Worldwide Insurance Services LLC - Claims Examiner Resume Example

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Andrew King
XXX X XXXX XXXXXX, Philadelphia, PA 19131
Ph: XXXXXXXXXXXX
XXXXXXXXXXXXXXXX
Professional Summary
Detail-oriented medical claims examiner with 18 years in the healthcare industry ,well versed in health insurance statues, and practices.  Excellent communications skills that serve to lessen claimant confusion about process and status.  Adapt at multitasking and completing assignments within any and all policy deadlines.
Skills
  • Effective Communicator
  • Complex Problem Solving
  • Time Management
  • Critical Thinking
  • Diligent Documenter
Experience
Claims Examiner Nov 2013Aug 2015 Worldwide Insurance Services LLC Radnor, PA
  • Investigate, evaluate and settle international claims, applying technical knowledge and human relations skills to ensure that claims are valid and that settlements are made according to company practices and procedures.
  • Responsible for independent research necessary to determine the correct application of benefits, maximums, and limitations.
  • Accurately performed the manual processing of the  claim from keying of data, translating language to the finalization of claim.
Claim Analyst May 1995Nov 2013 Independence Blue Cross Philadelphia, PA
  • Keep records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken.
  • Check to ensure that appropriate changes were made to resolve customers' problems.
  • Contact customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments.
  • Refer unresolved customer grievances to designated departments for further investigation.
  • Investigate, evaluate and settle claims, applying technical knowledge and human relations skills to effect fair and prompt finalization of claim.
  • Pay and process claims within designated authority level.
  • Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
Education
Associate of Science : Business Jun 2002 Pierce College Philadelphia, PA

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About this resume

Claims Examiner FROM Philadelphia , Pennsylvania RESUME

This is a resume for a Claims Examiner in Philadelphia, Pennsylvania with experience working for such companies as Worldwide Insurance Services LLC and Independence Blue Cross. The grade for this resume is 0 and is one of hundreds of Claims Examiner resumes available on our site for free. Use these resumes as templates to get help creating the best Claims Examiner resume.

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School Attended
Pierce College