Claims Manager Resume Samples

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A Claims Manager processes insurance claims for payment and answers questions about those claims or forwards concerns on to their supervisor or to an investigator. Depending on the type of insurance that is being handled, the process can become more or less complicated. Skills commonly found on a sample Claims Manager's resume include the ability to review, analyze, and settle different kinds of commercial and personal claims, and experience in working with multimillion dollar losses. A Bachelor's degree in business, business administration, or finance is the minimum educational requirement on a Claims Manager's resume.

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1

Claims Manager

Managed the Commercial and Medicaid/Medicare projects with issues due to the turn over to Managed Medicare and Medicaid.

  • Built and maintained close relationship with all payer provider representatives to insure proper claims processing.
  • Resolved Health First issue in regards to improper denials by 80%.
  • Recognized and resolved issues pertaining to contracts and improper billing procedures.
  • Assisted in implementing new intake as well as billing procedure to streamline the billing processes to improve the revenue cycle management by 45% overall 2013 fiscal.
Candidate Info
17
years in
workforce
1
year
at this job
2

CLAIMS MANAGER - PHYSICAL DAMAGE & RENTAL OPERATIONS

Successfully managed team of 30 geographically separated employees, with an oversight of Physical Damage and Rental Operations in the Mid-Atlantic and Northeast states.

  • Led process consistency and consolidation of multi-regional workforce which resulted in a 35% increase in productivity and delivered a 1.6% reduction in operational expense.
  • Developed rental analytics, engaged key stakeholders, and rolled out improved rental process which resulted in a savings in excess of $8.9M YTD.
  • Improved employee engagement results by 28% and finished in the top quartile of all companies as identified through JD Powers.
Candidate Info
30
years in
workforce
2
years
at this job
BA
Bachelor of Arts
3

Regional Claims Manager - Georgia, Alabama, South Carolina, Louisiana

Responsible for $100 million dollar property casualty claims operation

  • Instituted claims best practices resulting in 8% reduction in severity payments.
  • Created accountability standards resulting in 20% reduction in litigation costs.
  • Enhanced employee communication through creation of monthly open forums.
  • Improved employee retention by 15% through consistent personal feedback initiatives.
Candidate Info
14
years in
workforce
2
years
at this job
BA
History
Aic
4

Casualty Claims Manager

Led team of 3 supervisors, 20 adjusters, 1 nurse and 1 claims evaluator in the proper settlement of bodily injury claims. Managed processing of high-exposure and litigation claims with $100K in payment authority. Oversaw the budgeting, salary administration and expense control of the department.

  • Improved and enforced claims handling efficiencies to speed up claims payments and adjust reserves more effectively.
  • Reduced legal expenses by 20% within a year by utilizing in-house resources, cutting costs of outside counsel.
  • Led and represented the Claims Department as a Steering Committee Member and Subject Matter Expert on the MetLife New Hire eOrientation project.
  • Developed supervisory team to improve skills and assume additional responsibility.
  • Introduced round tabling of special investigation claims to ensure compliance with state unfair practices statutes.
Candidate Info
7
years in
workforce
4
years
at this job
AS
Business Management
5

Health Claims Manager

Manage all aspects of the claims and customer service area for clients supported in the Seattle Office.

  • Directed staff of ~80 FTE's to ensure client performance guarantees and company goals were met.
  • Developed and implemented a monthly production report template that was adopted by the entire Western Region in order to standardize performance goals.
  • Prepared and managed expenses to meet departmental budget goals.
  • Oversaw the successful transition over to a new claims system, Atlas for Sound Health.
  • Assisted with the onboarding of two new clients - ILWU-PMA and County of Kern.
  • Played integral role in the SSAE16 audit for certification of the Atlas Claims System.
Candidate Info
9
years in
workforce
6
years
at this job
Accounting Coursework
6

Claims Manager

Created and maintained accurate claim procedures and claims processing by federal regulations.

  • Documented all customer interactions using appropriate computer systems with strict adherence to confidentiality agreements, policies and procedures.
  • Established long term customer relationships through prompt and courteous service.
  • Led warehouse improvement initiatives to advance operational efficiencies and reduce freight claims.
  • Assisted in creating department's computer programing.
  • Identified and implemented supply chain improvement opportunities.
Candidate Info
18
years in
workforce
14
years
at this job
Accounting
7

Corporate Claims Manager

Reduced casualty claims corporate wide from $1.4 million to $17 thousand through contract compliance, negotiations, monitoring of TPA's, creating cost allocation mechanism for reimbursement of casualty claims which reduced the overall net claim cost's

  • Coordinated safety and loss prevention programs for seventy-one properties through internal audits and on-site safety inspections.
  • Responsible for compliance with Federal, State and local regulatory agencies.
  • Administered all corporate insurance litigation files in twenty-nine jurisdictions in the U.S., Canada and Cayman Islands.
  • Created and implemented corporate compliance reporting data bases. Areas of training include alcohol awareness, driver awareness, and accident investigation, MSDS, and claims mediation.
Candidate Info
12
years in
workforce
4
years
at this job
BA
Political Science
MA
Master of Arts
8

Claims Manager

Managed all Personal and Commercial line claims

  • Monitored claims with insurance carriers to ensure prompt resolution and provided client feedback
  • Evaluated all questionable and denied claims and successfully negotiated coverage with clients' insurance carriers
  • Updated and maintained the Agency Management System (AMS) and related excel spreadsheets with all reported claims, claims notes, claims status, updated reserves, closures, and financial transactions
  • Generated carrier loss runs and communicated with clients' insurance carrier representatives to provide comprehensive reports (daily, weekly and monthly) to clients and Account Managers
  • Initiated claim reviews with Account Teams and Managers regarding claims in excess of $25,000 and presented status to Roehrs Chief Operating Officer
  • Developed and implemented a claims reporting and filing system that provided an active record used to expedite claim closure which exceeded clients' expectations
Candidate Info
9
years in
workforce
3
months
at this job
BA
History
9

Claims Manager

Responsible for resolution of benefit claims from VISA-USA and VISA-Latin America cardholders.

  • Supervised a thirty person claims department consisting of claims examiners, team leaders and analysts.
  • Ensured compliance with Service Level Agreements between Mondial and Underwriters ACE & Chartis.
  • Created and implemented a management leadership initiative for supervisors, "Lead By Example".
  • Collaborated with Client Services to maintain timely, open communication with ACE and Broker, CBSI.
  • Directed the professional development and individual growth of staff through mentoring and focus sessions.
  • Delivered exceptional customer service in strict adherence to corporate mandates.
  • Successfully complied with and met all Service Level Agreements.
Candidate Info
29
years in
workforce
3
years
at this job
BS
Political Science
10

Claims Manager

Established long term customer relationships through prompt and courteous service.

  • Led warehouse improvement initiatives to advance operational efficiencies and reduce freight claims.
  • Created and maintained accurate claim procedures and claims processing by federal regulations.
  • Assisted in creating department's computer programing.
  • Identified and implemented supply chain improvement opportunities.
  • Documented all customer interactions using appropriate computer systems with strict adherence to confidentiality agreements, policies and procedures.
Candidate Info
18
years in
workforce
14
years
at this job
Accounting

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