Claims Assistant Resume Samples
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Claims Assistant Resume Samples
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RH
R Haley
Randy
Haley
4978 Koch Knolls
Dallas
TX
+1 (555) 823 4207
4978 Koch Knolls
Dallas
TX
Phone
p
+1 (555) 823 4207
Experience
Experience
San Francisco, CA
Claims Assistant
San Francisco, CA
Bernhard-Mante
San Francisco, CA
Claims Assistant
- Assist with workload and workflow management by monitoring claims systems, distributing workload and completing profile updates
- Develop a working knowledge of insurance carrier claim management systems and access carrier claims information
- Create Provider Dispute letters and track their aging
- Assist Case Managers in follow-up procedures, including diary system
- Works under general supervision and exercises a moderate level of discretion in performing duties of the position
- Assists in copying and production of material associated with subpoena work and Law Enforcement requests
- Provide relief for Receptionist and assist with front desk
New York, NY
Surety Claims Assistant
New York, NY
Gleason and Sons
New York, NY
Surety Claims Assistant
- Receive hard and electronic copy claims and/or notifications; investigates and researches claims information; obtain Claim File Instructions (CFI) and open Claim/Lawsuit in database
- Create and/or maintain spreadsheets to track state law regulations
- Process payments for costs incurred through the claims process; Research/verify OFAC prior to paying claimants and consultants; Track outgoing payments made by principal while under claim status to ensure OFAC regulations are adhered to. May submit reserve worksheets as directed
- Work closely with the claims representatives to ensure projects are taken through completion, providing administrative support as requested
- Process salvage payments from obligees, principals and other parties
- Work closely with home office claims assistants and executives to communicate claims status, payment processing, and obtain approvals per policy
- Take inbound calls from principals, obligees, subcontractors, claimants, agents, and other parties and field any questions pertaining to the bonding and claims process
present
Detroit, MI
WC Claims Assistant Lead
Detroit, MI
Goodwin-Rodriguez
present
Detroit, MI
WC Claims Assistant Lead
present
- Provide assistance and support regarding inquiries from policyholders, vendors and injured workers
- Work closely with peer lead claim assistants to ensure consistent work flow and job duties
- Conduct random audits of claims assistant work product to ensure compliance with internal policies and procedures and CA State rules and regulations
- Train new claim assistants on internal policies and procedures as well as performance expectations
- Assist with DIR I DWC CA State Audits and reinsurance audit
- Work on Claim Files, Medical Billing and In-house billing queues on a daily basis
- Return phone calls in a timely fashion
Education
Education
Bachelor’s Degree in Business
Bachelor’s Degree in Business
Loyola University Chicago
Bachelor’s Degree in Business
Skills
Skills
- Strong organizational skills, ability to multi-task and attention to detail
- Ensures quality and timeliness of team deliverables are consistent within segment of responsibility
- Knowledge of federal laws, regulations, policies, and procedures relating to basic eligibility for medical benefits
- Ability to interpret and apply guidelines, ability to organize work to stay within prescribed time limits, and use judgment in deciding on a course of action
- Ability to accurately perform work requiring attention to detail
- Strong attention to details and high numeracy skills
- Ability to pay close attention to detail and to produce extremely accurate work
- Knowledge and ability to use risk management claims system
- Detail-oriented with strong organizational and planning skills
- Strong analytical abilities along with the ability to prioritize work
15 Claims Assistant resume templates
Read our complete resume writing guides
1
Claims Assistant Resume Examples & Samples
- Strong organizational skills, ability to multi-task and attention to detail
- Knowledge of accounting principals and terminology
- Strong client relation skills and a sense of urgency
2
Claims Assistant Resume Examples & Samples
- Assist in obtaining specific information regarding loss/claim and report to proper carriers as necessary
- Assist Claims Rep in verifying facts and coverage, and document files. Help in the evaluating of policy clauses and determine coverage
- Advise customers what processes are necessary for claims settlement. Respond to customers regarding claims status
- Assist producers with claim status and special projects
- Respond to company request for policy information as necessary for claims settlements
- Maintain own follow-up system in claims inquiry menu for use in periodic status checks on open claims
3
Claims Assistant Manager Resume Examples & Samples
- Handle complicated medical claims such as A&H and WC
- Joint efforts with marketing & underwriter in product development and marketing facing activities
- Handle claims enquiry from internal & external customers
- Reporting and claims data analysis
4
Claims Assistant Resume Examples & Samples
- Computer proficiency in Microsoft Office Suite
- Ability to manage time wisely
- Demonstrate strong human-relations skills, including the ability to work with all levels of cast members and our guests
- Must be flexible to new procedures and equipment
- Attention to detail and confidentiality
- Self starter and independent thinker
- Familiarity with Walt Disney World property
- Experience with Business Objects
5
Claims Assistant Resume Examples & Samples
- Knows, understands, incorporates and demonstrates Oakwood's Vision, and Values in behaviors, practices and decisions
- Processes notices of loss and other claim information in the Legal Affairs' risk management data base. Records claim and establishes claim file numbers. Enters claim information in database, sets up claim files, sets initial reserves, creates diaries for management review, and distributes incoming work to appropriate claims professional
- Maintains Legal Affairs' claim files; assures completeness of claim documentation, and provides needed file information in a timely and efficient manner
- Identifies claims to be closed, processes claims for closure, inputs closing claim information into the Legal Affairs' risk management database and processes closure of claims file
- Produces monthly summary claim reports and other template reports as requested
- Completes and submits excess reporting forms and National Practitioner Databank reporting forms as directed
- Submits check requests with appropriate documentation and mails checks with explanatory correspondence as directed
- Reviews all incoming correspondence and places and revises diary dates in Outlook and in the Legal Affairs' database or other database. Files correspondence and documents as appropriate
- Coordinates and assists with Internal Claim Review and Block Review as directed
- Contacts defense counsel and communicates regarding defensive claims as directed
- Composes correspondence/mail and form letters as directed
- Coordinates the invoice payment process, reviews reconciles and processes HPL and GL vendor invoices and indemnity payments. Creates and maintains a billing folder for each claim. Responds to customer/vendor inquiries regarding billing or Tax ID questions and requests and maintains Tax ID information for experts and Attorneys
