Claims Analyst Resume Sample

Claims analysts work for Insurance companies to analyze and reviews insurance claims for completeness, accuracy and eligibility. Their duties include monitoring liability claims from beginning to the end, verifying information on submitted claims, reviewing insurance policy to determine which charges are eligible for payment, reconciling a claims adjuster’s estimates, negotiating payment to all parties and ensure payments are made.

For many, 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 Claims Analyst Resume Samples

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

Claims Analyst Resume Sample 1

  • Handled multi-line customer claims; evaluated policy coverage, estimated and documented damages and losses, and presented findings to adjusters.
  • Testified in court on three separate occasions for cases involving arson investigation.
  • Identified multiple ways to increase performance by processing 1000’s of dollars worth of claims per week.
  • Presented strategies for innovative program which increased productivity by 20%.
  • Topped third highest sales quota in company history through aggressive plan that identified service gaps, identified client needs, identified clients’ risk exposure and recommended cost effective solutions.

Claims Analyst Resume Sample 2

  • Analyzed and interpreted legal liability policies and coverage issues.
  • Prepared and wrote many important letters to adjusters, doctors and/or attorneys on various insurance matters and practices.
  • Understood the goals of independent agent groups’ marketing efforts. Presented relevant information to management including study findings, market research results, claim ratios, etc.; successfully participated in staff meetings as a member of team involved with producing reports for field offices as well as company-wide materials.
  • Reviewed policyholder complaints; performed analysis on these complaints to determine if they were related to any specific actions or inactions on the part of the agency. Determined whether further investigation by district or state managers was needed.
  • Created and implemented new training on coverage review for office staff. Used computer-based learning program to enhance learning about federal regulations, agency policies, and claim practices.

Claims Analyst Resume Sample 3

  • Handled claims for high net-worth individuals with insurance worth up to $250 million.
  • Presented a case study on scaling new capabilities in the organization’s cloud computing environment during an international conference, including the benefits of cost reduction and increased performance.
  • Built, tested, and deployed tools utilizing application programming interface (API), leading to improved turnaround time of 7 minutes average vs. 28 minutes average for prior processes; awarded by executive leadership team.
  • Achieved reputation as one of top analysts within organization, resolving over 60% of cases before receiving outside assistance; recognized by company leaders during quarterly meeting.
  • Delivered successful projects under tight deadlines while maintaining 100% compliance with internal controls.

Claims Analyst Resume Sample 4

  • Received praise from several independent medical review officers for investigating complex claims in a timely manner.
  • Helped to minimize workers’ compensation costs after identifying fraudulent expense reports.
  • Skilled at reconciling the statistics on over 500,000 clinical encounters which resulted in an overall reduction of $100 million within six months.
  • Pioneered new efforts to assist cancer patients with their insurance needs after discovering many ACOs were not billing all necessary codes.
  • Received President’s Award for training and instructing other claims analysts; organized classes by developing manuals and workbooks based on examination of best practices in field.

Claims Analyst Resume Sample 5

  • Handled mediations, arbitration hearings, and court proceedings in the adjudication of claims.
  • Reconciled claimant requests for payment to insurance contracts by correlating policies with damage reports.
  • Supported workers’ compensation claim processing team in establishing new procedures following client’s restructuring efforts.
  • Set up a satellite office to manage increased workloads due to rapid growth in business volume.
  • Implemented reporting procedures that allowed for more efficient analysis of data; recognized my contributions by upper management staff who approved my request for additional budget resources needed to perform the work.

Claims Analyst Resume Sample 6

  • Analyzed customer claims to identify cause of damages and recommended corrective action.
  • Prepared appeals for denied claims, demonstrating thorough knowledge of policy provisions and contract interpretation to resolve unresolved disputes.
  • Developed a new installation claim reporting system that reduced cost by 30% while increasing accuracy.
  • Redefined process flowchart for filing first notice of loss claims resulting in a 20% improvement in first notice of loss conversion rates.
  • Successfully resolved several under-reserves totaling over 9 million dollars through systematic analysis using individual account records as well as group insurance statistics from similar companies.

Claims Analyst Resume Sample 7

  • Reviewed, analyzed and processed work-related injury claims with a 98 percent accuracy rate.
  • Worked within the guidelines of an insurance company in order to minimize potential losses while increasing customer satisfaction.
  • Reopened closed files with 99 percent accuracy to ensure each claim was thoroughly examined and evaluated for fairness in settlement.
  • To maintain high productivity standards required successful management of assigned claimants while adhering to administrative procedures and departmental deadlines.
  • Achieved compensation levels consistent with industry standards by maximizing claim values, minimizing claim costs, and maintaining compliance with state laws.

Claims Analyst Resume Sample 8

  • Reduced the number of insurance claims by 10% in three months.
  • Reached understanding of multiple product offerings between companies, allowing me to facilitate reconciliations and recoveries for product reimbursements.
  • Resolved multiple vague or vague outstanding items in call reports which led to increased production in second quarter.
  • Gained customer satisfaction by providing prompt settlement service through several streamlined processes which allowed quick response time when responding to inquiries from customers.
  • Trained new staff on internal controls and procedures within department, resulting in an increase in productivity after each was certified in good standing.

Claims Analyst Resume Sample 9

  • Handled all aspects of claims from beginning processing to final settlement.
  • Resolved complaints by insuring complete customer satisfaction through effective communication and negotiation skills.
  • Proficient in processing, maintaining, developing, and interpreting data related to personal injury protection (PIP) claims.
  • Received Employee Recognition Award for coordinating efforts with other departments that resulted in significantly reduced costs while maintaining outstanding service levels.
  • Devised new divisional process for tracking PIP claim information; recognized as the division’s top performer and promoted to Supervisor over a staff of six employees.

Claims Analyst Resume Sample 10

  • Conducted over 100 investigations for first notice of loss to settlement.
  • Implemented new claim solutions, successfully saving the company thousands of dollars in unnecessary claim payouts.
  • Convinced claims adjusters to check multiple damages on total loss vehicles by preparing creative cost benefit analysis report.
  • Pioneered creative trends in insurance claims by utilizing appropriate technology and user-friendly software to maximize efficiency throughout the department.
  • Advised upper management on carrier contract changes that saved company more than $200K annually.

Claims Analyst Resume Sample 11

  • Reduced Auto Claims Costs by 23% for Property Casualty Company.
  • Redesigned policy forms and reduced claim processing errors by 50%.
  • Reduced Errors in Rate Filings to State Department of Insurance by 30%.
  • Predicted Hurricane Storm Surge Heights For Local, Regional, National news Weather Agencies. (FEMA)
  • Issued Corrective Actions to Underwriters on More Than 95% of Claim File Reviews Within 24 Hours .(ISO 9002 Certification)

Wrap Up

To work as a Claims Analyst, you need a Bachelor’s Degree and preferably, business experience. Claims Analyst should be computer literate, sound at Mathematics, persistent, curious, good at communicating, have sound research skills and be familiar with accounting software.

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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