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Claims administrator skills for your resume and career

Updated January 8, 2025
5 min read
Claims administrator example skills
Below we've compiled a list of the most critical claims administrator skills. We ranked the top skills for claims administrators based on the percentage of resumes they appeared on. For example, 12.1% of claims administrator resumes contained data entry as a skill. Continue reading to find out what skills a claims administrator needs to be successful in the workplace.

15 claims administrator skills for your resume and career

1. Data Entry

Data entry means entering data into a company's system with the help of a keyboard. A person responsible for entering data may also be asked to verify the authenticity of the data being entered. A person doing data entry must pay great attention to tiny details.

Here's how claims administrators use data entry:
  • Scheduled and trained all operators for Customer Service Representation and data entry support.
  • Prepare detailed reports and electronic data entry utilizing Excel spreadsheets.

2. Customer Service

Customer service is the process of offering assistance to all the current and potential customers -- answering questions, fixing problems, and providing excellent service. The main goal of customer service is to build a strong relationship with the customers so that they keep coming back for more business.

Here's how claims administrators use customer service:
  • Analyzed policies and processes with regard to customer service efficiency and recommended changes to account managers for improvements as necessary.
  • Handled self-administered general liability claims from inception to final resolution under limited supervision with focus on quality customer service.

3. Process Claims

Process claims refers to the procedure an insurance agent follows once receiving a claim from an insured individual. This often includes reviewing, investigating, and deciding on whether the claim will be accepted or denied depending on the results of the insurer's investigation. This is a common procedure for all kinds of insurance including medical, auto, and liability insurance.

Here's how claims administrators use process claims:
  • Process claims for security and non security in accordance with court-approved plan of allocation, and settlement stipulation
  • Analyze and process claims by investigating and gathering information to determine the exposure of the claim.

4. Phone Calls

Phone calls are a wireless or wired connection made over a telephone or a mobile phone between two people. Two parties are involved in a phone call, the caller and the receiver. A caller dials the number of the one he wants to call, and the recipient hears a bell or a tune to which he picks up the call. The call establishes a connection between them through which they can communicate. The voice is converted into signals and is transmitted through wired or wireless technology.

Here's how claims administrators use phone calls:
  • Answer phone calls in a fast paced environment; respond to questions and requests; referring inquiries to the pharmacists.
  • Answer phone calls from employees and Line HR members regarding status of claims, policies and assist with payroll issues.

5. HR

HR stands for human resources and is used to describe the set of people who work for a company or an organization. HR responsibilities revolve around updating employee records and carrying out management processes like planning, recruitment, evaluation, and selection processes. HR is a key contributor to any company or organization's growth as they are in charge of hiring the right employees, processing payrolls, conducting disciplinary actions, etc.

Here's how claims administrators use hr:
  • Reorganized HR tracking of required information.
  • Assisted the HR administrator in processing paperwork for new hires, disability and termination's.

6. Insurance Claims

Here's how claims administrators use insurance claims:
  • Required to review and processed medical documentation for payment processing for various insurance claims.
  • Analyzed & processed medical/hospital/life/disability insurance claims accurately following all government and Local guidelines.

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7. Claims Management

Here's how claims administrators use claims management:
  • Administer general liability loss control and loss prevention programs through identification/mitigation of risks and claims management.
  • Provided administrative support for optimal claims management services of numerous home owner insurance companies.

8. Warranty Claims

Warranty Claims refers to claims made by customers regarding a defective product or service. Many electronics will be covered by a warranty period of several years, meaning if the product becomes defective within that time range the customer can receive a new product at no extra cost.

Here's how claims administrators use warranty claims:
  • Negotiated with insurance companies*Compiled customer satisfaction surveys*Filed reports and submitted vehicle warranty claims*Answered multiple phone lines and assisted customers
  • Acted as an administrator and arbitrator in Toyota's extended warranty claims office to resolve customer complaints, legal matters.

9. Claims Administration

Here's how claims administrators use claims administration:
  • Received advanced training on claims administration at national bankruptcy trustee conference.
  • Provide claims administration for workers compensation and general liability programs.

10. Medical Terminology

Here's how claims administrators use medical terminology:
  • Utilized medical terminology, ICD-9, CPT, Medicare pricing, manual adjustments and benefits recalculations.
  • Possess general knowledge of insurance processing activities and operational functions, as well as a working knowledge of medical terminology.

11. Policy Holders

Here's how claims administrators use policy holders:
  • Educated and advised policy holders of insurance coverage.
  • Set follow up calls for policy holders to check status and outcome of claim process.

12. Claims Adjusters

Here's how claims administrators use claims adjusters:
  • Coordinate inspection arrangements for claims adjusters.
  • Research claim information, support claims adjusters, review damage reports and provide other administrative support.

13. Defense Counsel

A defence attorney is a counsel representing the defendant in a criminal prosecution or lawsuit. A defence attorney aims to solve court cases as swiftly and satisfactorily as possible. Client representations at arraignments, hearings, and court trials along with preparing and drafting legal documents, including legal briefs and appeals is all part of their job description. They are responsible for presenting convincing evidence to a jury and/or judge if the case goes to trial.

Here's how claims administrators use defense counsel:
  • Prepare settlement evaluations and coordinate referral to defense counsel to finalize the settlement process.
  • Administered all casualty claims activities; including work product of TPA's and outside defense counsel.

14. Inbound Calls

Here's how claims administrators use inbound calls:
  • Answered inbound calls to assist providers, clients, and patients with benefit verification.
  • Received inbound calls regarding settlement dipersments.

15. Office Equipment

Here's how claims administrators use office equipment:
  • Transcribe dictation; operate and maintain office equipment such as fax, printing and copying machines.
  • Moved office equipment that weight approximately 15lbs + when necessary, i.e.
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List of claims administrator skills to add to your resume

The most important skills for a claims administrator resume and required skills for a claims administrator to have include:

  • Data Entry
  • Customer Service
  • Process Claims
  • Phone Calls
  • HR
  • Insurance Claims
  • Claims Management
  • Warranty Claims
  • Claims Administration
  • Medical Terminology
  • Policy Holders
  • Claims Adjusters
  • Defense Counsel
  • Inbound Calls
  • Office Equipment
  • TPA
  • Insurance Adjusters
  • Workers Compensation Claims
  • HIPAA
  • Insurance Carriers
  • Bodily Injury
  • Computer System
  • CPT
  • Medical Claims
  • Claims Handling
  • Medical Treatment
  • Customer Complaints
  • Liability Claims
  • Medicaid
  • Outbound Calls
  • Police Reports
  • Open Claims
  • A/R
  • ICD-9
  • Hippa
  • Dental Claims
  • Arbitration
  • PowerPoint
  • FSA
  • EOB
  • Property Damage Claims
  • FMLA
  • Process Payments
  • AS400
  • Freight Claims
  • Interrogatories
  • Medical Bills
  • Client Guidelines
  • IRS

Updated January 8, 2025

Zippia Research Team
Zippia Team

Editorial Staff

The Zippia Research Team has spent countless hours reviewing resumes, job postings, and government data to determine what goes into getting a job in each phase of life. Professional writers and data scientists comprise the Zippia Research Team.

Updated January 8, 2025

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