- Completes medical record request form and obtains medical records as directed
- Coordinates Legal Affairs' office functions, activities and work schedules to ensure appropriate staff coverage, timely work completion, and effective communication
- Performs other claims support functions as assigned such as scheduling, calendar management, and expense tracking
6
Claims Assistant Resume Examples & Samples
- Identify ending and resumption dates for indemnity payments. Obtain earning information from Claimant and People Soft Accurately calculates indemnity rates in accordance with state laws. Accurately produce and distribute benefit notices in accordance with state laws rules and regulations. Accurately calculate and pay awards as directed. Pay reimbursement to Claimant for mileage, pharmacy and other reimbursable expenses
- Insure timely and accurate benefit provision to the injured workers through diary process. Schedules medical evaluations as directed, and provide timely notice to all parties. Send out state-mandated notices and mileage for medical evaluations. Provide administrative support in the creation of new files. Contact facility managers, Claimants, Corporate Risk management, attorneys, vendors etc. as required to obtain and ensure accurate claim information. Insure accurate injury and claims system coding in the risk management claims system
- Coordinate correspondence between defense attorney, vocational rehabilitation counselor and workers compensation examiner. File and serve medical reports to all parties as directed. Prepare response to subpoenas for medical and claims records. Identification and indexing of bills and correspondence. Investigate and respond to billing inquiries from vendors
- Subpoena medical records. Perform general office duties, file, data entry, mail and answering telephones. Create documents include letters, memos, forms, reports, dictation and certificates of insurance
- Basic understanding of medical and insurance terms
- Knowledge of workers compensation laws, rule and regulations
- Knowledge of internal claims administration processes
- Knowledge and ability to use risk management claims system
- Knowledge of state and internal indemnity rate calculation process laws, rules and regulations
- Knowledge of benefits payments and different indemnity rates, and calculation of award payments
- Knowledge of state mandated benefit notice programs
- Proficient in mathematics and reading skills
7
Claims Assistant Resume Examples & Samples
- Provide relief for Receptionist and assist with front desk
- Create Provider Dispute letters and track their aging
- Examine and adjudicate claims
- Verify member eligibility with Eligibility Department as necessary
- Handle physician, HMO and patient inquiries on claims status, as directed by supervisor
- Learn and apply the mandated health plan and IPA procedures for denied claims
- Assist with the preparation, mailing and filing of both CMS and Commercial denial letters
- Maintain thorough documentation and confidentiality
- Foster positive interaction and relationships with all internal departments as well as cultivating positive working relationships with external contacts
- Performs other assigned duties / special projects on an as-needed basis
- High School Diploma (or equivalent)
- Knowledge of medical terminology, CPT coding and physician reimbursement methodologies such as RBRVS
- Strong computer experience (minimum 1 year experience with EZ-Cap (preferred)
- 2+ years’ experience in claims payment and adjudication for an IPA, or other health care company
8
Claims Assistant Resume Examples & Samples
- Assists with calls to providers and policyholders to request medical requirements necessary to complete claim processing
- Assists with submitting invoices for medical records fees to be paid
- Assists claim adjusters with pending correspondence and with updating beneficiary information in administrative systems
- Review requirements received and routes to adjusters for review
- Assists claim adjusters with mailing correspondence and updating beneficiary information in the administrative system
- Strong analytical abilities along with the ability to prioritize work
- Ability to communicate effectively in both verbal and written correspondence to our customers
- 2+ years work experience required
9
Contestable Claims Assistant Resume Examples & Samples
- Initiates claim set up of all claims for the life and annuity lines of business
- Communicates with beneficiaries and agents with requests for required information to complete claim processing
- Ability to provide high quality and prompt service to our policyholders, beneficiaries, and agents
- Basic knowledge of claims administrative procedures
- Must be able to work in a fast paced work environment
- Knowledge of Microsoft Word, Excel, and Outlook
- Strong decision making abilities
10
Claims Assistant Resume Examples & Samples
- Process standard claims, such as ULR, within agreed parameters
- Process payments and recoveries
- Issue standard letters
- Process CRU matters
- Attend to diary and take responsibility for coding accuracy
- Update spreadsheets and run Risxfacs reports as required
- Instruct Solicitors on new litigation and other Experts where required
- Input claim notes
- Close files
11
Surety Claims Assistant Resume Examples & Samples
- Receive hard and electronic copy claims and/or notifications; investigates and researches claims information; obtain Claim File Instructions (CFI) and open Claim/Lawsuit in database
- As directed by manager/claims handler, develop, manipulate, and create correspondences, letters and notifications using templates to claims party within established (principals, claimants, and obliges). Meet deadlines and targets to notify principals that a claim has been filed, including the amount; Obtain background information from claimant and ensure all parties have proper documentation; Prepare tender of defense letter and secure claim handler signature as appropriate
- As directed, tender lawsuits and notify principals that a lawsuit was filed against the bond; Inform principal to obtain proper legal counsel. May produce discovery for courts in electronic format and overnight to appropriate parties
- Create and/or maintain spreadsheets to track state law regulations
- Process payments for costs incurred through the claims process; Research/verify OFAC prior to paying claimants and consultants; Track outgoing payments made by principal while under claim status to ensure OFAC regulations are adhered to. May submit reserve worksheets as directed
- Work closely with the claims representatives to ensure projects are taken through completion, providing administrative support as requested
- Process daily mail and scan into online folders, distributing to the appropriate party
- Process salvage payments from obligees, principals and other parties
- Work closely with home office claims assistants and executives to communicate claims status, payment processing, and obtain approvals per policy
- Take inbound calls from principals, obligees, subcontractors, claimants, agents, and other parties and field any questions pertaining to the bonding and claims process
- Close all claim files and lawsuits upon completion per request of claims representatives; Update spreadsheets, add remarks, and move to closed status in database
