Claims Administrator Resume Samples
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Claims Administrator Resume Samples
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DC
D Crooks
Darian
Crooks
5920 Zakary Course
Detroit
MI
+1 (555) 262 9010
5920 Zakary Course
Detroit
MI
Phone
p
+1 (555) 262 9010
Experience
Experience
Detroit, MI
Claims Administrator
Detroit, MI
Runolfsson and Sons
Detroit, MI
Claims Administrator
- Provide assistance and ensure transparency in the communication to key internal and external clients e.g., IT, business development, actuarial
- Assess accuracy and efficiency of claims management strategies, and provide feedback and recommendations
- Develop a good working knowledge with Claims Module
- Prepares correspondence explaining adjustments, denials and makes written requests for missing information
- Create accurate records of each loss on the claims management system
- Effective time management and strong work ethic
- Contract Analysis: Use of established claims handling protocols to review and provide claims administration
Boston, MA
Pensions Claims Administrator
Boston, MA
Mante-Bosco
Boston, MA
Pensions Claims Administrator
- Participate in individual and team development activities/training to maximise both individual and team performance
- Developing and maintaining strong relationships with our broker clients to ensure that we retain post retirement business and not lose it to our competitors (Annuities and ARFs)
- Positive and pro-active attitude towards change and continuous improvement
- Answering all customer queries in a timely and efficient manner
- Adhering to all relevant Revenue Legislation
- Strong technical competence
- Adhering to the Service Level Agreements in place for claims settlement
present
Dallas, TX
General Liability Claims Administrator
Dallas, TX
Wolff, Kessler and Langosh
present
Dallas, TX
General Liability Claims Administrator
present
- Advises management of potential areas of improvement for loss control
- Searches for opportunities to pursue indemnification, contribution or subrogation while reviewing claim files
- Handles pending cases as assigned
- Handles and resolves complaints and problems arising out of daily operations of the department
- Makes recommendations on how to precisely move forward with mandatory settlement conferences, mediations, arbitrations and trials as well as formal requests for authority /resolution
- Maintain GL files using internal and external computer systems
- Critical claims analysis on new and existing files
Education
Education
Bachelor’s Degree in Accuracy
Bachelor’s Degree in Accuracy
Belmont University
Bachelor’s Degree in Accuracy
Skills
Skills
- Keen attention to detail with strong analytical ability
- Approachable being able to listen to clients
- Highly organized, delivery-orientated with the ability to proactively manage stakeholder expectations
- A good team player with good interpersonal skills
- Excellent organization skills and ability to plan and prioritize workload and work effectively under pressure
- Ensures quality and timeliness of team deliverables are consistent within segment of responsibility
- Strong attention to detail
- Excellent attention to detail and accuracy
- Strong interpersonal skills
- RG146 certification / Diploma in Financial Planning is highly regarded
15 Claims Administrator resume templates
Read our complete resume writing guides
1
German Claims Administrator Resume Examples & Samples
- Provide operational support to Payment Protection Insurance (PPI) business units
- Demonstrate strong understanding of processes and activities
- Report on PPI activity
- Proactively support all units and teams
- Fluent German
- Excellent knowledge of Microsoft Excel
- Driven & motivated by achievement
- A call centre background
- General insurance knowledge, and/or specifically in Payment Protection Insurance
- Knowledge of insurance regulation/compliance requirements
2
Life Claims Administrator Resume Examples & Samples
- RG146 certification / Diploma in Financial Planning is highly regarded
- Exceptional communication and interpersonal skills
- Strong ability to self-motivate, prioritise competing demands and manage own workload to meet individual and team targets whilst continuing to provide a high quality level of service
3
Pensions Claims Administrator Resume Examples & Samples
- Administering claims on all of the core systems to include calculation of tax free lump sums, taxable balances, Annuities and Approved Retirement Funds (ARF) which require an in depth knowledge of both Revenue Legislation and the internal suite of Individual and Corporate Pension Products
- Developing and maintaining strong relationships with our broker clients to ensure that we retain post retirement business and not lose it to our competitors (Annuities and ARFs)
- Adhering to the Service Level Agreements in place for claims settlement
- Ability to work under pressure especially coming up to year end and in the run up to the budget
- Answering all customer queries in a timely and efficient manner
- Adhering to all relevant Revenue Legislation
