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Jesse Perez
Claims Specialist
Summary
Highly skilled Claims Specialist with 5+ years of experience in investigating and settling various claims, including bodily injury, property damage, and medical expenses. Proven ability to negotiate fair and equitable settlements with claimants, attorneys, and insurance companies. Strong analytical and investigative skills, with expertise in interpreting insurance policies and assessing liability and damages. Proficient in utilizing insurance software and databases to manage claim information and track progress. Committed to providing exceptional customer service and protecting client confidentiality.
Education
Bachelor’s degree
October 2017
Skills
- Insurance Claims Processing
- Claims Investigation and Analysis
- Insurance Policy Interpretation
- Subrogation
- Bodily Injury Claims Handling
- Property Damage Claims Handling
Work Experience
Claims Specialist
- Prepared and presented claim summaries and recommendations to senior management
- Collaborated with claims adjusters, attorneys, and other stakeholders to resolve claims efficiently
- Utilized insurance software and databases to manage claim information and track progress
- Handled sensitive information and protected client confidentiality
Claims Specialist
- Investigated and settled various claims, including bodily injury, property damage, and medical expenses
- Negotiated with claimants, attorneys, and insurance companies to reach fair and equitable settlements
- Analyzed claim documentation, medical records, and police reports to assess liability and damages
- Managed a caseload of complex and highvalue claims
Accomplishments
- Optimized claims processing workflows by implementing automated solutions, resulting in a 20% reduction in processing time and a 15% increase in accuracy.
- Developed and implemented a training program for new claims specialists, leading to a 30% reduction in initial claim processing errors.
- Successfully resolved complex claims disputes, resulting in significant cost savings for the company and improved customer satisfaction.
- Led a team of claims adjusters in handling a major catastrophe, ensuring timely settlements and minimizing financial impact.
- Successfully negotiated settlements with claimants, achieving favorable outcomes while maintaining company interests.
Awards
- Received the Pinnacle Award for Outstanding Claims Processing Performance, consistently exceeding accuracy and efficiency targets.
- Recognized as the Claims Specialist of the Quarter for exceptional customer service and proactive problem solving.
- Received the Presidents Award for Innovation for developing a new claims management software that significantly improved efficiency and reduced cycle times.
- Awarded the Claims Excellence Award for consistently surpassing performance goals and providing exceptional support to policyholders.
Certificates
- Associate in Claims (AIC)
- Fellow, Casualty Actuarial Society (FCAS)
- Certified Insurance Fraud Investigator (CIFI)
- Certified Claims Professional (CCP)
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How To Write Resume For Claims Specialist
- Highlight your experience in investigating and settling claims, including your ability to negotiate favorable settlements.
- Showcase your analytical and investigative skills, and your knowledge of insurance policies and procedures.
- Demonstrate your proficiency in using insurance software and databases to manage claims and track progress.
- Emphasize your commitment to providing excellent customer service and protecting client confidentiality.
Essential Experience Highlights for a Strong Claims Specialist Resume
- Investigated and settled various claims, including bodily injury, property damage, and medical expenses.
- Negotiated with claimants, attorneys, and insurance companies to reach fair and equitable settlements.
- Analyzed claim documentation, medical records, and police reports to assess liability and damages.
- Managed a caseload of complex and high-value claims.
- Prepared and presented claim summaries and recommendations to senior management.
- Collaborated with claims adjusters, attorneys, and other stakeholders to resolve claims efficiently.
Frequently Asked Questions (FAQ’s) For Claims Specialist
What is the role of a Claims Specialist?
A Claims Specialist investigates and settles insurance claims, such as bodily injury, property damage, and medical expenses. They assess liability, negotiate settlements, and manage claim documentation.
What skills are required to be a successful Claims Specialist?
Strong analytical and investigative skills, knowledge of insurance policies and procedures, proficiency in using insurance software and databases, and excellent communication and negotiation skills.
What is the career path for a Claims Specialist?
Claims Specialists can advance to roles such as Senior Claims Adjuster, Claims Manager, or Underwriter.
What is the salary range for a Claims Specialist?
The salary range for a Claims Specialist varies depending on experience, location, and company size, but typically falls between $50,000 and $80,000 per year.
What are the challenges faced by Claims Specialists?
Claims Specialists often face challenges such as dealing with difficult claimants, complex claims, and tight deadlines.
What is the job outlook for Claims Specialists?
The job outlook for Claims Specialists is expected to grow in the coming years due to the increasing demand for insurance services.
What are the benefits of working as a Claims Specialist?
Claims Specialists enjoy benefits such as job security, opportunities for advancement, and the satisfaction of helping others in their time of need.