- Create and/or maintain spreadsheets to track state/country law regulations or internal reporting, as appropriate
- Develop a general understanding of the Surety industry, including claims processing and state legal guidelines, lien and bond claim law and claim handling techniques; Understand basic construction documents as well as major parties of a construction project, roles, and common disputes that may arise on a project
- Participate in training as appropriate
- Provide administrative support, including answering phones and directing calls appropriately and filing documents in appropriate internal systems/application; Purchase office supplies, provides technical support, may provide travel and expense support to Claims Handlers; Schedules meetings and coordinates events as appropriate
- Provides high quality customer service when communicating with internal and external parties
- High school diploma required. Associates or Bachelor’s Degree in Business Administration or related field (including paralegal) or an Associate degree preferred
- 3+ Years of related of related administrative work experience in law, construction, claims or other business
- Surety specific work experience or general knowledge of Surety terminology preferable
- Previous Accounts Payable/Receivable experience preferred
- Works well in a dynamic team environment, as well as independently
- Superb customer service skills
- Proficient in MS Word, Excel, and Outlook
- Prior database experience preferred
- Able to manage multiple tasks and have strong organization skills and attention to detail
12
Claims Assistant Resume Examples & Samples
- Process various types of correspondence
- Handle check printing responsibilities
- Maintain customer service database
- Handle special projects
- Computer experience required (Windows Outlook, Excel, Word, Adobe)
- Previous claim or clerical experience preferred
- Ability to organize and plan
- Ability to work within a team concept
13
Surety Claims Assistant Resume Examples & Samples
- Manage and process international surety claims mailbox, directing correspondence, files, and notifications to the appropriate claims handler/contact. Includes receiving hard and electronic copy claims and/or notifications; obtain Claim File Instructions (CFI) and open Claim/Lawsuit in database or distribute to the appropriate party
- May gather data from multiple sources (globally), create and/or maintain spreadsheets and reports to track international law regulations, open and track international claims activity, and international vendors and partners
- Collaborate with global claims representatives, providing claims and administrative support as requested
- Respond to inquiries and questions from principals, obligees, subcontractors, claimants, agents, and other parties and field questions pertaining to the bonding and claims process
- Close claim files and lawsuits upon completion per request of claims representatives; Update spreadsheets, add remarks, and move to closed status in database
- Process payments for costs incurred through the claims process, including wire transfers; Process salvage payments from obligees, principals, and other parties. Ensure legal compliance in processing global payments. When applicable, research with OFAC or other international regulators prior to paying claimants and consultants; Track outgoing payments made by principal while under claim status to ensure OFAC regulations are adhered to
- Develop a strong and thorough understanding of the Surety industry, including claims processing and international legal guidelines, lien and bond claim law and claim handling techniques; Understand basic construction documents as well as major parties of a construction project, roles, and common disputes that may arise on a project
- Proactively pursues opportunities for process improvement and contributes to team workflows and building a strong team dynamic. Actively seeks new ways to enhance the overall operation
- High school diploma required. Associates or Bachelor’s Degree in Business Administration or related field (including paralegal) preferred
- 1 year with a preference of 3+ years of related administrative work experience in law, construction, claims or other business, preferred
- Proficient in MS Word, Excel, and Outlook. Prior database experience preferred
- Able to manage multiple tasks with strong organization skills and attention to detail
14
Claims Assistant Resume Examples & Samples
- Generate correspondence from claims system and order police reports via task assignments buckets (pool function)
- Provide remote assistance to FCRs without EPIC availability to include verifying contact information for loss participants and body shops, verifying vehicle location, re-assigning an appraisal activity and inputting a payment for FCR approval
- At the direction of claims staff, contact loss participants for loss information. Examples include verifying loss participant address, vehicle location, contacting lien holders for address and pay-off information
- Ordering supplies to include but not limited to paper, pictorials, copier toner
- Generating various weekly/monthly reports to include but not limited to workload, contact, status calls
- Supporting Telecommuting Claim Representatives and Managers
- Utilization of vendor reports to monitor sale of salvage through conclusion and send notification to the claims representative
- Update vacation calendars and Saturday schedules to ensure adequate coverage to service our loss participants
- Verifies accuracy and inputs data including, but not limited to: indemnity and expense payment transactions, police report data, loss participant information, and COA settlement into claims systems in direct support of claim representatives and claim managers
- Assist with workload and workflow management by monitoring EPIC buckets as well as completing re-assignments, territory changes, updating profiles, mail activities, diary and queries in direct support of claim representatives and claim managers
- May print checks, log checks in/ out, sign/burst checks and stuff in envelopes with attachments
15
Claims Assistant Resume Examples & Samples
- Ability to pass any required licensing exams within three attempts. Excellent written, verbal and mathematic skills
- Working knowledge of current PC software such as Word and Excel
- Familiar with industry terminology
16
Claims Assistant Resume Examples & Samples
- Handle all incoming telephone calls and inquiries to the Claims Department General Claims number, fax number, e-mail and, voice mailbox and return calls and send out claims forms to customers as needed
- Open, sort and, distribute all incoming departmental inter-office and postal mail, including acceptance of certified mail
- Review of all phone calls and mail, including e-mail and faxes, for existing claims and/or lawsuits by searching Claims data system
- Creation and setup of all new claims and claims related lawsuit files
- Data input of all new claims and claims related lawsuits into the Claims data system
- Typing of forms and letters as needed
- Mailing of various correspondences including USPS Certified and UPS or Fedex as needed
- Copying of various correspondences, documents and claim files as needed
- General claim and lawsuit filing
- Closed file management including boxing for Record Center retention
- Ordering of office supplies as needed
- Associates Degree or equivalent work experience
- Knowledge of National Grid policies and procedures
- Claims experience a plus
