure
- Detail oriented. Ability to multi-task. Manages time effectively
- Experience in project management, and intermediate experience with analysis of information and data
- Data analysis and integration experience; automotive experience an asset
- Demonstrated ability to consistently meet deadlines and prioritize tasks
- Knowledge, Skills, &Abilities
- Working knowledge of Excel, Access, Word, PowerPoint, Visio, Outlook and Internet Explorer. Experience in SQL or Analytical coding desired but not essetial
- Setting your own priorities in a fast paced environment
5
Experience For Group Claims Analyst Resume
- Managing priorities and escalations in a fast paced environment
- Researching claims to recover chargebacks, validate chargebacks and work with Senior Manager of Compliance to implement corrective actions
- Maintain claims in acceptable aging categories through prioritizing workload and multitasking to meet company goals and objectives
- Related experience, preferably in investigating, evaluating & responding to automotive product liability claims
- Problem solving individual able to manage a varied workload with changing priorities
- Experience with analyzing data and running reports – with cost/benefit analysis
- Claims processing, adjudication & examining experience required
6
Experience For Internal Mortgage Claims Analyst Resume
- Experience in warranty management, supply chain management, engineering, finance, accounting or business-related field
- Experience with adjudicating managed care claims including 2+ years at a senior level
- Experience analyzing claims data and identifying issues and trends
- Experience handling group policy information
- Has established and maintained effective working relationships within a team environment
- In P&C claims and at least 5 years’ experience with complex litigation claims handling
- Maintain good working relationships with all internal and external contacts to ensure optimal level of service
- Knowledge and a solid understanding of relevant fraud related legislation & case law desired but not essential
- Prepare denial letters for invalid claims and provide best corrective action to salesperson
7
Experience For Junior Claims Analyst Resume
- Proficiency in MS Word, Excel, PowerPoint and Access; and have good recall of detail and a mechanical aptitude
- Ensures the most appropriate and cost effective resolution of all claims is reached and that a high level of customer service is attained
- Download and organize Medicaid Summary invoice, summary data file and Claim Level Invoice using RPA tool. Upload data into Model N systems (Flex and Validata)
- Experience in insurance, investigation, research, LTD claim processing or financial reconciliation (5 or more years required)
- Experience answering LTC benefit questions
- Work experience handling workers compensation claims
- Experience working with Medical Claim forms (UB04, HCFA1500)
- Experience auditing previously adjudicated claims
8
Experience For Salvage Claims Analyst Resume
- Experience utilizing the Black Knight / LPS/Fidelity Mortgage Application System is desired
- Experience filing investor/insurer claims is required
- Familiarity with data mining and business intelligence tools; Business Objects experience an asset
- Manage claims from the review, validation and approval process for failure to supply, promotional claims and shelf-stock adjustments
- Validate that all mandatory fields have been entered properly
- Experience with MTV & CAS platforms
9
Experience For Business Claims Analyst Resume
- Process benefits based on the policy provisions, complete requirements, validity of claims and disbursement of claims benefits
- End-to-end process- validation of claims, computation of benefit value and check preparation
- Experience with claim management systems, preferably Riskonnect
- Experience with dram/alcohol-related claims
- Experience with EDI and integration solutions: Edifecs, etc
- Experience at a law firm or insurance company highly desired
10
Experience For HFP Claims Analyst Resume
- Experience with Epic's Tapestry AP Claims module and the CRM process
- Demonstrated ability to work well with others is a matrix team environment
- Creating, enhancing, and executing queries as needed in Business Objects for daily, monthly, and quarterly reporting
- Preparing, verifying, and distributing existing Warranty month-end reports for dealers, area managers, and warranty field managers
- Maintaining and building on existing reporting processes and documentation
List of Typical Skills For a Claims Analyst Resume
1
Skills For Senior Claims Analyst Resume
- Strong organizational and time management skills with the ability to prioritize work, meet deadlines and effectively manage changing priorities
- Strong analytical, technical, and communication skills, including group presentations
- Strong investigation and persuasive writing skills
- Highly developed analytical ability with good decision making skills
- Strong systems and spreadsheet skills, including Excel
- Proven ability to effectively present information and respond to questions from leadership, clients, and customers
2
Skills For Warranty Claims Analyst Resume
- Strong analytical skills, sound judgment, and high attention to detail
- Strong computer skills with the ability to work with MS Office software
- Excellent math, written and verbal communication skills
- Strong communication skills in English and French, both written and spoken
- Strong verbal and written communication skills with the ability to communicate clearly, professionally and empathetically
- Experience using industry standard coding (knowledge of ICD-9 and ICD-10); strong understanding of medical and dental terminology
- Oratory skills required for presenting reports and conducting meetings with the senior management of the company
3
Skills For Senior Casualty Claims Analyst Resume
- Clearly and effectively communicate, both verbally and in writing, with all levels of employees and outside contacts
- Bodily Injury adjusting experience OR related current litigation experience an asset
