Claims Processor Resume Examples

Claim Processors work in the insurance industry and are responsible for processing insurance claims. Common duties listed on a Claim Processor resume example are analyzing insurance information, performing data entry, handling insurance claims reimbursements, and deciding whether a claim should be processed or denied. Based on our most successful resume samples for Claim Processors, a successful candidate should demonstrate insurance claim expertise, analytical thinking, attention to details, communication and writing skills, and computer competencies. Most Claim Processors hold a Bachelor's Degree in a business-related field, although on-the-job training is usually provided by insurance companies.

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Claims Processor Resume Samples

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Candidate Info

15

years in workforce

1

year at this job

HS

High School Diploma

Child Advocacy

Psychology

Claims Processor

Determined if claim submission was completed correctly, verified data and entered into system for adjudication
Worked directly with beneficiaries to resolve any errors and answer any questions regarding eligibility status
Reviewed payments history to determine final payment amount, if any
Translated foreign language claims into English utilizing translation software, then manually checked and coded appropriately
Processed claims adjustments when applicable

Candidate Info

34

years in workforce

34

years at this job

Senior Claims Processor

Provided independent decision making skills and demonstrated initiatives to resolve issues for internal and external customers
Answered incoming calls while handling in-person inquiries
Composed and typed routine letters and documented file activity on a regular basis on the computer
Processed and handled new non technical claims
Performed clerical functions which included opening, sorting and distributing incoming mail and processing outgoing mail, copy work, handled office subpoenas, filing and assisted the unit and supervisor in multiple projects using expert time management with little supervision
Paid vendor statements and handled payment complaints and discrepancies
Processed checks, stop payments, cancellations, voids and journal entry payments
Scheduled appointments

Candidate Info

8

years in workforce

1

year at this job

Certification

Claims Processor

Research and process claims according the processing guidelines and benefits
Contact and follow up with members for additional correspondence
Responsible for accurate and timely daily reports
Assists with the training of new hires
Third Party Administrator knowledge and experience
Knowledge and use of ICD-9, ICD-10 and CPT coding

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