Claims Clerk Resume Samples

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Guide the recruiter to the conclusion that you are the best candidate for the claims clerk job. It’s actually very simple. Tailor your resume by picking relevant responsibilities from the examples below and then add your accomplishments. This way, you can position yourself in the best way to get hired.

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K Lowe

Karson

Lowe

778 Wehner Vista

San Francisco

+1 (555) 801 3961

778 Wehner Vista

San Francisco

Phone

p +1 (555) 801 3961

Experience Experience

Houston, TX

Claims Clerk

Houston, TX

Ondricka-Thiel

Houston, TX

Claims Clerk

Works on simple tasks using established procedures
Conduct data entry and re - work; analyzes and identifies trends and provides reports as necessary
Searches files and/or work areas for missing or requested files
Analyze and identify trends and provide reports as necessary
Consistently meet established productivity, schedule adherence, and quality standards
Provide telephone support for incoming calls, including taking loss notices that are called in
Work is typically reviewed by others

Detroit, MI

Claims Clerk Area

Detroit, MI

Grimes, Schimmel and Langosh

Detroit, MI

Claims Clerk Area

Removes Focus form letters from printer and distributes to sender for signature before mailing
Operates equipment such as copiers; obtains and distributes copies as requested
Contacts agents and insureds on routine claims to obtain coverage information or to clarify coverage information supplied on a loss report
Responds to insureds and agents to complete general loss report information and may respond to the more routine claim questions from insureds and agents
Determines proper file and claim number on unidentified claim correspondence by use of the Focus system
Types a variety of material such as letters, reports, form letters, or memorandums
Conduct data entry and re-work; analyzes and identifies trends and provides reports as necessary

present

Boston, MA

Claims Clerk, Area

Boston, MA

Sauer-Mitchell

present

Boston, MA

Claims Clerk, Area

present

Good working knowledge of Claim processing and of Claim policies and procedures
Proofreads work for accuracy; distributes all letters and memorandums for proper signatures before mailing
Performs a variety of clerical duties such as answering telephones, taking messages, and sorting and filing mail and correspondence
Keeps supervisor informed verbally and in writing of activities and problems within assigned area of responsibility; refers matters beyond limits of authority and expertise to supervisor for direction
May assist in typing and processing payments for approved billings and expenses
Assists in updating claim manuals
May assist in operating the check signing machine and in posting and distributing of claim checks issued

Education Education

Bachelor’s Degree in Social

Boston University

Bachelor’s Degree in Social

Skills Skills

Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
Good written and verbal communication skills, including professional telephone skills
Ability to access and retrieve information using a PC and basic understanding of Microsoft Office products
The ability to learn new and complex computer system applications
Ability to remain focused and productive each day though tasks may be repetitive
Ability to work on assignments with limited instructions from leadership
Ability to follow written policies and procedures
Ability to follow procedural guidelines.'
Experience in production based environment
Prior office or clerical experience

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7 Claims Clerk resume templates

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Claims Clerk Resume Examples & Samples

Conduct data entry and re-work; analyzes and identifies trends and provides reports as necessary. Provide general claims support by reviewing, researching, investigating claims
Analyze and identify trends and provide reports as necessary
Recognize claims by determining claim type - HCFA, Hospital, UB, and/or RX
Identify more complicated claims and refer them to Senior Claim Processor or Supervisor
Assign appropriate eligibility and provider records are matched to the claim
1+ years of experience in an office setting environment using the computer as the primary instruments to perform job duties
2+ years of Data Entry experience
Experience in multitasking within multiple software, which includes the ability to understand multiple products and multiple levels of benefits within each product
Basic proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
Ability to use MS Excel to sort, filter, formulas and display data
Ability to use MS Word to create professional correspondence
1 + years of experience working with Medical Claims
1 + years of experience working in a Production Based Environment
Prior experience working with IDX Software
Basic understanding of Healthcare Claims including ICD-10 and CPT Codes

