Claims Coordinator Resume Sample
Arvel Lueilwitz
811 Gracie Fall,
Philadelphia,
PA
+1 (555) 999 3294
Work Experience
Medicare Senior Claims Coordinator
11/2017
-
PRESENT
Phoenix, AZ
- Responsible for interface with members and providers as required regarding status, process and outcomes of complaints and appeals
- Coordinate the daily activity of the Automotive Protection Claims team
- Manage the workflow of the team, ensuring that tasks are prioritised
- Work as a team member globally, sharing skills and knowledge in order in to provide excellent claims handling advice
- Liaise with internal and external customers to provide and obtain feedback as well as customer projects
- Support global teams with service level monitoring and reporting
- Produce management information and written reports as required
- Ensure that enquiries and correspondence are responded to within agreed timeframes
- Coordinate or handle complaints
Claims Coordinator
06/2015
-
06/2017
Boston, MA
- Document new processes and ensure that existing ones are reviewed and updated at required intervals
- Completes and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third party payors
- Researches and resolves any electronic claim denials
- Reports any reimbursement trends/ delays to supervisor (e.g. billing denials, claim denials, pricing errors, payments, etc)
- Process payments as directed by Claims Leadership and according to company policy
- Assist with directing internal and external incoming calls and/or taking phone messages
- Process and distribute mail, faxes and reports to Claims Examiners
- Processes and request police reports, photographs, and maintains logs
Trade Claims Coordinator
07/2012
-
03/2015
Boston, MA
- Responsible for accurate statistical entry of all claims, check posting, voiding, or stop payment of checks in the AS400 computer system
- Skills: Computer keyboarding. written and verbal communication. PC skills including Microsoft Word, Excel and Power Point, typing skills
- Experience Required: 1 year experience in a Claims department. 2 years office experience
- Insurance claims management experience, with a heavy focus on Property & Casualty (P&C) claims
- General familiarity with handling high volume of work
- Upon receipt of new claim assignments; analyze the nature of the claim to identify and determine coverage and thoroughly evaluate questions of compensability, to include required investigation and handling in accordance with the MSIJ requirements and/ MSMM Claims Handling Guidelines
- Performs timely and thorough investigations in an effort to comply with all jurisdictional requirements and/or entitlements
- Conducts an informed case analysis to address claim entitlements, initiate reserve changes within assigned authority, provide recommendations to supervisor or manager where assigned authority is exceeded
Education
Colgate University
2006 - 2011
School's Degree in Physical Science
Professional Skills
- Excellent communication skills, both verbal and written with strong analytical, problem and problem solving skills
- Excellent mathematical skills with an accounting, medical billing, or banking background strongly desired
- Excellent communication skills with experience serving as the principal driver for claims process across a fast moving, mission critical enterprise
- Demonstrates attention to detail and has strong organizational skills
- Strong creative writing/reporting skills - proficient in grammar and sentence structure
- Strong claims / billing skills
- Excellent communication skills – written – telephone – personal
How to write Claims Coordinator Resume
Claims Coordinator role is responsible for excel, microsoft, computer, typing, finance, training, database, procurement, auditing, printing.