- Participate in individual and team development activities/training to maximise both individual and team performance
- Third Level Degree
- Superior communication skills, written, verbal and excellent customer focus
- Team player with the ability to take full ownership of work and responsibility for performance
- Highly organised with the ability to multi-task and make decisions
- Strong technical competence
- Positive and pro-active attitude towards change and continuous improvement
- Excellent accuracy and numeric ability with a strong focus on attention to detail
4
HOA Claims Administrator Resume Examples & Samples
- Associates Degree or in lieu of a degree two years’ relevant work experience
- Minimum two years collections and/or loss mitigation experience
- One year post charge off collections, repossession, remarketing, REO, foreclosure, loss mitigation or bankruptcy experience
- Working knowledge of MS Office, including Outlook, Excel, Word; Black Knight/Director
- Functional expert in the specific area of specialization (foreclosure, collections, REO, bankruptcy, loss mitigation)
- Analytic oriented
- Minimum three years’ collections experience and two years’ post charge off collections, repossession, remarketing, REO, foreclosure, loss mitigation or bankruptcy
- Knowledge of skip tracing software and BK servicing systems
- Prior departmental experience; foreclosure claims experience or pre-foreclosure experience
5
Claims Administrator Resume Examples & Samples
- Experience within the Financial Services Industry (preferably life insurance) working in a similar role
- Strong administration computer skills
- High computer skills
- Understanding of life insurance products and claims process
- Exposure to medical terminology through work experience or education
6
Claims Administrator Resume Examples & Samples
- Act as the first point of contact for clients, customers and employees
- Confident working in a fast moving, exciting environment
- A minimum of APA or CIP qualifications
7
Claims Administrator Resume Examples & Samples
- Administrative Analysis: Includes claims data analysis and first level adjudication for life, medical, accident and flex benefit claims administration
- Contract Analysis: Use of established claims handling protocols to review and provide claims administration
- Compliance: Review and adherence to internal compliance and client disclosure requirements, external vendor contracts and benefit provisions, policy digests and employee communications to ensure alignment with client expectations and legal requirements
- Participates in select client meetings to provide specific solution when needed
- College Graduate
- 3 years of experience in the insurance or financial services industry; life insurance / benefits administration experience is an advantage
- Knowledge with Microsoft Office
8
Group Claims Administrator Resume Examples & Samples
- Understanding of life insurance products
- Proven Customer Service experience
- Ability to operate under pressure with conflicting multiple priorities
9
Claims Administrator Resume Examples & Samples
- At least 1 year experience in insurance or financial services industry, life insurance, benefits administrations experience an advantage
- Knowledge with MS Office
- Ability to work with teams
10
Life Claims Administrator Resume Examples & Samples
- Processes customer requests in a timely and accurate manner
- Meets established quality control measures
- Meets individual productivity requirements
- Communicates with customers through written and oral correspondence
- Provides follow up on requests that cannot be immediately resolved
- Builds relationships with staff from other departments to ensure queries are responded to in a timely manner
- Escalates issues to management when needed
- Works with management to set daily priorities to ensure prompt and efficient service
- Maintains flexibility in a high speed, demanding team environment
- Identifies process improvements to increase efficiencies and streamline processes
- Actively participates in departmental team meetings and other open forums
- Assists with department projects and initiatives as needed
- 1-2 years of industry experience (annuity, mutual funds, banking, or insurance)
- Strong Math Skills
- Strong commitment to customer service and quality
- Strong research and follow-up skills
- Proven ability to work independently and in a team environment
- Knowledge of Microsoft Office Suite and Lotus Notes preferred
11
Asbestos Claims Administrator Resume Examples & Samples
- Under general supervision and acting on own initiative, performs advanced secretarial, clerical, and administrative duties for Executive level management
- Possesses extensive knowledge of office practices and procedures
- Possesses and displays the ability to apply techniques, procedures and criteria in carrying out a wide variety of related clerical and administrative tasks for executive management
- 4 + years of prior related experience
- Demonstrated experience designing, organizing, and administering a detailed document flow process
- Demonstrated excellent verbal and writing skills
- Demonstrated experience handling multiple tasks
