Claims Analyst Resume Sample

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CONTACT INFORMATION
  • Mrs Katherine Gonzales
  • 411, The Grove,
  • Colorado Springs, Colorado, 34228,
  • United States
  • (555)-555-0113
  • example+katherine.gonzales@1001sampleresumes.com
WORKING EXPERIENCE
  • Brinfor
  • Colorado Springs, Colorado
  • July 2017 - July 2020
  • Claims Analyst
    • Investigated, evaluated and settled claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
    • Adjusted reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
    • Resolved complex, severe exposure claims, using high service oriented file handling.
    • Paid and processed claims within designated authority level.
    • Examined claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.

  • Hondabo Enterprises
  • Colorado Springs, Colorado
  • January 2014 - July 2017
  • Data entry clerk
    • Resolved complex, severe exposure claims, using high service oriented file handling.
    • Presented cases and participate in their discussion at claim committee meetings.
    • Maintained claim files such as records of settled claims and an inventory of claims requiring detailed analysis.
    • Contacted or interviewed claimants, doctors, medical specialists, or employers to get additional information.
    • Conferred with legal counsel on claims requiring litigation.

  • Marvela Inc
  • Colorado Springs, Colorado
  • January 2011 - January 2014
  • Data entry
    • Maintained claim files such as records of settled claims and an inventory of claims requiring detailed analysis.
    • Entered claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
    • Verified and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
    • Communicated with reinsurance brokers to obtain information necessary for processing claims.
    • Reported over payments, underpayments, and other irregularities.

EDUCATIONAL QUALIFICATION
  • Bachelor's Degree
  • Arts
  • Hillcroft University
  • Colorado Springs, Colorado
  • August 2006 - August 2010
KEY SKILLS

  • Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
  • Managing one's own time and the time of others.
  • Teaching others how to do something.
  • Determining how a system should work and how changes in conditions, operations, and the environment will affect outcomes.
  • Understanding written sentences and paragraphs in work related documents.

QUALIFICATIONS

  • Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
  • Knowledge of laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the democratic political process.
  • The ability to identify and understand the speech of another person.
  • The ability to see details at close range (within a few feet of the observer).
  • The ability to tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem.


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