Claims Consultant Resume
Buying an insurance for protecting one's life, house, property, etc. may be easy. But the same cannot be said for claiming the insured money in case of any unpleasant situations. It takes great patience and intelligence to convince insurance providers to pay for what is right. Therefore, individuals, business, and other public and private organizations seek help of claims consultants. These consultants are expert in dealing with insurance companies, filing, processing, and negotiating claims. They may be an agency or a freelancer who negotiate with insurance providers for resolving financial issues related to life, property, business and health insurance.
To work as a claims consultant, a degree in business or accounting is essential. You have to work at the entry-level and gain experience to become a consultant. With proper education and experience, you can build the skills required in negotiating with insurance companies. This job application sample shows the types of competencies you should have to apply for the job.
Claims Consultant Resume Example
Howard K. Carroll
4125 Grey Fox Farm Road
Houston, TX 77032
Phone: 281-827-4656
Email: hkcarroll@freemail.com
Career Objective:
To work as a claims consultant for a health insurance company and perform thorough investigation for filed claims and resolved financial issues in an amicable manner.
Summary of Skills:
- Experience in solving medical claims dispute in a professional manner
- Knowledge of the medical industry, medical terminology, diagnosis and treatment procedures
- Thorough knowledge of claims verification, investigation process, fraud detection, and payment processing
- Strong numerical, computer, interpersonal and communication skills
- Matured, professional, good listener, and decent negotiator
- Skilled in holding meeting, presenting facts, and soothing clients
Work Experience:
Claims Consultant
ABC Insurance Company, Houston, TX
October 2013 - Present
- Verify claims submitted for completeness and authenticity
- Visit hospitals, clinics, and other medical service providers and collect information on treatment provided
- Ensure details filed are as per established medical insurance policies
- Negotiate with insured, service provider, and settle financial issues
- Approve and reject claims by conducting detailed investigation
- Maintain medical bills, medical reports, and other documents for reference
- Ensure no escalation for claims filed and try not to get involved in litigation process
Claims Consultant
Phantom Insurance Company, Houston, TX
May 2012 - September 2013
- Interviewed insureds, claimants, and witnesses and collected information
- Created physical and digital file with complete investigation report
- Evaluated filed claims and negotiated between the two parties
- Processed, adjusted, and issued checks for settling payment
- Negotiated settlement between insureds and claimants in a peaceful manner
- Provided support to insureds in completing forms for filing claims
- Verified authenticity and identify of the filed claims and insureds and processed claims
Education:
- Bachelor's Degree in Accounting
Houston University, Houston, TX
2011
Reference:
On request.