Claims Clerk Resume Examples & Samples

Provide general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
Authorize the appropriate payment or refers claims to investigators for further review
Conduct data entry and re-work; analyzes and identifies trends and provides reports as necessary
Calculate other insurance and re-pricing benefits
Work claims files to ensure the appropriate eligibility and provider records are matched to the claim
Updates and maintains claims tracking database
Proficient in Microsoft Excel and Microsoft Word
Proficient in 10-key numeric pad
1+ years of experience in an office setting environment using a computer as the primary instrument to perform job duties
1+ years of experience managing with multiple tabs within Internet Explorer in a work environment
Prior experience working with Medical Claims
Ability to type 60+ WPM
Proficient with 10 key numeric pad data entry
Basic understanding of Healthcare Claims including ICD-9 and CPT codes
Experience in production based environment
Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product

Claims Clerk Resume Examples & Samples

Verify Membership
Maintain files electronically
Generate and match enrollment letters with application
Receive and distribute reports on daily basis
Process online maintenance transactions
Participate in all required skills training
Obtain copies of claim records for medical records requests
Participate in all team processes and activities
Maintain/change toner in fax, copy, and batch machines
Ability to remain focused and productive each day though tasks may be repetitive
Oral and Written communication is necessary for success in this role
Must be a team player
Able to work full-time Monday - Friday within standard business hours
2+ years of data entry experience both numeric and alphanumeric
1+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
1+ years of experience using a computer and Windows PC Applications
1+ years of experience working with medical claims
Prior experience working with IDX software
1+ years of experience working in production based environment
The ability to learn new and complex computer system applications

Claims Clerk Resume Examples & Samples

Data Entry of Medical Record Invoices into internal claim system
Daily QA of fee verification, provider data, & contractual language
Provide customer service to internal and external customers
Monitor AP designated status codes in accordance with policies and procedures as assigned and resolve issues to ensure timely audit completion

Claims Clerk Entry Level Resume Examples & Samples

Making/receiving calls to follow up on unpaid claims
Duties include handling correspondence batches such as denials, refund request letters, and authorizations
Claims processing includes bad debt, bankruptcy, bad address, etc
Provides back up coverage for customer service
Strong communication and customer service skills

Claims Clerk Resume Examples & Samples

Provides assistance to insurance professionals by performing miscellaneous functions including, but not limited to, photocopying, faxing, scanning, word processing, and filing
Performs follow-up process to match mail to files
Handles incoming and outgoing departmental mail
Experience in a professional office environment preferred. No experience required
Excellent written and verbal communication skills to effectively interact with customers on the telephone
Strong organizational and time-management skills to handle multiple tasks and prioritize effectively
Detail oriented to ensure accuracy
Problem solving skills to resolve issues and take appropriate action
Ability to analyze data and interpret appropriate action
Possess self-discipline, self-motivation, and ability to meet assigned objectives
Basic computer skills and the ability to navigate through multiple systems without assistance
Basic knowledge of Microsoft Office
Core competencies include

Claims Clerk Resume Examples & Samples

2+ years of data entry experience
1+ years of understanding of healthcare claims including ICD-9 and CPT codes
Proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
Available to work possible overtime
1+ years of working in production based environment

Claims Clerk Resume Examples & Samples

Matches proper file and/or claim number on unidentified correspondence by use of the Focus automated systems
Searches files and/or work areas for missing or requested files
Performs control operator functions for the Focus equipment
Periodically reviews and removes files for destruction or transfer to central storage; retrieves and/or re-files items from central storage facility and maintains accurate records of file activity
Obtains copies of materials and/or operates photocopy equipment and assists in preparing materials for distribution
Receives dock and messenger service deliveries and verifies accuracy of delivered material
Prepares outgoing mail for shipment which includes the necessary attachments, wrapping, and sealing
May assist in updating department manuals
Performs a variety of clerical duties such as answering telephones, taking messages, and sorting and filing mail and correspondence
Performs other related work as required or requested

Claims Clerk Resume Examples & Samples

Matches proper file and/or claim number on unidentified correspondence by use of the various Service Center or Claim Office data systems
Performs control operator functions for various equipment
Removes System form letters from printer and distributes to sender for signature before mailing

