Health Insurance Claims Resume

[First Name] [Last Name]

Contact Address: [street]

[Country] [City] [State/Province] [Zip Code]

Contact Number: (012)-345-6789

Email Address: [[email protected]]

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Career Objective:


An insurance specialist with strong track record of claims handling and analyzing insurance-related documents is looking for an health insurance specialist position with “Sun Insurance Group.”

Summary of Skills:

  • Thorough knowledge of healthcare products and insurance policies

  • Excellent analytical, communication, and critical thinking skills

  • Adept in analyzing information and working with database

  • Experience of accepting and denying questionable claims

  • Strong familiarity with medical terminology, diagnosis, and treatment

  • Strong knowledge of Medical Coding, Risk Management, and Process Management

Work Experience:


Insurance Claims Processor

ABC Company, Cape Girardeau, MO

October 2015 – Present

  • Researching and processing claims as per Company guidelines and benefits

  • Communicating with the insured via emails, phone, and personal meetings

  • Drafting reports on acceptance and denial of applications for claim

  • Meeting hospitals and clinics and collecting necessary documents

  • Analyzing medical documents for authenticity and clearing doubts from subject-matter experts

  • Answering incoming calls, emails, and inquiries personally

Junior Claims Processor

Noble Insurance Company, Cape Girardeau, MO

February 2013 – September 2015

  • Made code calling to prospective customers and converted them into regular customers

  • Demonstrated features and benefits of health insurance policies to customers

  • Reminded customers on renewal of policies and fetched reference from them

  • Validated insurance submitted for medical claims and re-worked on closed claims

  • Coordinated with medical staff of respective hospitals and collected treatment papers

  • Calculated the limit of amount to be cleared for medical billing

Education:

  • Bachelor’s Degree in Health Management Science

    ABC University, Cape Girardeau, MO

    2012

Reference:

On request.