Claims Analyst Resume
Today, insurance is available for every thing you possibly could own right from your life to the vehicle you drive, the home you stay in and the furniture you use. Many insurance companies offer coverage options for all tangible assets and human lives. However, the problem arise when one submits claim against insurance. To help solve such problems, which could have arose due to not reading the terms and conditions completely, insurance companies hire claims analyst. The role of claims analysts is to evaluate claims and ensure that they are presented in compliance with the company's rule.
A great attention to detail with good eyesight and complete knowledge of chosen insurance field are essential for this position. The claims analyst will check claims, see if they are complete, request additional details and certificates, and analyze whether the claim fulfills the eligibility criteria or not. This is a challenging job where at one side he has to save the company from paying unnecessary money to the insurer, and on the other, he also has to see that right dues are paid to the insurer. If a challenging job is what you crave for, and have necessary education and experience for the same, this sample resume is for you.
Claims Analyst Sample Resume
Bernard B. Cox
566 Oakwood Avenue
New York, NY 10004
Phone: 212-623-0194
Email: bbcox@anymail.com
Career Objective:
To obtain a claims analyst position with “Paramount Insurance Corporation,” where my skills in evaluating claims submitted would help resolving disputes and maintaining relationships between clients and company.
Summary of Skills:
- Strong analytical, critical thinking, and evaluation skills
- Experience of researching and finding facts on submitted insurance claims
- Excellent knowledge of the legal terminology used in insurance policy contracts
- Strong verbal and written communication, and problem-solving skills
- Ability to prioritize and multi-task according to the business needs
- Strong knowledge of Six Sigma principles, SAP, SQL, and computerized claim system
- Comfortable in working with ICD-9, CPT coding systems and HCPCS
Work Experience:
Claims Analyst
Trinity Health Care, Inc., New York, NY
October 2014 - Present
- Preparing, reviewing, and submitting health claims to state Medicaid agencies
- Performing eligibility checks for Medicaid providers
- Handling claims procedures for clients and guiding them on submitting additional documents
- Gathering, compiling, and analyzing data necessary for claims submission
- Coordinating with all the departments and ensuring personnel are aware about claims procedures
- Identifying claim files and securing appropriate medical documentation
Claims Analyst
ABC Company, New York, NY
February 2013 - September 2014
- Answered and responded to calls and emails from insurance companies and solved their queries
- Researched, validated, and resolved claims and performed billing adjustments
- Handled claims procedures effectively and follow-up with insurance companies
- Researched, obtained, and submitted supporting documents as required
- Monitored claims process and ensured benefits are received as per terms and conditions
- Assisted in monthly, quarterly, and annual audits and evaluated claim process
Education:
-
Bachelor's Degree in Finance
ABC University, New York, NY
2012
Reference:
On request.