Claims Clerk Resume Examples & Samples

Retrieves and matches US postal mail and electronic mail to the appropriate claim file through CMS and AMS. Enters information into CMS
Forwards documents as necessary and files to adjuster when ready for processing and completion
Proofreads work for accuracy; distributes all letters and memorandums for proper approval before mailing
Performs a variety of clerical duties such as answering telephones, taking messages, and sorting and filing mail and correspondences. Assists management and adjusters as needed
Determines proper file and claim number on unidentified claim correspondence
Responds to claimants and insureds on status inquiries and routine claim questions
Contacts agents and insureds on routine claims to obtain or to clarify information supplied on a loss report
Removes letters from printer and sends with appropriate forms
Operates equipment such as copiers; obtains and distributes copies as requested
Prepares outgoing mail which includes the sorting and stuffing of envelopes
Assists in updating claim manuals and documents on shared drive
May assist in typing and processing payments for approved billings and expenses
Needs to be available and take overflow First Notice of Loss calls and enter them into TCC
Upholds the Crawford Code of Conduct

Claims Clerk Resume Examples & Samples

Good organizational, time management and customer service skills
2+ years of general work experience preferred
Must type a minimum of 35 wpm
Knowledge of MS Word, Excel and Outlook

Claims Clerk Resume Examples & Samples

Provide general claims support by reviewing, researching, investigating claims
Identify more complicated claims and refer them to Senior Keyor or Supervisor
1+ years of experience in an office setting environment utilizing the computer and keyboard as the primary instruments to perform data entry (you will spend each work day in-putting data with no phone interaction with internal or external groups)
Recent experience analyzing complex medical claim information (i.e. forms, determining claim types, codes) and a high level understanding of how to identify the claims (recognize claims by determining claim type - HCFA, Hospital, UB, and/or RX)
Proficient with computer and Windows PC applications, which includes previous experience working with dual computer screens and multiple applications at a time (ability to navigate new applications is key)
Ability to create, modify, and manipulate word documents and spreadsheets within Microsoft Word and Microsoft Excel
1+ years of experience working in a production based environment
Basic understanding of healthcare claims including ICD-9 and CPT codes

Claims Clerk Resume Examples & Samples

Answer phone calls from insureds or their representatives, agents, independent adjusters, contractors, etc
Input new claims into the system
Upload new mail into the system and check file out to appropriate adjuster
Track status request and re-diary claim, as needed
Match claim checks to claim payment log verifying check data is correct and give to Manager for approval
Mail out claim checks
Upload claim log payments
Make note who claim check was mailed to in claim message screen
Transfer files as noted on claim payment log
Previous insurance experience preferred
Ability to examine documents for accuracy and completeness
Competent in MS office and PC skills
Bi-lingual HIGHLY PREFERRED!

Warranty Claims Clerk Resume Examples & Samples

Receive documents in from dealers and customers
Check email folders on a regular basis for incoming documents to import into scanning software
Index documents to the correct department for processing
Contact customers / dealerships concerning payable issues
Other duties may be assigned
Strong keyboard skills including 10 key
Minimum high school diploma or GED equivalent required
Excellent customer service skills, underwriting background a plus
Ability to be analytical and multi-task
Ability to work with little supervision
Self-motivated, enthusiastic presence in a team environment
Working knowledge of Microsoft Office
Consistent and stable work history
Professional appearance and work ethic
All potential employees must pass pre-employment testing to include a background check and drug screen

Claims Clerk Resume Examples & Samples

Act as a liaison to Recoveries Department with an emphasis on COB verification in order to ensure real-time, prepayment system updates based on the final COB determination
Claims will be adjudicated based on the findings of the COB verification which will lessen the amount of unprocessable claims during the Encounters process
Claims investigation of problem issues are complete and accurate
Appropriate paperwork is submitted to IS and Network Departments to ensure that providers are loaded in the claims operating system in a timely manner
Claims are tracked and sent to the file room for re-stamping and then to processing team for adjudication
Management is able to assess and monitor productivity, and ensure review of medical records in coordination with timely claims processing
Adjustment counts are reported to the Adjustment Supervisor on a daily basis, allowing supervisors to assign claims to adjustment teams for review and re-adjudication