- Knowledge of litigation process preferred
- 2 years of experience with the company preferred
- Familiarity with LawTrac, Serengeti Tracker or equivalent legal matter management software, MS Office Suite programs, specifically Word, Excel, and familiarity with database software including Access or equivalents for information management and production of reports for in-house and outside legal counsel, financial tracking and reporting, audit and risk management
12
Claims Administrator Resume Examples & Samples
- Entering new claims into the computer system
- General administration related to claims including information gathering, treatment requests and obtaining incident reports
- Answering incoming calls and, where possible, dealing with inquiries, or directing the call to the appropriate person
- Generating and sending appropriate letter/faxes/emails to follow up on claims and sending referrals to specialists
- Keep updated records and provide these to key stakeholders in a timely manner
13
Claims Administrator Resume Examples & Samples
- Project & Process Excellence
- Performance & Total Cost Management
- Value Creation
- Grade 12 National Certificate with Exemption
- Clear ITC and Police clearance
14
Trade Claims Administrator Resume Examples & Samples
- Support BSC / Genpact & LOC sales teams in the administration of trade claims, including leading issue resolution & process improvement
- Ensure complete and comprehensive Audit (all – internal, external, controls & financial) control & compliance for ANZ. Governance on end to end month end process from commercial teams to GL delivery
- Build & maintain strong working relationships with the BSC, global TCM colleagues, Sales finance partners
15
Claims Administrator Resume Examples & Samples
- Undertaking reviews/audits of claims against a qualitative audit tool
- Assess accuracy and efficiency of claims management strategies, and provide feedback and recommendations
- Conducting audits of policies and procedures ensuring that “best practice” is met with regards to statutory, regulatory and ethical requirements
- Applying critical thinking and an evidence based approach to case management and claims settlement
- Utilising audit data and results to develop reports for the U.S
- Identification of key strengths and areas for improvement in U.S. operations; and
- Providing recommendations and feedback to stakeholders in relation to skill gaps identified
16
Senior Claims Administrator Resume Examples & Samples
- Determine compensability and total value of claim
- 4+ years of experience in an adjuster role, demonstrating ability to manage simple to complex claims
- Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to details
- Computer literacy, including MS Office, Word, Excel
17
Claims Administrator Resume Examples & Samples
- Convey positive attitude and team spirit for optimum provision of services to customers
- Determine subrogation potential and pursue recovery where applicable
- Maintain acceptable claim closure ratio
- Negotiate settlement of claim if warranted
- Bachelor’s degree, or four or more years of equivalent work experience
18
Claims Administrator Resume Examples & Samples
- Receives client correspondence and files it in the correct files
- Draw claims files for Claims Advisors
- Metrofile / archive older claims files
- Ad hoc administrative tasks
- Registering of new claims and updating claims records on system
- Creating of claims files
- Prepare insurance claims forms or related documents and review them for completeness
- Call or write to insured or other involved person for missing information and post or attaches information to claim file
- Generate First Notification of Loss, acknowledgments, closing and additional correspondence
- Facilitate / Assist with payment for claims where required
- Minimum of 1 years' work experience required
- Clear and concise oral and written communication skills
- Proficient in Microsoft Office tools (or equivalent) - Outlook, Word and Excel
- Self-organized and can work independently
- Good command of English an Afrikaans
- Good written communication
- Approachable being able to listen to clients
- Strong admin skills
19
Claims Administrator Resume Examples & Samples
- Complete claims reviews to validate accuracy and validity of client reported claims
- Perform claims administration as required: validating and logging claims files and data, tracking, reviewing and aging of claims
- Produce, analyze and update control reports and escalate any issues with potential or known financial impact
- Develop effective working relationships with external clients (ceding companies) and local office and colleagues across the organization to ensure both client and internal customer needs are met
- Analyze and validate reinsurance files and corresponding premium payments. Processing and providing accurate and timely information to internal and external stakeholders in relation to the client data
- Actively seek enhancements and make recommendations for new processes to improve efficiencies or rectify inaccuracies or information gaps. Assist with small to medium sized client projects
