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Cruz Long
Claims Assistant
Summary
Highly accomplished Claims Assistant with proven experience in claims processing, adjudication, investigation, and customer service. Demonstrated ability to handle a high volume of claims and maintain accuracy levels above 98%. Proven expertise in identifying potential fraud and overpayments, resulting in significant loss prevention. Excellent interpersonal and communication skills, with a strong track record of building and maintaining relationships with policyholders, brokers, and adjusters to ensure timely and effective claim resolutions.
Education
Bachelor’s Degree
August 2018
Skills
- Claims Processing
- Claims Investigation
- Claims Adjudication
- Policy Interpretation
- Subrogation
- Insurance Regulations
Work Experience
Claims Assistant
- Utilized insurance software and databases to gather and interpret claim information, ensuring adherence to company guidelines.
- Participated in insurance industry training programs and webinars to stay updated on industry best practices and legal guidelines.
- Collaborated with crossfunctional teams, including underwriting and legal, to provide comprehensive claim support and analysis.
- Investigated complex claims, conducting research and interviewing witnesses to gather evidence and determine liability.
Claims Assistant
- Processed and adjudicated over 150 claims per month, resulting in 98% accuracy and a 25% reduction in processing time.
- Reviewed and analyzed claims documentation to identify potential fraud and overpayments, preventing losses of approximately $100,000 annually.
- Established and maintained strong relationships with policyholders, brokers, and adjusters, ensuring timely and effective claim resolutions.
- Managed a high volume of incoming calls and emails, providing excellent customer service and resolving inquiries promptly.
Accomplishments
- Processed over 500 claims accurately and efficiently, reducing turnaround time by 20%
- Developed an innovative claims processing system that automated tasks and improved accuracy by 15%
- Trained and mentored junior claims assistants, ensuring highquality claim handling
- Consistently met or exceeded performance targets for claim settlement and customer satisfaction
- Established strong relationships with claimants and stakeholders, fostering positive outcomes
Awards
- Claims Adjuster of the Year Award
Certificates
- Associate in Claims (AIC)
- Adjuster Associate (AA)
- Claims Professional (CP)
- Certified Insurance Claims Professional (CIC)
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How To Write Resume For Claims Assistant
- Highlight your experience in claims processing and adjudication, emphasizing your accuracy and efficiency.
- Quantify your accomplishments whenever possible, providing specific metrics to demonstrate your impact.
- Showcase your skills in detecting fraud and preventing overpayments, as these are highly valued by employers.
- Emphasize your customer service and communication abilities, as these are essential for building rapport and resolving claims effectively.
- Review the job description carefully and tailor your resume to align with the specific requirements and keywords.
Essential Experience Highlights for a Strong Claims Assistant Resume
- Processed and adjudicated a high volume of claims, consistently exceeding accuracy targets while meeting deadlines.
- Reviewed and analyzed claims documentation to assess validity and identify potential fraud, preventing substantial financial losses.
- Established and maintained strong relationships with policyholders, brokers, and adjusters, providing exceptional customer service and resolving inquiries promptly.
- Managed a high volume of incoming calls and emails, providing clear and empathetic assistance to customers.
- Utilized insurance software and databases to gather and interpret claim information, ensuring adherence to company guidelines and regulatory requirements.
- Participated in insurance industry training programs and webinars to stay updated on best practices and legal guidelines.
- Collaborated with cross-functional teams, including underwriting and legal, to provide comprehensive claim support and analysis.
Frequently Asked Questions (FAQ’s) For Claims Assistant
What are the key responsibilities of a Claims Assistant?
The key responsibilities of a Claims Assistant include processing and adjudicating claims, investigating and assessing claims, providing customer service, and maintaining relationships with policyholders and other stakeholders.
What skills are required to be a successful Claims Assistant?
To be a successful Claims Assistant, you need strong analytical and problem-solving skills, attention to detail, and excellent communication and interpersonal skills.
What are the career prospects for a Claims Assistant?
With experience and additional qualifications, Claims Assistants can advance to roles such as Claims Adjuster, Claims Supervisor, or Claims Manager.
What is the average salary for a Claims Assistant?
The average salary for a Claims Assistant varies depending on experience, location, and employer, but typically ranges from $40,000 to $60,000 per year.
What are the common challenges faced by Claims Assistants?
Claims Assistants may face challenges such as dealing with difficult customers, managing a high volume of claims, and staying up-to-date on industry regulations.
What is the best way to prepare for a career as a Claims Assistant?
The best way to prepare for a career as a Claims Assistant is to obtain a degree in a related field, such as business, finance, or insurance, and gain experience through internships or entry-level positions.