Resolutions Claims Clerk Resume Examples & Samples

Sort claims according to form type and number
Prepare claims for adjudication by entering the information into the claims operating system
Log claims by entering the date received, member, provider, dates of service and billed amounts for incoming paper claims into the claims system
Place folders on shelves for processing in Batch # order
Providers and claims staff are informed on how to handle future situations
Error reports are available for prompt addressing of issues/adjustments, ensuring timely claims processing/adjudication
Additional duties are met with a positive attitude

Claims Clerk Resume Examples & Samples

Completes tasks beyond general support level
Accepts instruction and direction from leadership. Ability to manage tasks and assignments without detailed direction
Identifies, prioritizes and resolves some issues independently, and escalates more complex questions or issues appropriately
Complies with contract requirements, business unit rules and related and legal regulations
High School Diploma or equivalent; may hold 2 year post-high school Degree; may hold Bachelor’s degree
Ability to access and retrieve information using a PC and basic understanding of Microsoft Office products
Ability to work on assignments with limited instructions from leadership
Good written and verbal communication skills, including professional telephone skills

Claims Clerk Resume Examples & Samples

1 to 2 years office experience
Previous automobile insurance experience a plus
Exceptional verbal and written communication skills
Exceptional computer skills and proficiency using Microsoft Office Suite including Outlook, Word and Excel
Excellent telephone and problem solving skills
Must be able to type 25 wpm

Claims Clerk Resume Examples & Samples

Conduct data entry and re - work; analyzes and identifies trends and provides reports as necessary
Recognize claims by determining claim type - HCFA, Hospital, UB, and / or RX
Calculate other insurance and re - pricing benefits

Claims Clerk Area Resume Examples & Samples

Types a variety of material such as letters, reports, form letters, or memorandums
Determines proper file and claim number on unidentified claim correspondence by use of the Focus system
Removes Focus form letters from printer and distributes to sender for signature before mailing
May assist in operating the check signing machine and in posting and distributing of claim checks issued
Assists in maintaining office supplies and forms; completes requisitions and orders supplies as needed

Claims Clerk Resume Examples & Samples

Maintain / change toner in fax, copy, and batch machines
2+ years of data entry (both numeric and alphanumeric) experience
1+ years of experience using a computer and Windows PC applications

Claims Clerk Resume Examples & Samples

Operate a variety of office equipment, including computers, printers, and copy machines
Other tasks as assigned by supervisor
Self- organized and detail oriented
Ability to toggle between multiple computer screens
May require occasional evening and/or weekend work
Ability to work well under pressure, multi-task in a fast-paced environment, and meet production guidelines
6 months experience in an insurance claims department or related experience
Data entry experience preferred

Claims Clerk Resume Examples & Samples

Provide telephone support for incoming calls, including taking loss notices that are called in
Create, organize, and ship out claim kits to new accounts
Operate a variety of office equipment, including computers, printers, copy machines, facsimile receiver/transmitter and mailing equipment

Claims Clerk Resume Examples & Samples

Minimum of two years clerical experience
Typing and mathematical skills
Able to handle a large volume of work accurately
Completes tasks within allotted time frame
Monitor incoming faxes on Fax to Server
Open mail, search, sort, prep, scan, index and route to the examiners inbox
Prepare and index daily correspondence and route to the Examiners inbox
Set-up new claim and route to the Examiners inbox
New claim (DB450), search and verify coverage
Type various letters and forms
Input data on various logs
Answer incoming calls
Make call to Employer for policy number
Prepare DB120.1 requests, scan, email or fax completed forms to the insureds
Performs miscellaneous duties as necessary

Claims Clerk, Area Resume Examples & Samples

Creates claim file by inputting initial loss report information into the Focus system; completes and distributes paper file to the appropriate claim area
Proofreads work for accuracy; distributes all letters and memorandums for proper signatures before mailing
Contacts agents and insureds on routine claims to obtain coverage information or to clarify coverage information supplied on a loss report
Assists in updating claim manuals
Keeps supervisor informed verbally and in writing of activities and problems within assigned area of responsibility; refers matters beyond limits of authority and expertise to supervisor for direction
Performs other related duties as required or requested