- Document and follow operations procedures and adhere to SOX process controls
- Ensure accurate, complete and timely checking of all personal data received against OFAC list/PRIME software
- Provide assistance and ensure transparency in the communication to key internal and external clients e.g., IT, business development, actuarial
- Perform ad hoc tasks as requested
- 1-3 years experience in reviewing/approving insurance claims
- 1-3 years life reinsurance/insurance experience preferred
- Post -secondary education or equivalent with a background in business, mathematics, economics or accounting
- Strong analytical and problem-solving skill
- Intermediate to advanced MS Excel skills
- Shows judgment in critically evaluating client data
- Takes responsibility for quality, completeness and accuracy of work
20
General Liability Claims Administrator Resume Examples & Samples
- Critical claims analysis on new and existing files
- Maintain GL files using internal and external computer systems
- Work directly with TPA in proactively handling the general liability claims through timely investigations, accurate reserves and resolution focused action plans and strategy
- Promptly respond to calls from customers, store associates and division personnel
- Handles and resolves complaints and problems arising out of daily operations of the department
- Drives thorough file documentation and active diary review
- Searches for opportunities to pursue indemnification, contribution or subrogation while reviewing claim files
- Regular examination of ways to improve claim handling making recommendations to the liability manager for continued improvement of Company guidelines for processing general liability claims
- Advises management of potential areas of improvement for loss control
- Makes recommendations on how to precisely move forward with mandatory settlement conferences, mediations, arbitrations and trials as well as formal requests for authority /resolution
- Handles pending cases as assigned
- Attend regularly scheduled File Reviews with TPA and Roundtables where appropriate
- Indirectly leads, mentors and trains Claims Adjusters and Claims Investigators
21
Claims Administrator Resume Examples & Samples
- Analyze and interpret claims documents to locate correct data applicable to adjudication of the claim
- Prepares the Explanation of Payment showing relevant amounts and deductions (i.e., unpaid payment, interest, refundable insurance and fees, deductions from auto insurance claim settlements)
- Determines Retail Value and value at date of loss using appropriate reference materials
- Prepares correspondence explaining adjustments, denials and makes written requests for missing information
- Prepares Supplementary GAP payments based on new information submitted by lender, dealers, insurance companies and Agreement Holders
- High school diploma required, finance and/or accounting courses preferred
- Experience in a customer service role, strong preference for experience in an office and/or call center environment
- Insurance experience a plus
- Knowledge of finance and insurance
- Microsoft Word and Excel
22
Claims Administrator Resume Examples & Samples
- High School Diploma, 2 years’ college preferred
- 3 years of risk management, insurance, claims experience
- Ability to utilize online claim management systems
23
Claims Administrator Resume Examples & Samples
- Load Claims Notifications onto admin system
- Prepare payment requests for settlement
- Develop a good working knowledge with Claims Module
- Communicate effectively with Internal and external clients
- Update and maintain procedure notes/processes
- Generate reports for internal/external clients
- Maintaining Month End closure
- Maintain claims admin system
- Assist with audits when required which may include taking part in client audits or covering certain tasks for other members of the team
- Good academic record - A level passes at minimum
- Experience working in a similar role within Financial Services
- Keen attention to detail with strong analytical ability
- Intermediate to advanced MS Excel and Access skills required
- Highly organized, delivery-orientated with the ability to proactively manage stakeholder expectations
- Excellent organization skills and ability to plan and prioritize workload and work effectively under pressure
- Customer focused; with the ability to develop relationships with both internal and external clients/customers
- The ability to take on responsibilities and see them through to completion
- Can work to deadlines and consistently meet agreed service standards
- A good team player with good interpersonal skills
24
Claims Administrator Resume Examples & Samples
- Assists in general administration of claims: Prepares and maintains claims files by obtaining reports of injury/illness from vessels; medical reports from medical providers and claimants; maintains insurance database; taking telephone calls from vessels, claimants, medical providers and attorneys; notifying appropriate office staff of claims when they occur; resolves minor claims issues
