Great Sample Resume

Claims Adjudicator Resume

Feel free to use this Claims Adjudicator Resume example to update your own resume. Even though this is a free resume example, it is important to adjust your own resume to present your relevant work history and skills according to the job you are applying for.

Our resume examples are written by certified resume writers and is a great representation of what hiring managers are looking for in a Claims Adjudicator Resume. Use this example for reference as you create your own resume or use this easy resume builder that will guide you through every step of your building your resume in just a few minutes.

Here is the Claims Adjudicator Resume example:

James Thompson

978 Elk Avenue

Lansing, MI 48933



Job Objective Claims Adjudicator with excellent skills and the ability seeking to work for your company.

Highlights of Qualifications:

  • Excellent experience in processing claims for general accounts
  • Sound knowledge of insurance procedures and accounting processes
  • Profound knowledge of management utilization techniques
  • Ability to multitask and maintain accuracy in high pressure environment
  • Ability to coordinate with team members for various activities
  • Familiarity with claims processing, accounts payable, general accounting

Professional Experience:

Claims Adjudicator

Northwest Community Hospital, Lansing, MI

August 2012 – Present


  • Monitored various inputs from physicians such as x-ray and dental records.
  • Evaluated referrals and provided authorization for claims.
  • Managed claim system and provided information to new providers.
  • Coordinated with IT team for upload and obtained required DDE rates.
  • Generated remittance notice when required and obtain authorization from management.
  • Coordinated with departments and assisted in transmission of claim files.

Claims Adjudicator

Valence Health, Lansing, MI

May 2009 – July 2012


  • Adjudicated various medical and non-medical provider claims and updated on CMS.
  • Procured rate tables for Medicare processes and monitored expenses.
  • Maintained and generated accruals for accounting processes.
  • Evaluated plans and maintained notes of patient records.
  • Coordinated with providers and carrier contracts for authorization.
  • Performed research and facilitated processing of claim payments.


Bachelor’s Degree in Finance

Edward Waters College, Jacksonville, FL

  • 1.0.0Version
  • --Download
  • 1File Count
  • March 1, 2024Create Date
  • March 1, 2024Last Updated

Average Rating

Be the first one to review