To write great resume for claims coordinator job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Claims Coordinator Resume
The section contact information is important in your claims coordinator 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 Coordinator Resume
The section work experience is an essential part of your claims coordinator 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 coordinator 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 coordinator position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Claims Coordinator resume experience can include:
- Manages, controls and negotiates timely and equitable claim payments and settlements in accordance with jurisdictional and fair claims practice requirements and company policy and procedures
- Skills: Computer keyboarding; written and verbal communication; PC skills including Microsoft Word, Excel and Power Point, typing skills
- Shipping education and/or experiences relevant to the area of responsibility
- Logistics education, preferably shipping Education and/or experiences within container transport (claims handling is an advantage)
- Previous experience in working in a lending or financial instruction with an emphasis in auto loan reconciliation
- 2-3 yrs experience working with Workers Compensation Insurance Company or a Third Party Administrator
Education on a Claims Coordinator Resume
Make sure to make education a priority on your claims coordinator resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your claims coordinator 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 Coordinator Resume
When listing skills on your claims coordinator 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 coordinator skills:
- Good computer skills required including Word and Excel
- Organizational Skills – Ability to prioritize individual and departmental workloads
- Good Communication/negotiation skills
- Strong Administration, Task Management, Planning and Scheduling Experience
- Exceptional writing and communication skills, with a heavy focus on phone and email
- Knowledge or familiarity with the medical insurance carrier experience strongly desired
List of Typical Experience For a Claims Coordinator Resume
1
Experience For Os-risk Claims Coordinator Resume
- Solid understanding of insurance and risk management principles
- Develop a solid working relationship with the Client’s and other utility locate companies and their claims coordinators and management
- Validate and maintain incident reporting tool
- Capture all technical impacts stemming from design change requests to input into the consolidated claim
- Previous experience in a similar role working on a major infrastructure project
- Scanning of all opening and closing notices and attaching to TAM
- Monitoring incoming accidents from the off airport locations and ensuring all required documentation is attached
- Closing of all files ensuring that fees/payments from all subscribes are recorded to TAM before closing
- Gathering and Investigating of Vehicle Damage Claims
2
Experience For Trade Claims Coordinator Resume
- 1- Daily pre-processing of incoming Life & Disability claim mail, faxes, or electronic submissions and preparation of claims inventory spreadsheets
- 3- Ordering of necessary medical reports and claims documentation from claimaint or the claimants physician requiring phone calls or electronic correspondence
- 5- Proofreads claims examiner correspondence and coordinates printing and mailing
- Documents actions by accessing and entering data into Excel Access database
- Responsible for coordinating product returns and freight claims filing
3
Experience For Damage Claims Coordinator Resume
- Daily communication with customers on status updates as well as answering inquiries relating to issues
- Take ownership and responsibility for resolving customer concerns with every interaction by providing accurate and timely resolution
- Handle all incoming call from broker /TPA/UW’s assisting with queries
- 2- Pre-processing of claim payments, intial claim setup in workflow system and claim number assignment
- Monthly generation and distribution of company reports and preparation for Claims Meeting
4
Experience For Industrial Claims Coordinator Resume
- Maintains up-to-date status of all pending claims
- Monthly balancing of claim reserves (reconciliation)
- Maintains documentation of provider claims/billing forms to support payment decisions
- Ensures that claims processing is consistent with applicable policies, procedures and department guidelines
- Provide guidance to client as to claim process along with direction regarding likely outcome and timelines
- Maintain claim files, diary, and/or record keeping, etc
- Work with team on the accurate filing of claims
5
Experience For WC Claims Coordinator Resume
- Work as key liaison between the TPA and internal management personnel to include the resolution of claims handling issues or problems
- Create a tracking tool to assist in follow up and resolution of claims
- Initiates claims against offending parties
- Monitors/responds to ongoing questions or requests for additional information
- Assists in providing monthly reports for Project Coordinators
- Carry out all work activities upholding the Company values of Safety,Innovation, Collaboration, Integrity and Excellence
6
Experience For Warranty Claims Coordinator Resume
- Basic working knowledge of Word, Excel and Outlook required
- Automotive Service Support - Conduct diagnostic troubleshooting and assist with service execution
- Focus on the big picture while being detail-oriented
- Pursue subrogation/recovery, including first party property damage
- Coordinate development of program data/reporting for control and management purposes
- Handle incoming inquiries from third party providers
- Possess of time management and problem solving ability
7
Experience For Benefit Claims Coordinator Resume
- Maintains current case diary and ensures appropriate file documentation
- Provides accurate claim system documentation and paperless file documentation as required by company claim manuals and procedures
- Responsible for completion and/or submission of claim forms and reports as required by outside agencies
- Investigates and evaluates recovery potential. Conducts timely and thorough subrogation investigation in accordance with company policy and procedures. Timely handling and referral of all claims involving recovery potential
- Provide exceptional customer service to our customers, to include prompt responses to the insured’s, claimants, medical providers, etc. in accordance with company policy and procedures
8
Experience For Medicare Senior Claims Coordinator Resume
- Partner with internal and external customers to bring about an appropriate claim resolution in a timely and effective manner in accordance with MSIJ and MSMM Claims handling Guidelines
- Assists attorneys, risk manager and adjustors with processing claims, subrogation and workers compensation paperwork