- Reviews invoices from medical providers for accuracy and completeness ensuring that medical reports are included when necessary. Coordinate payment of medical invoices with medical providers and union medical plans, contracted medical auditors, and contracted nurse case managers. Prepares claims for recovery from underwriters or union medical plans and monitor recoveries
- Provides information and documentation requested by the Claims Manager for internal and external auditors, outside company counsel and various departments in the company. Prepares month-end close to balance insurance system with the general ledger. Provide administrative support to the department as directed by supervisor, including filling and making copies
- Confirms invoices for medical services received are authorized, accurately processed and transferred between the Insurance/Claims system and SAP completed and accurately
- Prepares reports used by the accounting Department in the reconciliation of applicable insurance account numbers
- Three to five years of experience in a position related to bodily injury liability or workers’ compensation insurance claims administration or adjusting required
- Must be proficient in Microsoft Word, Excel, and Adobe Acrobat Writer
25
Claims Administrator Resume Examples & Samples
- Meet our Support Center objectives which include… “If you are not serving the Guest, serve someone who is” and “consistently deliver an awesome family friendly experience so that every guest leaves happy.”
- Work closely with your Claims Lead and Team to investigate General Liability and “Fast Track” incidents by effectively executing claims handling practices in accordance with departmental standards and procedures. Resolve guest’s complaints, issues and claims in a fair and equitable manner always upholding Chuck E. Cheese’s and Peter Piper Pizza’s core values
- Perform quality investigations to ensure timely assessment of facts and liability by obtaining video/photos, statements, medical authorizations, records and expense documentation
- Interview and work with guests, Cast Members, landlords, attorneys and vendors to help ensure complete and factual information is gathered on a timely basis
- Utilize Origami (claims management system) to properly document claim files. Maintain accurate and complete notes and claim file documentation. Manage assigned claims using a diary/task system and act with due diligence to manage case backlog
- Work closely with the Claims Lead and Team to determine an appropriate liability exposure. Set realistic reserves based on the facts of the case and anticipated outcome. Negotiate settlements with guests to reach an amicable resolution. Execute proper releases to ensure everyone is protected
- Accurately process and ready expense documentation related to claims for entry into the review and approval process
- Perform other duties and responsibilities as assigned
- Customer Service or Guest Relations experience with a progressive organization
- Claims handling is a plus but not required – We will train you!!
- Experience in a self-insured environment is a plus
- Willingness to commit to learning/studying to obtain a Texas Property/ Casualty or Multi Line adjuster’s license within 12 months of employment
- Organized, detail oriented, flexible and able to multi-task
- Exceptionally strong communication and math skill
- Ability to work closely with team members in a friendly and engaging manner
- Proficient with MS Office and Outlook
26
Junior Claims Administrator Resume Examples & Samples
- Investigate claims by interviewing claimant, employer and witnesses
- Maintain adequate reserves for life of claim
- Bachelor’s degree (preferably in Risk Management or Business), or four or more years of equivalent work experience
- Strong organizational skills with demonstrated ability to work independently and deal effectively with multiple tasks simultaneously
27
Claims Administrator Resume Examples & Samples
- 1 year administrative experience, preferably with Insurance products
- Proficient in MS Office including Word and Excel
- Good command of spoken Chinese and fair of English
28
LMI Claims Administrator Resume Examples & Samples
- Upload claims information submitted
- Respond to customers enquiries and requests efficiently and effectively
- Provide superior assistance to the claims and recoveries team members
- Develop a good understanding of the mortgage industry and processes
- Understand best practice and overall quality of policy origination requirements
- Keep managers aware of potential issues, areas for process enhancement and lender educational requirements
- A minimum of one year’s experience within the mortgage and or insurance industry
- Organisational and communication skills
- Demonstrated ability to work well in a team
- A Strong attention to detail
- Sound Excel and Word skills
29
Claims Administrator Resume Examples & Samples
- Successfully manage workload in a timely and professional manner in line with company policy and credit control guidelines
- Follow agreed processes and procedures to ensure customers are treated in a fair manner following the guidelines provided by clients and underwriters and ensuring the practice of TCF is observed
