Claim Representative Resume Sample

Claim representatives investigate and process claims made for insurance coverage. For one claim, they assess the circumstances surrounding the claim, determine whether the customer fits the criteria for compensation, determine its monetary value, discuss the calculated value with the customer, authorize payments, document all actions, maintain documents on all claims dealt with and remain up to date on current regulations of insurance claims.

For many people, writing a resume can be daunting. If you are working on your own, it is easy to become overwhelmed with the amount of information you need to include and how best to present yourself.

The sample resumes below provide great examples of how to write an effective resume.

The Best Claim Representative Resume Samples

These are some examples of accomplishments we have handpicked from real Claim Representative resumes for your reference.

Claim Representative Resume Sample 1

  • Evaluated, evaluated, and negotiated over 100 claims of property damage, automobile accidents, workers’ compensation, and personal injury.
  • Gathered medical documentation for accident victims which was then used to negotiate fair settlements with the insurance companies.
  • Determined disability status of injured workers based on requirement guidelines established by the Social Security Administration.
  • Handled many difficult claims over the phone using tactfulness to satisfy both insureds and insurance companies.
  • Adhered to all customer service guidelines while continuously striving for 100% client satisfaction.

Claim Representative Resume Sample 2

  • Served as a support team member to recognize and correct internal controls for proper claim resource management.
  • Reduced outstanding balance on a single claim from over $8,000 to less than $300 by locating a primary policy through a search program that netted a savings of more than $100,000.
  • Proven skills in claim investigation, including supervisory skills in conducting employee terminations successfully.
  • Gathered pertinent information needed for most effective results in adjusting claims with the most minimal of efforts.
  • Personal accomplishments include high volume of closed files, awards for increased volume of business, and increased volume of transactions with minimal staff.

Claim Representative Resume Sample 3

  • Effectively and quickly resolved escalated claims; assisted in the recovery of $20,000 of loss.
  • Created and implemented a marketing campaign that resulted in an increase of $4,000 in revenue within the first month; recognized by president for outstanding performance.
  • Streamlined and organized accounts payable functions; cut down on customer wait time by 60%.
  • Trained staff to become proficient in the use of the pre-packaging program, which ultimately facilitated their growth in efficiency and accuracy.
  • Handled fourteen claims simultaneously to decrease claim settlements from one month to less than three days; recognized for superior performance by CEO at the annual awards banquet.

Claim Representative Resume Sample 4

  • Handled all claims with a positive, cheerful attitude and conveyed a professional image to clients.
  • Accepted responsibility for job assignments with ease and execute tasks in a timely manner.
  • Examined all cases for concealed damage, estimated replacement value, and title condition using the International Guide for Salvage Appraisers.
  • Experienced a high volume of cases per day while maintaining a high approval rate due to extensive experience gained from training courses.
  • Received letter of recognition from the Insurance Commissioner thanking me for saving the company money through careful inspections and quick turn-around times on all claims.

Claim Representative Resume Sample 5

  • Successfully resolved claims in a timely manner; completed quality work for 12 insurance companies.
  • Identified and resolved claims for customers in a timely manner; assumed role of marketing intermediary between customer and vendor.
  • Assisted in employee training by facilitating the development of company insurance retention strategies.
  • Developed skills through regular hours spent assisting other employees with their claims, taking notes on maintenance, construction, and pest control services for Pest Control Services Company.
  • Produced weekly consumer information inserts for Insurance Claim Services Company.

Claim Representative Resume Sample 6

  • Advised customers regarding claims processing procedures.
  • Promoted the overall recognition of insurance policies by promoting new policies to customers, notifying them of claims that were received, and processing said claims.
  • Worked closely with the sales department to maintain sufficient stocks on hand for sales associates to conduct out-of-state business.
  • Attained degrees in Bachelor of Arts (B.A.) and Master’s Degree (M.S.); performed weekly clerical work efficiently and maintained a positive attitude.
  • Obeys all company policies and procedures, including maintaining a thorough knowledge of all internal and external changes to federal, state, and local laws.

Claim Representative Resume Sample 7

  • Represents insureds to government agencies and employers who have been victimized by fraud.
  • Communicates effectively with clients, associates, and superiors. Performs investigative research. Communicates findings to client and associates.
  • Effectively presents a client’s case for compensation based on loss estimates which exceed the insurer’s cap amount.
  • Provides client service training to new associates in order to provide the highest level of customer service possible for each client’s claim.
  • Demonstrates superior time management skills as a result of scheduling, assigning work to others, and completing administrative duties within set deadlines as needed.

