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Insurance Claims Representative Resume

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Looking for Cover Letter ideas? See our sample for Customer-focused Claims Representative Example Cover Letter and Customer-focused Claims Representative Example Responsibilities and Duties.

Here is the Insurance Claims Representative Resume example:

Hai James

600 Straford Park

Lexington KY 40505



Job Objective Qualified Insurance Claims Representative seeking a position with growing firm in which to utilize my skills and expand my knowledge.

Highlights of Qualifications:

  • Huge experience in claims field and general group claims
  • Wide knowledge of medical terminology and computer programs
  • In-depth knowledge of insurance policies and coverage’s, claim payment procedures
  • Superior data entry skills and amazing ability to work autonomously
  • Ability to review and interpret complex and detailed documents
  • Ability to exercise judgment, and evaluate claims
  • Solid communication skills and excellent ability to nurture relationships
  • Efficiently professional and motivated with a sound positive attitude

Professional Experience:

Insurance Claims Representative

OrthoSynetics, Lexington KY

November 2006 – Present

  • Analyzed EOBs and evaluated patient’s provided insurance data and updated database and system.
  • Corresponded about denied claims to appropriate channels and resubmitted claims when required.
  • Evaluated accessions and submitted write-off.
  • Outlined course of action to smoothen payments and analyzed negotiated agreements.
  • Maintained proper patient billing and monitored mail/faxes and coursed appropriate actions.

Insurance Claims Representative

Nationwide Relocation Services, Lexington KY

February 2001 – October 2006

  • Updated imaged claims documents on Imaging System.
  • Aided Life, Short Term Disability and Long Term Disability claims areas.
  • Managed claims forms and document types.


Bachelor’s Degree In Business

Drew University, Madison, NJ

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  • March 1, 2024Create Date
  • March 1, 2024Last Updated

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