- Actively follow team procedures; taking ownership of issues and brings to Team Managers attention opportunities for improved efficiencies to processes or procedures
- Successfully use the technology and information available to identify and assist daily activity
- Understand where KPI levels are consistently met or exceeded; acknowledging and seeking to remedy areas of concern when necessary; take ownership of lost opportunities
- Provide an accurate and efficient ‘same-day’ administrative support, with duties including the actioning of Customer specific email inboxes and internal workflows
- Consistently provide a high level of service through the successful nurturing of and cooperation with internal relationships with those departments who depend on or who influence own work
- Proactively build own knowledge and seeks opportunities to develop own skills
- Strong customer focus and team working skills adhering to internal and external customer satisfaction values
- Proactive in reviewing own work and highlighting areas of concern
- Reliable and flexible approach to work situations
- Integrity towards individual customers and ensures that the interests of both the company and the customers are met
- Proven success in a call centre or customer service environment or equivalent
- PC literate with comprehensive knowledge of call centre software
30
Claims Administrator Resume Examples & Samples
- Written and verbal communication skills to communicate with various departments and external clients
- Proficient with Excel – sort filtering, formatting cells, converting decimals to dollars, moving data, creating formulas, etc
- Critical thinking skills
- Ability to multi-task and maintain a high production pace and focus
- Support all functions2. Help to continually improve business processes and find workflow efficiency3. Ability to Multi-task and work with multiple computer systems at one time
31
Claims Administrator Resume Examples & Samples
- Basic understanding of underwriting principles
- Strong knowledge of Microsoft Office, specifically Excel, Word, and Outlook Exchange; proficient in Internet Explorer
- Communicate effectively with all levels of internal and external personnel, both verbally and in writing
- Negotiate with agents and brokers
- Determine when problems should be escalated
- High School diploma or equivalent, with a minimum of one (1) year of underwriting or related medical insurance experience. Associate degree preferred
- Working knowledge of medical conditions/terminology and insurance products
32
Claims Administrator, Strata Resume Examples & Samples
- Analytical with a high level of attention to detail and accuracy
- Excellent communication skills (written & verbal)
- Intermediate MS Office and Excel proficiency required
33
GAP Claims Administrator Resume Examples & Samples
- Communicates with lenders, insurance agents, dealership finance and insurance managers, attorneys and agreement holders
- Assembles all required documents; finance contract, GAP Agreement, insurance documents, police report, etc
- Determines the payoff balance of the loan based on the interest calculation used in the Finance Contract, calculates interest to the date of loss and prepares an amortization schedule
- Prepares the Explanation of Payment showing relevant amounts and deductions(i.e., unpaid payment, interest, refundable insurance and fees, deductions from auto insurance claim settlements)
- Processes GAP Payments on the AS400
- Office experience
- Verbal communication skills
- Familiar with automobile comprehensive and collision insurance
34
Claims Administrator Resume Examples & Samples
- Check references on TIA system in line with post received
- Act as point of contact for their Claims team by collating relevant information and any other request from the team
- Undertake administration duties, such as photocopying, printing, faxing etc when required
- Manage all settled batching of post scanned in mail room in accordance with procedure including offsite storage with Iron Mountain
- Organise and sort incoming and outgoing post for the Claims area
- Manage all electronic emails/faxes ensuring they are passed onto relevant claims departments and is completed within the agreed SLA
- Manage kofax ensuring that batches of post are passed through to the relevant claims and ensure this is completed within agreed SLA
- In order to adopt a flexible approach, the Claims Administrator may be required to assist in other claims areas e.g
35
Claims Administrator Resume Examples & Samples
- Manage incoming mail, email and fax notification of claim
- Assign work to claims analysts for handling
- Initial claim set up
- Management of claimant cheques
- Manage extensive reports and audit requirements
- Work very closely with claims analysts in all locations
- Identify opportunities for process improvement
- Communicate with clients, advisors, legal, internal partners and management
- Experience with handling confidential information
- Intermediate to advanced level Word and Excel skills
- Proficient data analysis, research, problem-solving, decision-making, influencing skills