Claim Representative Resume Sample 8

  • Maintained a perfect score on the C.P.I.R.S.I., a required course which could lead to a complete loss assessment for a client, thereby saving the client money and additional risk from an audit notice from the underwriters during their due diligence process.
  • Researched, discovered, and ultimately settled the rights of my client in a matter that could have cost them hundreds of thousands of dollars.
  • Maintained exemplary communication with my client’s claims representatives to ensure their satisfaction with the work being done.
  • Negotiated my client’s value proposition with their underwriters, thereby ensuring favorable treatment for our client at the expense of the employer’s coverage.
  • Preserved my client’s rights against an insurer that was attempting to lower their excess by several millions dollars in order to avoid offering coverage in excess of an employee’s benefits package.

Claim Representative Resume Sample 9

  • Earned recognition for outstanding performance in claims and collections; was rated number one in each category.
  • Received excellent recognition through client surveys and referrals.
  • Received excellent recognition and client referrals after resolution of client problems.
  • Received excellent recognition and client referrals after resolution of claims problems.
  • Received award for outstanding customer service; was rated by clients as the best when it came to the home warranty insurance claim process.

Claim Representative Resume Sample 10

  • Handled 1300 inquiries and expedited claims within 4 months, including 100 personal injuries, 100 property damage, and 100 commercial Liability Claims.
  • Maintained a 90-percent accuracy rating for all inquires and completed over 100 research projects such as insurance coverage determination.
  • Pushed for the completion of all claims within twenty days of submission.
  • Indicated commercial liability risk features triggering higher premiums; conducted extensive research resulting in frequent callbacks to clients; achieved approval rate for a premium increase.
  • Received outstanding performance award; effectively communicated with corporate personnel to support progress and determine requirements.

Claim Representative Resume Sample 11

  • Dedicated to all aspects of our company, consistently worked extra hours to meet deadlines.
  • Displayed attention to detail, initiative, and innovation by continually researching new policies for our company by gathering market information.
  • Delivered customer service with an emphasis on exceptional knowledge of the products and services offered by all companies.
  • Regularly provided updates on current relationships with clients to other claims representatives.
  • Received numerous accolades for being a great team member at work, always smiling and having fun despite working long hours.

Claim Representative Resume Sample 12

  • Dislocated shoulder while climbing down a ladder; required medical attention.
  • Moved two heavy cases of chemicals during the middle of the night; avoided spills because of safety precautions.
  • Assured personal property was in compliance with insurance policies; responded to requests for information through the phone in a timely manner.
  • Quickly located and dispensed information in support of claims; assisted in locating records during telephone conversations.
  • Recognized by management for great work ethic, professionalism, and customer service skills after successfully handling over 300,000 claims.

Claim Representative Resume Sample 13

  • Identified, rated, and tracked the priority of all claims for investigation within the company guidelines.
  • Provided company customers with expedited claims resolution that met or exceeded their expectations according to company standards.
  • Mentored junior claims representatives by sharing my knowledge of investigative procedures.
  • Accomplished Top 10% of my department in reduction of outstanding claims.
  • Increased efficiency in processing a large number of incoming claims and reduced expense in claim investigations through the use of company-issued computer equipment and software.

Claim Representative Resume Sample 14

  • Established presence in the field by a brand new family to drive business.
  • Maintained high-performing claims operation while increasing production of claim adjusters and closing qualified claims.
  • Strongly advocated for increased revenues by personally managing claims operations, re-selling accounts, and increasing product coverage.
  • Developed sound broker relationships within 10 months while constantly seeking ways to improve business performance.
  • Received several awards for excellent performance; provided support to the company’s overall financial system through prudent policy decisions.

Wrap Up

To work as a claim representative, you need a general education degree while an associate/bachelor’s degree in business is beneficial. The skills targeted include logical thinking, data analysis, computer skills, organization, communicating with insurance claimers and fellow colleagues, documentation, attention to detail, problem-solving and multi-tasking.

Resumes are a crucial aspect of any job search. In order to make a good first impression, it is important that your resume be formatted and written professionally. To create the perfect resume, think about what skills and qualities you want your future employer to see.

Hope these samples gave you an idea of what your resume should look like and some tips on how to make sure that your resume stands out from the rest.


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