Claims Examiner Resume Sample

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Nadine Klemperer

100 Broadway Lane
New Parkland, CA, 91010
Cell: (555) 987-1234
example-email@example.com

Professional Summary

Detailed and well-versed Insurance Claims Examiner that knows all the guidelines and regulations for successfully reviewing submitted claims. Utilizes the expertise of a variety of trusted contacts in various industries to evaluate and verify circumstances behind claims, as well as thorough personal investigations, and recording data into reports used to make sound settlement determinations.

Core Qualifications

  • Adherence to State of California insurance regulations
  • Work with adjusters on complex claims
  • Loss control
  • Project management
  • Return to work strategies
  • Litigation and subrogation management
  • Criminal and civil law
  • Actuarial impact
  • Latest computerized insurance solutions

Experience

Insurance Claims Examiner – March 2007 to Present
Amble Insurance Companies, New Cityland, CA

  • Manage investigations and resolutions of workers’ compensation claims.
  • Ensured all processes complied with workers’ compensation rules, laws and procedures.
  • Work with employers to implement risk management programs.
  • Develop financial analysis of claims.
  • Involved in settlement negotiations.
  • Prepare and distribute status reports on individual claims and overall operations.


Insurance Claims Examiner – March 2002 to February 2007
Masterson Health Services, New Cityland, CA

  • Reviewed lower level personal injury and personal damage claims.
  • Identified liability exposure and reserve values.
  • Researched referrals for customer service.
  • Conducted third-party administration healthcare claims.

Education

2002 Associates Degree, Business Accounting
University of California, New Cityland, CA

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