- Willingness to embrace new business concepts, approaches and ideas
- Interpersonal and strong customer service skills
- Aptitude for dealing with demanding and sometimes contentious situations
- Ability to manage/schedule a fluctuating, unpredictable and stressful workload
- General understanding of Life Insurance
36
Claims Administrator Resume Examples & Samples
- Inputs new loss and payment information on computer
- Generates and maintains claims records, reports, and logs for assigned claims unit. Submits completed information to appropriate personnel or bureaus
- Types forms and letters for claims representatives and adjusters. Sends out correspondence such as delay or rental letters and surveys to customers and agents
- Take first reports over the phone, by mail, or fax and processes new losses
- Requests title information and makes copies of all documents received from the processing of titles
- Prefer 1 year of claims experience
- Prefer 1 year of data entry experience
- 1 years previous administrative support experience preferred
37
Claims Administrator Resume Examples & Samples
- University graduate or equivalent education
- Bilingual in written and spoken French preferred
- 3 to 5+ years prior retail or customer service experience preferred
- 1 to 3+ years of customer service experience
- Computer proficiency in Microsoft Office applications and system databases
- Ability to work well in an individual and team environment
38
Claims Administrator Resume Examples & Samples
- Answer in English and/or French inbound claims related calls from members, producers and others
- Make callbacks in English and/or French as required
- Proficiently determine the needs of the caller then provide accurate and timely resolution
- Meet tight timelines under pressure while delivering quality service
- Own the results, share work experiences and willingly seek and accept personal accountability
- Continuously learn about customers, their priorities and their expectations
- Take ownership and responsibility for resolving customer concerns with every interaction
- Be flexible, personally embrace change and commit to continuous learning
- Support the organization’s and the Claims Team’s key priorities
- Demonstrate leadership, model customer service values and drive quality and process optimization
- Manages business needs through entry level project and analysis work while assigning a high priority to customer excellence, quality and meeting service level agreements
- Manage the claim notification process: including updating various systems and maintaining the claims register, sending out claim requirements and regular ongoing follow up for outstanding requirements
- Communicate verbal and written information as appropriate to those with a need to know, ensuring information is clear, accurate and compliant with all legal, privacy, confidentiality and company standards
- Perform all required calculations and ensure all activities are in compliance with reinsurance treaties, legal and internal standards, including timely submission of information to the reinsurance companies and of the various tax information forms to government offices
- Assist other team members to ensure that the team meets objectives
- Create ad hoc correspondence and reports for members, producers and external partners
- Communicate with various Reinsurance Companies regarding the submission of claims under various reinsurance treaties, including the recovery of reinsurance funds owing on paid claims
- Receive, verify and match claims benefit cheques to be mailed to claimants
- Meet service level agreements and achieve productivity and quality standards
- Deal with customer complaints defined in company guidelines
- Meet privacy and compliance guidelines
- Self starter with demonstrated ability to prioritize own work and ability to research/problem solve and make decisions both independently and collaboratively within a fast-paced team environment
- Must be proficient in both verbal and written communication in both English and French to effectively communicate with internal and external customers/partners and vendors
- Understanding of insurance products, services, systems and regulatory requirements, with the ability to recognize discrepancies, anomalies and inconsistencies
- Results-oriented with emphasis on accuracy and attention to detail and the ability to understand and balance both the short and long-term impact of decisions and actions
- Effective multi-tasking and time management skills, including the ability to adapt to changing demands and priorities
- Strong organization skills to effectively monitor and track information with quick ability to learn and leverage new technologies
- Strong reasoning and judgment to balance commitments, financial soundness and quality customer focus
- Creative problem solving skills to resolve transactions and has an interest in research and problem solving
- Mathematical skills needed for calculation of benefits, taxation and reinsurance
- LOMA 281 and 291 courses an asset
- Post-secondary education preferred and/or related work experience (minimum 1 year work experience)