- Communication, Oral - Ability to communicate effectively with others using the spoken
- Extensive experience providing excellent customer service to the public via telephone and e-mail
- Solid understanding of and experience with fundamental principles of risk management and insurance
- Vision: continuously conceives of and aspires toward long-term change, while effectively executing short-term goals
- Top-notch organizational habits with experience prioritizing large volumes under tight deadlines
- Computer skills in Windows environment, working knowledge of Word, Excel, Access, Lotus Notes software, on-line claims data base systems
- Computer skills, especially: Word, Excel, Visio, Power Point, ticketing systems and SharePoint
4
Skills For GAP Claims Analyst Resume
- Computer skills, including Excel
- Able to adapt communication style and skills depending on situational dynamics
- Problem – solving capabilities and sound judgment are skills that are required for a risk manager to have
- Superior writing skills for communications of claim exposure to the company’s senior management
- Advanced to Expert level data entry skills
- Strong experience of SAS or equivalent
5
Skills For Group Claims Analyst Resume
- Do call out - phone skills
- Above average oral and written skills
- Meets deadlines consistently and partners effectively with internal partners
- Mathematical Skills - Ability to add, subtract, multiply and divide in all units of measure,
- High computer literacy skills, particularly in Excel, Word and PowerPoint
- Exceptional customer service skills in order to build and maintain relationships with internal and external clients
- Able to effectively negotiate “win-win” outcomes
- Superior interpersonal skills and ability to handle stressful situations with tact and courtesy
6
Skills For Internal Mortgage Claims Analyst Resume
- Utilize Change Management skills to promote and implement change positively and work as part of a team to accomplish the goals of our department
- Mathematical skills and attention to detail
- Prior rebates processing and customer service experience helpful
- Good aptitude for math and strong attention to detail
- Proficient in MS Office/PC Skills
- Creating a positive work environment and being an effective role model by championing TDI’s mission, vision and values
- Assessing claims experience for underwriters to use during policy renewals
- Ensuring all key data is available to claims assessors prior to entering assessment phase
- Setting your own priorities in a rapidly changing environment
7
Skills For Junior Claims Analyst Resume
- Working knowledge and experience with mediation and arbitration
- Coding experience – CPC/CCS
- Demonstrating good knowledge and use of claims management systems; ability to adapt well to system and process changes
- Determine validity and compensability of the claim by investigating and gathering information regarding the claim
- Experience explaining Billing Oregon Administrative Rules (OARs) and Billing supplemental guide
- Efficiently and accurately processing, allocating and inputting claims evidence
- Experience processing and adjudicating Claims
8
Skills For Salvage Claims Analyst Resume
- Knowledge of legislation, compliance and tax reporting requirements. Good working knowledge of Manulife contract provisions
- Previous experience Managing and handling claims within authority levels
- Previous experience handling and understanding legal documents and financial instruments (i.e. checks, IRAs, CDs, mortgage statements, etc.)
- Medical background, such as nursing, medical technologist or experience in medical claims handling required
- Experience using multiple mortgage servicing systems
- Previous experience of working in an Analyst role
- Previous experience of working in an Insight / Analyst role
- Experience of Analysis & Coding
- Excellent understanding of the insurance claim process
9
Skills For Business Claims Analyst Resume
- Operate within our best practices guidelines, including timely reserve review, notes, payment requests, electronic diary
- Experience with medical, dental and/or institutional claims billing and payment in electronic and/or paper formats
- Experience as a processing analyst
- Good analytical, problem-solving and research aptitude
- Experience working with a Third Party Workers Compensation Claims Administrator on Indemnity, Attorney Represented and Medical Only claims
- Previous experience of working in Claims
- College/University graduate preferably with previous related work experience in the financial services, Health Sciences (Nursing, PT, MT, Medicine)
- Preferably with previous related work experience in claims processing or financial services
- Experience leading projects and cross functional teams in an automated production environment
10
Skills For HFP Claims Analyst Resume
- Good exposure of working within the general insurance industry
- Experience managing claims
- 3 months Claims filing experience
- Experience and ability to use Microsoft Office Software, including but not limited to; Word, Excel, Document Management, and Outlook
- Experience performing advanced analysis, formulas, data capture, charts, graphs, pivots and presentations with MS Excel
- Demonstrated ability to run and manipulate data from reporting application
- Strong working knowledge of the Microsoft Office suite of programs
- Work experience handling workers compensation, property and casualty claims
List of Typical Responsibilities For a Claims Analyst Resume
1
Responsibilities For Senior Claims Analyst Resume
- Build strong internal and external relationships through excellent written and oral communication skills and data presentation capabilities
- Strong verbal and writing skills for complex communications (presentations, negotiations, etc.) with clients, markets and colleagues at all levels
- Strong verbal and writing skills for complex communications (presentations, negotiations, etc.) with clients, markets and GC colleagues at all