- Strong organizational skills including the ability to manage and process multiple priorities
- Ability to establish credibility and maintain relationships both internally and externally
- Ability to self manage
- Proficient in word processing and other business software including but not limited to, applications such as MS Office, Word, Excel, Power Point and Access
- Must be a demonstrated self-starter
17
Claims Assistant Resume Examples & Samples
- Sets up and compiles claim files and other documents which many include subpoenas, demand packages and policy coverage confirmations
- Provides resolution for image documentation errors
- Manages, organizes and routes incoming/outgoing mail; includes monitoring of printers. Ensures all correspondence is scanned as appropriate
- Responds to Adjuster and Unit Manager request’s such as retrieving files, data inquiries, preparation for audit, research and problem resolution
- May act as backup support for other departments, LOB’s and hubs
18
Claims Assistant Resume Examples & Samples
- 10. Must have regular predictable attendance
- Must exhibit and use good verbal and written communication skills
- Minimum one (1) year experience in a similar job which included customer service
- Good organizational skills and attention to detail required
19
Claims Assistant Resume Examples & Samples
- Investigate and maintain a complete and thoroughly documented claim file
- Control losses by ensuring repairs and costs are appropriate. May control salvage pre-charge
- Conduct timely investigations including recorded statements
- Secure account information from Ally AF
- Identify subrogation and/or salvage situations in a timely manner to protect the interests of the Corporation
- Maintain technical expertise through educational efforts and necessary licensing for continuing education
- 2 + years' experience in financial services or similar industry. Associate's degree or Bachelor's degree in business or related may be used as a proxy for the experience
- Performs clerical, administrative and technically based activities and/or supporting tasks
- Typically requires intermediate knowledge of Microsoft Office programs
- Intermediate written and oral communication skills
20
Claims Assistant Resume Examples & Samples
- Match insurers documents with Mercer’s cover letters
- Ensure that details on Insurer’s document versus Mercer’s letters tally
- Perform verification of amount paid by Insurer against claim records via in-house claim system – training will be provided on in-house claim system
- Prepare documents to be sent out to clients – follow instructions given by servicers
- To report any discrepancy for investigation to servicers in charge
- Any other ad hoc administrative tasks
- Minimum education attained : O level pass or higher
- Able to read and write in good English
- Like numbers, and meticulous with details
- Ability to use PC
- Prior administrative work experience will be an advantage but is not a must
- School leavers waiting for admission to University, those waiting for enlistment are also welcomed
21
Claims Assistant Resume Examples & Samples
- Superior administrative office skills
- Must demonstrate an aptitude for learning additional computer skills
- Good communication skills and effective telephone manner
- Requires good math skills and ability to use adding machine or calculator with accuracy
- Must have an excellent attendance record and be proficient at performing branch administrative office functions
- Above average knowledge, understanding, and usage of all computer system functions
- Works under general supervision and exercises a moderate level of discretion in performing duties of the position
- Accountable for performing assigned duties accurately and efficiently and in accordance with established company policies and departmental procedures
- Responsible for handling sensitive and confidential matters and documents appropriately
- Ability to keep a steady work schedule with regular, predictable attendance to ensure steady work flow and minimal disruption to department schedules and deadlines
- Ability to perform essential functions of the job, with or without a reasonable accommodation
22
Claims Assistant Professional Liability Resume Examples & Samples
- Sets up new claim files pursuant to department protocol
- Prepares standard form responses as directed by claims staff
- Handles special mailing and delivery requests
- Processes claim payments as appropriate
- Maintains professional liability manuals as directed by management
23
Claims Assistant Resume Examples & Samples
- Claims Process: Receive and file claims documents. Maintain electronic and database claims files
- CHVs: Complete Claims History Verifications for requesting parties or redirect as needed to other insurers
- Provide support as needed to Manager Liability Claims and Legal Claims Specialist
- Meeting Prep: Prepares for and attends meetings and events when necessary. May record, type, distribute, and file meeting minutes and work with outside vendors to prepare for meetings and events
- Departmental Interface: Works closely with the legal, credentialling and provider enrollment departments
- Other: Composes, prepares, maintains, and distributes word processing documents, spreadsheets, databases, graphs, presentations, reports, newsletters, packets, enrollment applications, and other department documents with an emphasis on accuracy. May involve transcribing dictation into letters and other documents, using specialized software applications, and gathering pertinent data from a wide variety of sources
- Assists other department personnel and acts as a backup when needed
- Performs and assists with other duties as needed
- Thorough knowledge of and skill in using Windows computer with an emphasis on word processing, spreadsheet, presentation and database applications and Internet usage
- Skill in operating various office equipment, including but not limited to, dictation equipment, facsimile, copier, calculator, and document scanner
- Ability to pay close attention to detail and to produce extremely accurate work
- Ability to effectively work in a multi-task environment and to coordinate and prioritize various activities, projects and duties simultaneously
- Ability to effectively communicate orally and in writing with employees, physicians, management, and external business contacts and vendors in a courteous and professional manner. Must have knowledge of correct English and grammar usage. Ability to maintain confidentiality
- Ability to work overtime and put forth extra effort when needed. Position requires flexibility such as coming in early, staying late, or postponing lunch to accommodate department needs
- Ability to process assigned duties in an efficient and organized manner
- Ability to identify, research, and resolve problems and discrepancies
- Ability to maintain patience and composure in difficult situations
- Ability to identify emerging issues and to communicate them to management
24
Claims Assistant Resume Examples & Samples
- May be required for training purposes
- Develop and process claims and determines legal entitlement for medical benefits and authorized and unauthorized medical services for the Clinic of Jurisdiction (COJ) NVCC programs
- Reviewing NVCC consults generated by clinic providers to assure appropriateness
- Using knowledge of medical terminology, regulations, and manuals related to the administration of NVCC programs
- Experience with performing in-depth reviews of operations and conducting special studies