- Reviews files for missing documentation, contacts third parties to request claim documentation, prepares incoming information and enters the information into a claims information system
- Prepares files, reports and related materials for review to document claims, subrogation and workers compensation
- Obtains insurance information, medical documentation, payment and billing records or records supporting claim. Coordinates with adjustors, attorneys or risk manager in finalizing documentation for claims, subrogation or workers compensation
9
Experience For Life Claims Coordinator Resume
- Reviews and prepare files, archives files and gathers supporting documentation from claimants, witnesses, law enforcement, medical professionals or insurance companies
- Compiles information and enters data into a claims management system. Updates the claim management system with incoming data, updated losses, medical, billings or payments made
- Prepares and drafts correspondence, claimant notices, requests for information, settlements, releases, and discharges of title
- Prepares and files electronic workers compensation forms, first report of injury (FROI) and supplemental claim documentation
- Interacts with attorneys and opposing counsel, law enforcement, claims adjustors, risk manager, safety manager, claimants, insurance agencies, other agencies and the public
- Performs computer searches, data inquiries, and creates reports to coordinate billings and payments
- Prepares and maintains insurance files and claimant files
10
Experience For Associate Claims Coordinator Resume
- Searches public and private records
- Prepares files, reports and related materials for review to document claims, subrogation, and workers compensation
- Communicate, on both a written and oral basis, with stakeholders including agents, IMO’s, claimants, beneficiaries and internal departments such as Underwriting, Legal/Compliance and Actuary. Strictly adheres to HIPAA guidelines in all communication
- Professional industry designations such as Chartered Life Underwriter (CLU), ICA’s Associate/Fellow Life and Health Claims (ALHC/FLHC), LOMA’s Associate Life Management Institute (ALMI) or demonstrated work toward achieving designations
- Administers Self-Insured medical only claims in compliance with the rules and regulations of the State of California by authorizing treatment and billings, setting medical examinations and acting on all other requests to bring the file to closure. Answers questions and explains workers’ compensation benefits to the employees
- Communicate effectively and tactfully with all levels of management, attorneys and other individuals
- Prior experience on the Ivos Workers Compensation software
List of Typical Skills For a Claims Coordinator Resume
1
Skills For Os-risk Claims Coordinator Resume
- Very good German and English language skills, written & oral
- Experience in a Claims department. 2 years office experience
- Previous auto dealer experience in a finance office or equivalent auto dealership experience
- Experience:6 months to one year of related experience
- Experience of dealing with complex and varied tasks
- Experience in a similar processing role in insurance desired
- Heavy typing and data entry experience required
2
Skills For Trade Claims Coordinator Resume
- Work in a team environment and in an ever-changing environment along with the ability to prioritize multiple tasks
- Experience handling liability claims, preferably PD, BI and PIP
- Previous experience working in workers compensation
- Experience handling medical only and lost time claims
- Set the right priorities by spending time of what is important
- Validate the claim against defined agreed criteria
3
Skills For Damage Claims Coordinator Resume
- Insurance or Car Warranty experience
- Claims experience
- Automotive service experience Ability to approach conflict resolution with a positive attitude
- The ability to manage multiple concurrent tasks and to prioritize workload
- Work experience
- Five years of medical malpractice or general liability claim experience –(required)
- Five years insurance, legal, health care operations, and medical experience – (required)
- Work experience related to the position
4
Skills For Industrial Claims Coordinator Resume
- Insurance/claims experience
- Hospitality experience
- SAP, TMS, Syncada Freight Payment System experience
- Preference for experience with Worker’s Comp Claims
- Demonstrated ability to collaborate with others is a team player and builds business relationships throughout the organization
- Proven ability and expertise to solve complex problems and issues
5
Skills For WC Claims Coordinator Resume
- Multi task and prioritize workload to meet deadlines
- Demonstrated proficiency using Microsoft Office Suite (Word, Excel, Power Point, Access and Outlook)
- Be tactful in resolving issues and demonstrates respect to others
- Rapidly adjust to changing priorities
- Excellent problem solverDetail and task oriented
- Experiences with Operations Claims Handling and Intermodal activities/processes
6
Skills For Warranty Claims Coordinator Resume
- Strong knowledge of various computer software (Word, Excel and Power Point) with ability to create reports
- Prioritize and complete a high volume of work and manage multiple projects
- Continuously learn about our products, our sponsors, our customers, their priorities and their expectations
- Demonstrated ability to collaborate with others and work as part of a team
- Setting educational goals to improve personal performance/continuing education
- Typing speed of 40 words per minute of better
- Pulling appropriate support documentation as requested
7
Skills For Benefit Claims Coordinator Resume
- Partnering with internal teammates to resolve open questions as necessary
- Managing full equipment Claims Handling for port of Bremerhaven, Hamburg, Wilhelmshaven and inland terminals
- Coordinating safe cargo handling between stakeholders (local and area)
- Representing the carrier on relevant equipment claim surveys and attending meetings called for from port authorities on potential incidents
- Ensuring cost saving cooperation with local subcontractors
- Negotiating damage handling with the freight station providers beyond standard rate agreements
- Managing a team of young, motivated colleagues based in German, Netherlands and Belgium offices
- Processing Claim Recoveries from third parties
8
Skills For Medicare Senior Claims Coordinator Resume
- Maintaining transparency to superiors and colleagues on task and performance
- Evaluating further efficiency potentials with operations departments, and local partners to optimize processes
- Interacting with both internal and external customers to follow up for Damage documentation
- Sending complete damage package to insurance company
- Interface with other departments in Exelon including Audit Services and corporate accounting
- Liaise with accounting and finance to execute month end close, Cost-To-Serve, CFF, PO management, GL account coding, etc.,..
