Insurance Specialist Resume

An insurance specialist is a job title that is assigned to people who hold strong proficiency in risk management. The specialty of these insurance professionals is used for identifying, assessing, and mitigating risks associated with insurance products and investment. Based on their specialty, they may work with products such as term insurance, life insurance, health insurance, asset insurance, investment policies, endowment, and mortgage insurance.

Since the core job of insurance specialists is risk management, they have to work closely with wealth managers to ascertain assets and liabilities; investment advisors to interpret policies and decode rules and regulations associated with insurance; loan specialists to understand needs of individuals and businesses for loan.

Individuals who wish to apply for an insurance specialist position must include analytical abilities, detail-oriented, technical and social skills, and risk management experience.

Sample Insurance Specialist Resume

Robert G. Hawser
3024 Smith Street
Boston, MA 02110
Phone: 508-182-9178
Email: robert.hawser@anymail.com

Career Summary:

Highly-competent and dedicated Insurance Specialist with over 8+ years of experience in handling insurance coverage, explaining policies, ensuring proper payments or reimbursements of the clients. Adept at coordinating between the medical health center and the policy provider to give a hassle-free customer service to the client using exceptional communication as well as organization skills.

Summary of Skills:

Sound working knowledge of health insurance billing and payments, including interpretation of billing codes and processing claims
Adept in using exceptional research and analytical skills to examine accuracy of claims with the help of necessary paperwork
Capable of interpreting and deciphering complicated insurance laws & policies to determine exact coverage
In-depth information on risk management and familiar with handling cases involving emergency needs, accidents and cash flow needs
Detail-oriented, good communication, and active listening skills
Outstanding mathematical and organizational skills to ensure apt reimbursement to the concerned individual
Proficient in working with database and various applications such as MS Office Suite, updating spreadsheets, and responding to mails/calls
Excellent written and verbal skills to convey proper messages to the insurance companies and the medical clinics/private hospitals

Work Experience:

Insurance Specialist
ENGS Insurance Agency, Boston, MA
November 2016 – Present

Maintaining regular communication, correspondence and follow up with patients and families to keep them informed about the clearance or pay issues
Coordinating with the insurance policy providers to follow-up with pending insurance, coverage and other payment-related issues
Inspecting insurance policies given by the providers, including Medicare and Medicaid to ensure compliance with the federal laws
Supervising a team of 10 Insurance Verification Specialists and reviewing their work
Receiving phone calls to and from insurance companies aimed at accurately completing FSC information at the patient registration desk
Representing the company for meetings and committee discussions
Responding to patient inquiries by giving in detail information about the policy cover, benefits and solving doubts in cases, involving accidents, emergencies or chronic diseases

Insurance Specialist
EXL Life Saver Co., Boston, MA
April 2013 – October 2016

Liaised between patients and insurance companies to resolve insurance-related issues
Assessed insurance benefits and explained levels of coverage as well as specific medical criteria related to policies
Corresponded with the policy holders to inform about the overdue balances while serving as a collection agent for the organization
Managed phone calls, mail and in-person inquiries related to medical billing, insurance and general information increasing clients by 34%
Performed daily functions of administrative support and customer service to help clients in need of financial assistance by informing about the various available policies and selecting the best that suits their needs
Took responsibility to assess the investment withdrawals, oversee accounts activation, manage client insurance policies as well as monitor policy lapses
Continuously provided effective, persistent and assertive actions in resolving claims issues and appeals while maintaining compliance with the HIPPA laws

Entry-level Insurance Specialist
Metroplus Health Services, Boston, MA
August 2010 – March 2013

Enter patient information with proper medical codes in the organization's database
Worked with Call Center representatives to convert prospective clients into long-term customers
Verified patient insurance coverage to ensure necessary procedures are followed for proper payment of the medical bills
Gained familiarity with insurance regulations and policies, payment guidelines and effectively handled issues to get payer claims resolved
Reviewed insurance claims submitted by clients and investigated doubtful claims
Read through and explained health-care contracts to inform about complex clauses to the clients, and ensured proper contract work-flows

Education:

Bachelor's Degree in Insurance Services
Boston University School of Medicine (BUSM), Boston, MA
2010

Certification:

Insurance and Coding Specialist Certification, 2012
Health Insurance Portability an Accountability Act Certification, 2013

Reference:

On request.