- Experience with compiling monthly statistics reports
25
Claims Assistant Resume Examples & Samples
- Knowledge of federal laws, regulations, policies, and procedures relating to basic eligibility for medical benefits
- Ability to communicate orally with a variety of individuals from varying backgrounds
- Ability to communicate in writing with a variety of individuals from varying backgrounds
- Knowledge of computer systems for data entry, retrieval, tracking, and trending, to include the control process for correspondence, files, and documents
- Ability to interpret and apply guidelines, ability to organize work to stay within prescribed time limits, and use judgment in deciding on a course of action
26
Claims Assistant Resume Examples & Samples
- Ability to comprehend interpret, and apply written procedures, guidelines, and regulations that apply to claims activities
- Ability to independently organize assigned tasks, set priorities, and meet deadlines
- Ability to accurately perform work requiring attention to detail
- Ability to demonstrate priorities and organize work to stay within prescribed time limits
- Ability to communicate orally and with people from a variety of backgrounds
27
Claims Assistant Resume Examples & Samples
- Demonstrate the knowledge required for utilizing various computer systems to prepare correspondence, analyze claims and determine if end product controls are needed
- Develops, gathers, and reviews evidence received in conjunction with claims and updates VBMS/MAPD to show receipt of such evidence
- Utilizes the centralized mail portal to review mail and routes all mail and any files to the appropriate location
- Processes powers of attorney
- Responsible for the care and maintenance of claims folders and insures all pertinent records and documents are filed chronologically
- Processes admission notices and requests for evidence from various computer systems and provides accurate and complete replies
- Schedules request for hearings by contacting service organizations and the veterans and greet visitors
- Determine basic eligibility for benefits, processes dependency questionnaires, processes Notices of Disagreements, performs weekly WIPP reviews, inputs exam request, and performs other administrative duties when needed
- Analyzes claims and determines if dispositions of claims and control actions have been appropriately identified
- Establishes or updates control actions, to include VBMS, MAP-D, SHARE and COVERS
28
Claims Assistant Resume Examples & Samples
- OR-
- Best qualified - applicants possessing experience that substantially exceeds the minimum qualifications of the position including all selective factors, and who are highly proficient in all requirements of the job and can perform effectively in the position
- Highly qualified - applicants possessing experience that exceeds the minimum qualifications of the position including all selective factors, and who are proficient in most of the requirements of the job
- Well qualified - applicants possessing experience that meets the minimum qualifications of the position including all selective factors, and who are proficient in some, but not all, of the requirements of the job; and
- Qualified - applicants possessing experience and/or education that meets the minimum qualifications of the position including all selective factors
- Other Veterans Document
29
Claims Assistant Resume Examples & Samples
- Courteously and promptly answering calls received in the OSD Service Center from insured’s, claimants, agents and any other parties and gathering the necessary information in a timely manner - accurately enter the first notice of loss information into the IRIS application, identifying those claims that require immediate adjuster or supervisor attention
- Responding to status and inquiry calls from customers regarding policy and coverage information within authority - appropriately transferring calls without inconveniencing the customer
- Performing data entry of faxed and Agency eLoss claims, to include most lines of business and loss types, with minimal supervision
- Assisting other units within Claim Services, including but not limited to Branch Services, Auto, Mail scan, Property and Recovery
- Prior knowledge of Claim Services and Call Center functions, theories and practices a plus
- Strong Time Management Skills
- Ability to effectively interact with all levels of internal and external business partners
- Demonstrated strength in written and oral communication
- Able to work in high volume environment
- Knowledge of Microsoft Office Suite, as well as other business-related software and claim task processing
30
Claims Assistant Resume Examples & Samples
- Assist and provide a high standard of administrative and claims management support to the Claims function, including handling of Express claims as directed by Senior Case Managers/ Functional Managers
- Direct all customer inquiries or claims to appropriate personnel or attend to personally where appropriate
- Requisition and payments of accounts when required
- Registration of new claims when required
- Modifications to Claims data as directed
- Responsible for accurate entering of data (as per Zurich guidelines at the direction of the Senior Case Managers/ Functional Managers)
- Participate in team meetings and projects
- Assist Case Managers in follow-up procedures, including diary system
- Ensure a diary system is maintained to facilitate adherence to required time frames
- Provide prompt and accurate word-processing and related PC skills (when required)
- Photocopying/filing/file location (when required)
- Assist with archiving of claims files (when required)
- Ensure proficiency in key tasks
- Bachelor Degree or insurance diploma
- 'A' level or good GCE 'O' level with relevant work experience will also be considered
- Candidate with prior experience in dealing with claims would be ideal
- Strong attention to details and high numeracy skills
- Prior experience using AS400 would be an advantage
- Team player with a strong desire to acquire skills in managing insurance claims and potential to progress further in case management
31
Casualty Claims Assistant Resume Examples & Samples
- Assist adjusters or other involved persons to obtain missing or incomplete information
- Provide customer service completing timely and accurate responses to customer inquiries and resolving minor complaints which arise during the claims handling process
- Basic knowledge of claims procedures and policies
- Highly proficient in MS Word and Excel
32
Claims Assistant Resume Examples & Samples
- Gather documents and required paperwork to submit manufacturer recalls
- Research and enter active vehicle recalls into the Warranty Solutions database
- Provide service excellence with all customers
- Incoming and outgoing calls from consumers, dealers, agents and internal partners
- Process and assign incoming email and fax requests
- Handle special projects as assigned by claims adjusters, supervisors and manager
33
WC Claims Assistant Lead Resume Examples & Samples
- Will support one claim examiner
- Timely payments of indemnity benefits
- Return phone calls in a timely fashion
- Ability to research payment type, dates of service and/or payment amounts
- Conduct disability confirmation calls as assigned through Image Right Tasks and document file accordingly
- Provide assistance and support regarding inquiries from policyholders, vendors and injured workers