9
Skills For Life Claims Coordinator Resume
- Participate as a key team player by supporting department functions and goals
- Coordinate billing and collection of Company damage cases and property damage cases
- Apply common sense and logic to issues rather than relying on strict procedure, solution-oriented
- Serve as a resource to claims auditing when needed
- Familiarity with computer along with intermediate knowledge of Microsoft Word & Excel
- Data Entry of 8,500+ Keystrokes per hour
- Process the claim on the system as per agreed and defined process
- Speak a foreign language(s)
- Able to produce high-quality written and numerical reports
10
Skills For Associate Claims Coordinator Resume
- Define and deliver product claims strategy and ambition for Global brands providing a critical link between Regional/Category R&D, Legal Marketing and Brand Development and Building
- Work on a product and/or technology from concept to launch within multi-disciplinary teams and liaising with scientists to tell a story and drive understanding of the technology and consumer benefit and how this is communicated in advertising, print, TV, digital spaces and in store
- Have an in depth understanding of category, brands, competitive environment, technology and consumers (their buying habits and drivers; through robust consumer insights) to generate, develop and support winning product claims
- Communication – Ability to identify and effectively communicate unresolved problems to Management in a timely manner
- Experience with TAM or Policy Works broker management systems
- Develop consumer relevant product demonstrations to enable innovation and technology understanding in consumers, sales teams and pr/advertising agencies
- Deliver robust claims support dossier and final recommendation to relevant teams including approval of all packaging, label copy, advertising briefs and final commercials, public relations materials, and sales materials
- Support relevant strategic activities as part of the larger claims team to “raise the game” in the claim generation process/ in the way we develop claims
List of Typical Responsibilities For a Claims Coordinator Resume
1
Responsibilities For Os-risk Claims Coordinator Resume
- Computer skills: Microsoft Excel, Word, Access and Outlook
- Fluent German language and very good command of English (written/oral)
- Experience in transportation
- Transportation and Freight Payment experience
- Demonstrate improvement in customer satisfaction
- Experience in insurance business would be advantage
- Reviewing the RTV email inbox and responding to queries
- Communicating with Buying Offices and Vendors via telephone
- Confirming and updating TAM with adjuster assign details and claim number
2
Responsibilities For Trade Claims Coordinator Resume
- Ensuring that all subscribers are advising of new claim
- Monitoring Large loss notifications and advising UW and EMT of same
- Updating claims with Return Authorizations as received
- Preparing appropriate paperwork for claims
- Identifying vendor trends and specific needs
- Setting up new claims in TAM
- Advising UW of of new claim submission
3
Responsibilities For Damage Claims Coordinator Resume
- Maintain reserves in TAM (including noting and attaching subrogation and DD cheques)
- Conduct audits of open and closed liability claims being handled by the TPA
- Knowledge of the State of California Workers’ Compensation rules and regulations
- Dedicated to meet the expectations of internal and external customers
- Decide and solve problems independently
- Work with large quantities of data
- Works with outside vendor to arrange light duty offsite if opportunities don’t exist at the branch
- Manage multiple tasks simultaneously, and meet deadlines under pressure
- Proficient in Microsoft Word, Excel and Outlook. Ability to learn and work with new programs
4
Responsibilities For Industrial Claims Coordinator Resume
- Respond to claims appeals and disputes in a timely manner
- Track disputes and adjustments to monitor compliance
- Prepare and refine loss correspondence in Reinsurance / Insurance applications and facilitate with IT the appropriate access to MRAm’s secured FTP site for legal counsel’s review
- Manage and prepare hard copy/CD Claim correspondence by consulting with the Claims Divisions, Third Party Administrators and/or Micrographics to enforce a paperless environment; Support the Claims Content Stewards to comply with corporate’s Enterprise Content Management strategies
- 4- Taking of incoming calls to claims department and prioritizing and transfer to appropriate claims personnel. Resolve simple incoming customer claims calls and requests
- Sets up new claims in the Claims Management System (CMS)
- Accurately records all payments in CMS