- Strong organizational, time management, communication, and detail-oriented skills
- Excellent negotiation and investigation skills
- Excellent computer skills and proficient in Microsoft Office, i.e. Excel, Words, Powerpoint
2
Responsibilities For Warranty Claims Analyst Resume
- Self-motivated and self-directed as well as possess strong time management and organizational skills
- Above average attention to detail and verbal and written communication skills
- Understand and effectively execute mutually successful negotiations in litigated and non-litigated claims
- Demonstrate capacity for gathering and scrutinizing data to identify issues, opportunities, patterns, and sustainable business solutions
- Experience with the following programs required: Microsoft Outlook, Excel, PowerPoint, Word
- Query building experience
- Solid working knowledge - Word, Excel
- A good working knowledge about the concepts and practices of risk management is also a pre – requisite
3
Responsibilities For Senior Casualty Claims Analyst Resume
- Two years' recent claim adjudication experience (beneficial if with TPA or similar office setting)
- Experience in sales, marketing or finance
- Valid driver’s license and satisfactory background check
- Validate that all mandatory fields have been submitted properly
- Proven ability to work independently; make sound and timely decision with minimal guidance
- Three to five years’ experience handling personal lines automobile physical damage claims
- Prepares cases for legal action and secures evidence and documentation
4
Responsibilities For GAP Claims Analyst Resume
- Detail and results oriented with the ability to prioritize workload as needed
- Has at least 2 years of relevant work experience
- Critical Illness claims experience
- Construction claims experience
- Supply Chain, Continuous Improvement, Six Sigma, or Lean Sigma experience
- Medical Claims negotiation experience
- Professional, trustworthy and reliable with strong attention to detail
5
Responsibilities For Group Claims Analyst Resume
- Take responsibility and exercise good judgment consistent with Nordstrom’s high ethical standards
- Provide a legendary customer experience by ensuring our premsies and overall work environment is inviting and comfortable for our customers
- Mortgage experience
- Three to five years experience in Risk and Claims management
- SAS experience (or equivalent)
- Default experience
- Similar work experience required
- CLAIMS ADJUDICATION experience
- Five (5) years experience required in liability claims or related area
6
Responsibilities For Internal Mortgage Claims Analyst Resume
- Demonstrated an ability to be a fast learner with a proactive ability to take action and ownership of their work
- Work with appropriate business partners for effective resolution of suspense discrepancies
- Conduct analysis to ensure the client’s requirements are clearly understood, communicated and implemented to provide an effective solution
- Demonstrates positive attitude and works well in a team environment
- Demonstrates a positive attitude and works well with other team members
- Tracking & maintaining processing times to meet required deadlines
- Liaising closely with all disciplines e.g. claims, underwriting, technical accounting and client markets
- Working knowledge of the primary class of business to include an understanding of the operation of the policy and associated coverage issues
- Working knowledge of financial/accounting principles and general business practices
7
Responsibilities For Junior Claims Analyst Resume
- Understanding of legislative laws pertaining to carrier’s liability
- Working knowledge of Default Reporting
- Contributing accurate administration information for business reporting purposes
- Training Schedule: Mon-Fri, 8am-4:30pm (8-9 weeks)
- Working knowledge of CPT, ICDA-9, and HCPCS codes as well as OCB and TPL guidelines
8
Responsibilities For Salvage Claims Analyst Resume
- Understanding of London Market Claims systems
- Troubleshooting: leverages systems and tools knowledge to locate and repair root causes for error
- Working knowledge of Collections, Foreclosure, REO, and Loss Mitigation process
- Working knowledge of LPS (Fidelity), the Internet, EfannieMae.com, and FHA website
- Working knowledge of LPS (Fidelity), the Internet, EfannieMae.Com, FreddieMac.Com and FHA website
- Driving and travel as required #LI-POST
- Understanding and knowledge of the insurance/ reinsurance industry
- Working knowledge of corporate actions (e.g. stock splits, mergers, bond conversions, employee stock options)
9
Responsibilities For Business Claims Analyst Resume
- Developing processes/systems to ensure that knowledge and best practice standards are stored and easily accessible to the wider business
- Ensuring client contact information is up to date at all times
- Understanding of Claims and Insurance
- Being able to resolve situations with policies and procedures
- Communicating written position(s) to insured’s and other required parties on coverage, liability, damages and other issues
- Preparing comprehensive reports to claim leadership on case developments and policy issues, etc.
- Working knowledge of principles of accounting and accounts receivable
- Working with various systems, Business Objects, PKM”s, Essentus, among others
10
Responsibilities For HFP Claims Analyst Resume
- Understanding of standard and extended warranty plans for vehicles
- Understanding of standard repair times and basic principles of warranty and claim payment in the automotive industry
- Understanding of vehicle systems (i.e. Engine, Powertrain) and familiarity with warranty processes
- Working knowledge of Microsoft Outlook, Word, and Adobe Professional
- Working knowledge of Collections, Foreclosure, REO and Loss Mitigation process
- Liaise with the underwriting/processing teams on the requisite information/supporting documents for claims processing
- Adept at managing multiple competing projects under deadlines in an evolving, fast paced, environment
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