Claims Analyst Resume Example
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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
- April 2022 - April 2025
- 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
- October 2018 - April 2022
- 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
- October 2015 - October 2018
- 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
- June 2011 - June 2015
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.