- Work on Claim Files, Medical Billing and In-house billing queues on a daily basis
- Complete benefit notices, including but not limited to, objections, denials and acceptance notices on a timely basis
- Complete referrals including, but not limited to, legal, utilization review and investigators
- Provide back-up support for peers as needed
- Organize and handle special projects as assigned
- Train new claim assistants on internal policies and procedures as well as performance expectations
- Work closely with peer lead claim assistants to ensure consistent work flow and job duties
- Conduct random audits of claims assistant work product to ensure compliance with internal policies and procedures and CA State rules and regulations
- Assist with DIR I DWC CA State Audits and reinsurance audit
- Experience working (4 years or more) with and extensive knowledge of CA WC laws, rules and regulations
- Excellent written and verbal communication skills; ability to document notes and compose and edit correspondence and notices
- Excellent customer service skills; ability to handle most customer/vendor/injured worker issues; provide and assist through viable solutions
- Present an excellent image of company to external contacts
- Team player: able to work well with internal and external contact
- Ability to work with numbers
- Work independently; ability to solve problems with little or limited supervision
- Excellent computer skills including word processing, spreadsheet development and analysis, electronic mail, database maintenance and update, develop graphic representation of data
34
Claims Assistant Resume Examples & Samples
- Make payments as directed by Claim Adjuster
- Assist the Claim Adjuster in the set-up of rentals and the payment of rental invoices
- Pay Copart invoices as required and directed. Assist with the processing of salvage and title paperwork for total loss vehicles
- Send a task to the adjuster that the Appraisal is attached to file
- Obtain invoices from Appraisers if not attached in the completed assignment
- Send letters as requested
- File ISO/ NMVTIS
- Answer phone calls
- Fill out mailing document when mailing federal express or next day
- Self organized and detail oriented
- Ability to learn new procedures quickly and adapt to a changing environment
- 3+ years of experience in a worker's compensation claims department or related experience
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Claims Assistant Resume Examples & Samples
- A basic understanding of insurance claims preferably surrounding property but this is not essential
- The skills necessary to be self- motivated and be able to work independently
- Good inter-personal skills and be able to communicate effectively and professionally both verbally and in writing
- An ability and attitude to support wider claims team in reaching and exceeding work-team objectives and Key Performance Indicators
- An ability to develop their insurance knowledge through formal and informal learning
- An ability to manage time, prioritise and ensure that deadlines are met without compromising quality
- A good understanding of the MS Office Suite, including Outlook & Excel, as well as electronic claims systems
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Claims Assistant Resume Examples & Samples
- Communicating and collaborating with adjusters to provide claims support during the claim file process
- Researching, obtaining and documenting claim information to ensure the level of service provided to our customers meets/exceeds service level agreements
- Successfully navigating the Claims Workstation to answer customer inquiries and accurately documenting pertinent situations
- Processing financial transactions to include loss and expense payments, stop payments, voids and re issuance of payments
- Managing claim file maintenance to include closings, transfers, splits, claim file audit pulls, etc
- Processing & managing file support associated with paperless departments
- (Auto, Property, Casualty, Northern & Southern Zone Work Comp as part of Ongoing document
- Management initiative)
- Processing letters, and any related claim forms and correspondence
- Creating and maintaining technical and production logs for the purpose of tracking results
- Effectively managing Task Assistant buckets within established service guidelines
- Efficiently researching claim issues to determine appropriate action
- Recognizing, prioritizing and escalating severe claims according to escalation guidelines
- Assisting with special projects as required/requested
- Demonstrating a technical proficiency with all computer systems necessary for the efficient management of daily tasks
- Insurance experience not required
- Demonstrated technical expertise and systems specific knowledge
- Knowledge and skills in results orientation
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IDI Claims Assistant Resume Examples & Samples
- Performs various support functions with standard procedures and under specific instructions
- Examines various transactions and documents for correctness to ensure compliance with company guidelines
- May select, classify, or compile information from sources to prepare reports or studies
- May examine and evaluate inquiries; replies by telephone or standard form letter
- May receive and review data from sources, including policy holders; may interpret data and translate it into appropriate media for system input
- May maintain files and / or classify, index, and cross-reference records
- 1-3 years of relevant business experience
- Ability to acquire general knowledge of the unit’s business functions and standard operating procedures
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Claims Assistant Resume Examples & Samples
- Typing, filing, faxing, photocopying, scanning, UPS, dictation
- Phone
- Must be able to work alongside claims adjuster as a partner as clerical support
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Claims Assistant Resume Examples & Samples
- Setting up new claims within 1 day, preparing required letters and data integrity in claims system
- Processing payment of in house bills timely
- Fosters a teamwork attitude in the department to include maintaining good relationships with examiners and supervisor, initiative to learn workers comp and offering assistants when daily work has been completed
- Must be able to work alongside claims examiner as a partner as clerical support
- 1 year of prior administrative experience needed; preferably in an Insurance Claims office
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Recovery Claims Assistant Resume Examples & Samples
- Completes letters and other correspondence as directed
- Assists in copying and production of material associated with subpoena work
- Receives telephone calls and returns telephone calls as directed
- Performs other tasks relating to subrogation or recovery on claim files as directed
- Excellent keyboard skills with limited errors
- Moderate to high end personal computer skills including MS Word and Excel is a must
- Past use of a Claims operating systems in a claims environment is preferred
- Telephone skills & Customer Relationship skills
- Must be self-directed, self-motivated and willing to work in fast paced work environment
- Strong command of the English language; both written and verbal
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Claims Assistant Oa Resume Examples & Samples
- 469336000
