Claims Specialist Resume Sample

Claims Specialists help clients by preparing and processing their claims. Their responsibilities include performing site inspections, analyzing complicated insurance claims, reviewing new claim reports, communicating with insurance departments, organizing claim review plans, and resolving claims.

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 Specialist Resume Samples

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

Claims Specialist Resume Sample 1

  • Picked up the phone on the first ring to answer policyholders’ insurance claims.
  • Composed and typed letters of notification to policyholders with verifiable claims.
  • Rediscovered my love for people, tackling jobs that require tactfulness and patience, when helping customers restore their lives following disasters.
  • Acted as liaison between insureds and underwriters in settling disputes over claim packages.
  • Improved organization and time management skills by coordinating productivity and taking responsibility for tasks and projects assigned.

Claims Specialist Resume Sample 2

  • Handled 4,000 policy claims and prevented $500,000 in damages through early claim identification and response.
  • Liaised with local fire departments to ensure proper investigation of potential arson claims prior to processing insurance payouts.
  • Resolved client concerns regarding liability coverage by crafting a letter from the underwriter for an additional premium payment.
  • Achieved 20 percent reduction of business overhead before initiating a merger with a new firm through cost analysis and problem solving measures.
  • Recruited as a team leader position due to management’s recognition of superior performance toward achieving profit targets for the division.

Claims Specialist Resume Sample 3

  • Gathered, computed, and documented information for claims to be presented to agencies.
  • Resolved over 5000 policyholder issues in a timely fashion with clear communication from the beginning of claim process to conclusion.
  • Ranked #1 among 200 employees in Claims Department by exceeding expectations in criteria such as overall quality, productivity, and customer satisfaction.
  • Gained knowledge of regulation changes within industry while developing relationships with various insurance agents and agency personnel.
  • Discovered benefits provided by company-sponsored health club through establishing personal health goals and creating a self-sustained fitness plan that became personalized exercise program.

Claims Specialist Resume Sample 4

  • Supervised 6-person claims unit in expediting the assessment process, meeting or exceeding productivity goals.
  • Earned praise from management for meeting quality guidelines in resolving customer concerns.
  • Worked independently in meeting statistical productivity quotas by reviewing assigned files and identifying potential claim adjustments.
  • Supervised claims processing during relocation of in-house office staff without loss of productivity or employees’ morale.
  • Received award for outstanding leadership during an emergency situation when fire destroyed the Claims Unit’s building; helped employees maintain their focus on work priorities while implementing transfer plans to another branch office location.

Claims Specialist Resume Sample 5

  • Gathered all necessary documentation to process claims within assigned authority on first-in, first-out basis with an average processing time of 10 days.
  • Assessed customer complaints, appeals, and disputed claims on fair assessment of facts; recognized by peers as a team player who voluntarily helped cover shifts in absence of other employees.
  • Authored newsletter articles on timely topics related to new policy changes that were distributed across district to all Insurance Agents via email every month for six months resulting in increased awareness and understanding of policies among agents.
  • Achieved award for professionalism and excellence based on performance metrics; examiner for the Claims Department said I maintain high standards and follow through with each insurance claim accurately and in a timely fashion.
  • Received double-up award for outstanding production performance based on metrics during tax season; personally processed over 50 claims during the busiest time of the year.

Claims Specialist Resume Sample 6

  • Prepared, processed, and documented comprehensive property loss claims for customer satisfaction.
  • Regulated claim disputes from a third party to a prompt and equitable settlement, effectively utilizing tactics such as fact-finding, negotiation, and trial preparation.
  • Overhauled the company’s procedures for handling property claims by initiating new methods of documentation and ultimately increasing productivity.
  • Recognized for effective use of our state-of-the-art image processing equipment that enables users to digitize policies, photos, videos, and audio files into an organized digital library system.
  • Achieved top ten percent compensation in the nation as a Regional Assistant Claims Manager; oversaw customer enquiries from technicians nationwide and assisted in centralized technical investigations.

Claims Specialist Resume Sample 7

  • Took claims for personal injury, property damage, medical malpractice, fire loss, and worker’s compensation.
  • Gained experience in motor vehicle accident reconstruction by completing all investigations used to determine damages outside of court.
  • Captured information through the use of various computer programs including e-mail, Case Management Software (CMS), GIS mapping software.
  • Repaired relational essence damaged by assault; restored our policyholders’ connections to one another after a large tree had fallen on seven homes during a hailstorm.
  • Successfully coordinated responsibilities between automated software systems that had stopped communicating with each other due to network overlap.

Claims Specialist Resume Sample 8

  • Handled complex claims, handling over 500 instances of observation, calculation, and evaluation.
  • Resolved a claim in 30 days after the accident occurred; recognized by the Branch Manager for outstanding performance.
  • Awarded “All Stars” out of 400 employees for superior customer service to policyholders exceeding that standard set by the company.
  • Achieved top sales achiever status as a member of our 10-person team.
  • Effectively managed multiple work responsibilities while working overtime during peak periods without compromising the quality or quantity of work produced.

Claims Specialist Resume Sample 9

  • Provided superior client service by researching and resolving claims in a timely manner.
  • Assisted Company’s Regional Vice President with several investigations involving suspected fraudulent claim activities.
  • Earned choice assignment for meeting the Company’s customer service goal metric based on production, timeliness, and quality of service.
  • Awarded “Claims Quality” achievement award for resolving more than 100 non-standard claims within 15 business days from the inception date.
  • Developed research skills that showcased an ability to properly identify the steps required to find solutions while maintaining a high level of attention to detail.

Claims Specialist Resume Sample 10

  • Collected documents and information required to process claims within established time guidelines.
  • Diagnosed causes of clients’ loss for increased claim success rates.
  • Negotiated benefits with medical providers, employers, and carriers to ensure maximum recovery.
  • Met or exceeded individual production goals for five consecutive years; recognized by peers as an exceptional Claims Specialist.
  • Earned top performance awards through the use of advanced customer service skills to boost productivity and meet company standards.

Claims Specialist Resume Sample 11

  • Gathered, compiled, and arranged data in order to resolve property damage claims.
  • Helped clients learn about their options when filing a claim for an accident involving the insured’s vehicle.
  • Determined eligibility for coverage by verifying policy information.
  • Accurately priced repairs based on client-specific modifications after inspecting damages.
  • Used advanced technology systems to communicate with other departments over multiple phone lines while resolving property damage claims quickly.

Claims Specialist Resume Sample 12

  • Directed and instructed 5 employees to process all claims within company guidelines, ensuring each claim went through the proper channels.
  • Exceeded quota for claimant response by email, phone, and letter; recognized by Regional Manager for performance.
  • Achieved award for accuracy in processing during first quarter of employment with client’s largest insurance carrier partner.
  • Recognized as a “five-star” agent amongst 110 other employees during client convention for outstanding customer service ratings.
  • Acted as a liaison between internal departments and external vendors to resolve issues related to reimbursements from medical providers.

Wrap Up

To work as a Claims Specialist, a high school diploma, or equivalent is required. Prior work experience is preferred but not required. To succeed as a Claims Specialist, it is essential to have excellent analytical skills, organizational skills, interpersonal skills, communication skills, time management skills, logical thinking, and customer service skills.

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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