5
Responsibilities For WC Claims Coordinator Resume
- Requests appropriate documentation from claimant, manager, co-workers, providers, etc
- Processes payments and recoveries through CMS
- Creates new claim files and keeps all claim files current
- Maintains calendar of deadlines and/or actions to be taken for each claim
- Reviews all claim forms for completeness
- Ensures evaluation of all claims for determination of type and amount of benefit payable
- Prepares regular periodic reports and reviews system reports to ensure adherence to corporate and regulatory standards within established guidelines
6
Responsibilities For Warranty Claims Coordinator Resume
- Maintain confidentiality and treat sensitive information appropriately
- Complete work in a timely manner or notify appropriate person with an alternate plan
- Follow instructions and respond to management direction
- Liaise with carriers and representatives through claim process
- Answer basic coverage questions
- Conduct and participate in claim reviews
- Work closely with the field, as needed, to assist them in the reporting, documentation and handling of variety of claims to include liability, auto, workers compensation and property claims
- Assist in the management of property claims under large deductible program to include outside adjuster assignment, collection and transfer of supporting loss documentation and the review and administration of loss transfer from the field to Risk Management
- Handle large volumes of claims data and documents and attach to corresponding file in Risk Management Information System (RMIS). Create and provide regular claims reports, analysis and loss run reports from various TPA and RMIS systems. Assist department management in claims loss analysis reviews
7
Responsibilities For Benefit Claims Coordinator Resume
- Establish new claims for all lines that are handled internally and maintain a working diary to follow up internally. Process internal reserve and payment transactions in the RMIS
- Assure adequacy and accuracy of loss data in RMIS to include BOU assignment. Review and Correct loss data monthly after data load
- Works with internal management to help maintain company assets schedules
- Assist in Risk Management and Claims special projects as needed
- Receives audits and maintains the documentation packet from Emergency Response Coordinators which outlines accidents that have damaged highway property. It contains
- Makes arrangements for payment options with uninsured/underinsured parties
- Initiates small claims processes for unpaid claims. Initiates bad debt write-offs
- Proficient use of Microsoft Suite Software
8
Responsibilities For Medicare Senior Claims Coordinator Resume
- Navigate/manage complaints through the claims process
- Identify potential issues and make decisions as appropriate to the process
- Ensure compliance with procedures and documentation accuracy
- Provide claims related support to various departments to include customer service, sales, and quality/technical
- Dispatch photos and inspections to appraisers
- Process auto approved claims
- Process payments for claims
- Claims Administration – Review, make necessary adjustments and adjudication of claims for Valvoline and VALVOLINE INSTANT OIL CHAGNE business units
- Fluid Analysis – Act as the liaison between consumers/customers and the New Products Development Laboratory for all fluid analysis needs
9
Responsibilities For Life Claims Coordinator Resume
- Manage the claim notification process, including updating various systems, sending out claim requirements and regular ongoing follow up for outstanding requirements
- Own the results of your work, share work experiences and willingly seek and accept personal accountability
- Excellent knowledge of Windows, MS Office products (in particular Word, Excel)
- Demonstrate commitment to success for yourself, as well as your employer and their customers
- Work cooperatively and assist team members to meet team and company objectives
- Self-starter with demonstrated ability to prioritize your own work, and ability to research/problem solve and make decisions both independently and collaboratively within a fast-paced team environment
- Proficient in both verbal and written communication to effectively communicate with internal and external customers, partners and vendors
10
Responsibilities For Associate Claims Coordinator Resume
- Willingness to learn multiple claims systems
- Written and spoken proficiency in French an asset
- Small dollar general liability physical damage claims
- Collect data, investigate, and research
- Communicate with operations, customer service, claimants, etc
- Claim payment process improvement
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