- Receive phone calls for the Section and direct callers/visitors
- Provide information about the Section, its functions, activities, and personnel
- Assist visitors and/or callers with the completion of forms or documentation
- Receive and collect incoming/outgoing mail or other documents
- Process, deliver, collect, and distribute mail and materials
- Perform clerical or support work for a variety of technical and/or program specialists in support of the programs of an agency
- Operate computer systems and/or perform data processing support and service functions
- Maintain different types of tracking sheets, log books, and suspense files
- Respond to a variety of inquiries from different sources
- Perform a variety of administrative functions to including copying, pasting, scanning, and uploading documents
- Perform other related duties as assigned within the HAS
- To begin, click to create a USAJOBS account or log in to your existing account. Follow the prompts to select your USAJOBS resume and/or other supporting documents and complete the occupational questionnaire
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Claims Assistant Resume Examples & Samples
- Request confirmation and information from insurance companies, agents, or insureds within 24 hours
- Key into agency management system and forward claim documentation to carriers timely
- Communicate with insured's contact person same day or within 24 hours on status of claim, coverage concerns, resolutions
- Keep records current in electronic database, including claims dates or medical/third party notices
- Under direction of Claims Manager, communicate with producers, insurance adjusters, and representatives with timely follow-up
- Maintain up-to-date (electronic and manual)claim records and information necessary for claims department per established standards and procedures
- Using online system, follow up with companies, insureds, loss payees, and third party claims issues within established time limits to ensure proper handling of claim and document activity
- On impacted/disputed claims, timely communicate with Claims Manager or review of claim issues and status. Contact insurance department personnel, as requested by Claims Manager for action and other follow up
- Under direction of Claims Manager, provide claim payment and activity information, with changes/updates to interested parties within 72 hours from request
- Phone messages, claim notification and inquires activity pursued on a same or next day basis per standards and procedures
- Key detailed claims activity and costs into agency management system and/or electronic programs as established by standards and procedures
- Maintain proper documentation and filing of correspondence and activity with insurance company and insured on problem claims
- Complete and maintain daily work and report to Claims Manager as directed
- Complete and maintain proper documentation and timely follow up for resolution with insurance companies and insureds on problems with policy coverage or claims
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Claims Assistant Resume Examples & Samples
- Communicate and collaborate with other department personnel to provide claims support during the claim file process
- Research, obtain and document claim information to ensure the level of service provided to our customers meets/exceeds service level agreements
- Successfully navigate the Claims Workstation to answer customer inquiries and accurately documenting pertinent situations
- Process financial transactions to include loss and expense payments
- Process & manage file support associated with paperless departments
- Efficiently research claim issues to determine appropriate action
- Recognize, prioritize and escalate claims issues to the appropriate level
- Assist with special projects as required/requested
- Demonstrate a technical proficiency with all computer systems necessary for the efficient management of daily tasks as needed
- Courteously and promptly answer calls received from various parties including 3rd party claimants. Accurately record all pertinent claim information and completing accurate/timely information into the claim system
- Promptly take action on updated claim information received
- Provide assistance to other areas when necessary
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Claims Assistant Resume Examples & Samples
- Provide clerical support to nationwide team of claims adjusters to facilitate timely and accurate management of claims. This includes but is not limited to completing complex state forms
- Input new claims into claims processing system, process the data through ISO ClaimSearch and attach policy information in ImageRight
- Process electronic mail and tasks in ImageRight in a timely manner
- Screen all incoming phone calls, assess and assign out to proper party
- Retrieve and work general voice mailbox
- Prepare written correspondence
- Process outgoing mail / FedEx
- Other assigned tasks or projects
- Must have good business acumen (i.e. understand how an insurance company works and makes money, including how this role impacts both Argo’s and our customers’ ability to be profitable)
- Highly accurate typing with speed of at least 50 wpm
- Strong PC skills, including extensive experience working on Windows and good knowledge of MS Outlook, Word, and Excel. Experience with ImageRight and MS Access a plus
- Extremely detail oriented and organized
- Desire to work in a fast paced and flexible environment
- Polished and professional written and verbal communication skills. The ability to communicate proficiently in English is required
- Experience in the insurance industry required. A bachelor’s degree can substitute for industry experience
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Claims Assistant Resume Examples & Samples
- Provides prompt and quality claim customer service at all times through professional written and oral communication
- Updates and maintains accurate information in the Claims Operations database (ORCHID)
- Provides support for claim payments and tracking, including: W-9 form entry and maintenance on payees or contacts, data entry and coding of claim payments, preparing correspondence with outgoing payments or other claim related communication
- Ability to respond to general claim questions and complete claim support functions (update file data, order police reports, index claimants, manage claim retention policies
- Minimum two (2) years of customer service and data entry
- Experience in a position that required the ability to effectively and clearly communicate information and answer questions in a variety of situations
- Insurance, claims or other related experience
- Property Casualty Insurance or Commercial Claim Operations experience (preferred)
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Claims Assistant Resume Examples & Samples
- Provide administrative assistance in the delivery of claims service, determining proper policy coverage to conclude, investigate, evaluate and negotiate assigned cases
- Handle queries and provide professional supports to Claims Manager and case handlers
- Provide ad-hoc administrative support to the department as assigned by the Department Manager
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Claims Assistant Resume Examples & Samples
- Assist and provide a high standard of administrative and claims management support to the Claims function, including handling of express claims as directed by senior case managers/ functional managers