Outside Claims Clerk Resume Examples & Samples

Date stamps all incoming claims daily
Reviews claims from contracted providers to assist in the determination of eligibility
Enters all data related to approved claims into the payment system
Copies all approved claims and batch sends to Accounts Payable
Posts all payments to the appropriate accounts
Processes unfiled claims
Requests refunds for mileage adjustments on behalf of the Outside Claims Specialist
Tracks all Motor Vehicle Accident (MVA) claims
Provides backup support to the local Billing office as needed
Minimum of 1 year of clerical experience
Strong Microsoft Office experience with emphasis on Excel
Exhibit high degree of social, ethical, and organizational norms
Maintain a stable disposition despite external pressure and opposition
Excellent Customer Service (for internal and external customers)
Exceptional attention to detail

Provider Claims Clerk Resume Examples & Samples

Ensure all adjustment requests are entering into the system within required timeframes to meet performance guarantees
Participate in meetings to share, discuss, and solution for question or error trends, as well as potential process improvements
Identify issue trends affecting multiple areas and escalate to appropriate partners
Participate in individual coaching sessions as requested by management
Attend group training sessions as requested by management
Provide expertise or general claims support by reviewing, researching, investigating, and entering all types of reconsideration requests
Analyze and identify trends and report as necessary
Consistently meet established productivity, schedule adherence, and quality standards
Works independently
May act as a resource for others or back up for SME
May be a resource for new hires
May work complex special projects
Able to type minimum 40 WPM and 10 Key of 10K or better
Previous Data Entry experience
Experience using computer and Windows PC applications, which includes strong keyboard and navigation skills and learning new computer programs
Experience using MS Word (create, update, format documents) and MS Excel (create, update spreadsheets, pivot tables, sort data)
Monday - Friday 8 hour shift between 6am - 6pm / Weekends / Overtime based on business needs

Claims Clerk Resume Examples & Samples

Complete the initial entry of loss notices in the claims system and distribute the claim to the appropriate supervisor
Perform research on losses that have entry-level coverage issues
Maintain daily production requirements
Index documents from imaging system to claim files
Operate a variety of office equipment, including computers, printers, copy machines, and facsimile receiver/transmitter
6 months experience in a workers compensation insurance claims department or related experience
Self-organized and detail oriented
Professional telephone demeanor and good oral communication skills
Ability to work well under pressure and multi-task in a fast paced environment

Claims Clerk Resume Examples & Samples

Responsible for USPS mail, FedEX, etc Outgoing/Incoming
Manage Office Supplies - ordering, stocking, delivering
Reports- weekly, monthly, quarterly
Special Projects as assigned
Liaison with Property Management
Ability to work well under pressure, multi-task in a fast-paced environment, and complete daily assigned tasks in the assigned time frame

Claims Clerk Resume Examples & Samples

Reviewing invoices in a detailed manner for necessary information in order to issue payments for Workers Compensation claims
Detailed audit of issued payments verifying substantiating documentation
Indexing claims documents by identifying and routing mail appropriately through an imaging system
Operate a variety of office equipment, including computers, printers, Rightfax, and copy machines
Tracking and reporting daily productivity
Ability to take direction
Logically process technical information
Productivity conscious with accuracy
Basic understanding of business technology, practices and professionalism

Claims Clerk Resume Examples & Samples

Open, sort, and process incoming and outgoing mail
Provide claim file storage services-boxing, shipping, and maintaining records
Operate a variety of office equipment, including computers, printers, copy machines, and mailing equipment
Must be able to lift 50lbs
Basic understanding of shipping and receiving protocols

Claims Clerk Resume Examples & Samples

Key claims meeting department performance standards for production and quality
Report claim entry and/or claims system issues to management
Proactively identify client service improvement opportunities.As appropriate, work in collaboration with the unit supervisor(s) to resolve problems
Contribute to a team environment by consistently exhibiting excellent interpersonal skills and demonstrating flexibility with daily operations/function

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