- Responsible for accurate entering of data (as per Zurich guidelines at the direction of the senior case managers/ functional managers)
- Assist case managers in follow-up procedures, including diary system
- Candidate with prior experience in dealing with claims will be an advantage
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Claims Assistant Resume Examples & Samples
- Receive claim information from Lockton clients, claimants, associates, and insurance carriers; verify current insurance coverage
- Report claim information accurately and promptly to the appropriate insurance carrier on behalf of Lockton clients, via mail, fax, or telephone
- Utilizes on-line systems to retrieve and deliver reports
- Enter diary upates for follow up by Claims Consultants and Claims Coordinators
- Check status of claims at appropriate diary dates and re-diary claims as appropriate
- Field questions and act on requests from clients, commerical insurance department, and other claims department associates concerning status of claims
- Develop a working knowledge of insurance carrier claim management systems and access carrier claims information
- Prepare written correspondence, analyses, reports, and memos as requested and/or needed
- Researches a variety of technical General Liability issues, as requested
- Files miscellaneous papers in appropriate files
- Performs other work related duties, as needed
- Makes positive contribution to client satisfaction and constantly strives to improve service to the client
- Protects the confidentiality of reference information utilized and information learned by performing the duties of the position
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Claims Assistant Resume Examples & Samples
- Create and submit EDI First Report of Injury and Subsequent Reports in our EDI programs to be sent to the Florida Division of Workers Compensation
- Research Workers Compensation Claims in applicable claim system for information needed to complete EDI reports. This would include reviewing the claim and determining what information needs to be reported based on the State requirements
- Review state websites for filing information, potential penalties or fines. Analyze any EDI errors and make necessary corrections as stipulated by the state requirements
- Complies all data using state EDI reporting requirements and time frames
- Keep up on new EDI rules and requirements. As well as IAIABC release updates
- Assist the team with problem solving
- Communicate with claims adjusting staff regarding missing necessary EDI filing data
- 3+ years of experience in a worker's compensation claims department or related experience preferred
- Basic understanding of business technologyAbility to take direction and make decisions
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Claims Assistant Resume Examples & Samples
- Works with Legal-X to facilitate claim SIU payments, forms and other documents as directed
- Completes SIU referrals
- Assists in copying and production of material associated with subpoena work and Law Enforcement requests
- Receives and returns telephone calls as directed by SIU Director
- Performs other tasks relating to an SIU and Other duties as assigned
- Is assigned work related to regulatory compliance as needed
- Conducts in-depth database research
- Moderate to high end personal computer skills including MS Word and Excel
- Past use of any data base program such as MS Access is a plus
- Past use of Claims operating systems in a claims environment is preferred
- Basic mathematical skills are necessary
- Strong reasoning ability is required. Must be able to think independently and make sound judgments with little supervision
- Possess the ability to research and comprehend insurance regulations and criminal statutes
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Claims Assistant Resume Examples & Samples
- Providing support to the Environmental Claims Department by
- Processing all vendor invoices for payment
- Documenting weekly vendor meetings by creating meeting notes
- Processing all payments on claims files after Adjuster approves them
- Updating claims files by attaching newly received documentation to the file
- Completing a technical review of the vendor reports and creating and entering a summary of the reports to each claims file
- Tracking newly received claims and following up with Adjusters and vendors to ensure timely coverage decisions are made within 25 calendar days upon receipt
- Drafting update aggregated erosion/reserve status letters to insureds and consultants
- Monitoring reserve depletions and provide alerts to ensure reserves are updated timely and adequately
- Developing direct billing of larger invoices to capitalize on prompt payment discount
- Drafting coverage letters
- Analyzing claim forms, policies and endorsements, client instructions and other records to determine whether the loss falls within the policy coverage
- Denying any claims that are not covered or do not meet compensability criteria and successfully defending that decision if challenged
- Must possess a strong customer focus
- The ability to read and write English fluently is required. The ability to read and write Spanish fluently is strongly preferred but not required
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Claims Assistant Resume Examples & Samples
- Participates in providing inputs to overall operational strategies
- Ability to work with teams, and can work with less supervision
- Ability to communicate in English
- Knowledge in policy administration
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Claims Assistant Resume Examples & Samples
- Create and mail appropriate claim correspondence
- Maintain office supplies for claims staff
- Work on daily maintenance and update of assigned tasks, correspondence, etc
- Generate various weekly/monthly reports
- Develop a basic understanding of the functions of other departments, such as Policy Ops and Marketing
- Develop a basic understanding of systems and technology used within the company
- Identify customer needs and work to meet those needs using appropriate customer service skills
- Detail-oriented with strong organizational and planning skills
- Ability to work well under deadlines in a changing environment
- Ability to perform multiple tasks effectively and concurrently
- Possess skills in in decision-making and problem solving
- Possess prior claims experience
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Bodily Injury Claims Assistant Resume Examples & Samples
- Contact loss participants or vendors for information at the request of claims staff
- Order records and reports applicable for claims processing
- Assist with workload and workflow management by monitoring claims systems, distributing workload and completing profile updates
- Perform other projects and assignments as directed
- Possess professional verbal and written communication skills
- Possess skills in customer service
- Possess negotiation skills
- Ability to work effectively independently and within a collaborative team oriented environment
- Proficient in Microsoft Office (Word, Excel, Outlook, PowerPoint) and internet
- Ability to gains a general understanding of insurance law as it relates to claims
- Associate's degree or in-lieu of degree equivalent education, training and work-related experience
- Possess a thorough understanding of the NGIC Insurance brand and ability to exhibit the behaviors
