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Senior claims representative skills for your resume and career

15 senior claims representative skills for your resume and career
1. 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.
- Provided exceptional customer service by assisting claimants with rental car reservations, contact information for collision repair facilities and scheduling appraisals.
- Mentored other Claims Representatives in case management, strategic considerations, reserve computation, settlement negotiations, and effective customer service.
2. Claims Handling
- Investigate liability and negotiate liability and total loss settlements with customers and attorneys, while mitigating expenses associated claims handling.
- Created flowchart showing step-by-step claims processing that illustrated efficient claims handling to representatives and increased customer satisfaction.
3. Litigation
- Handled and negotiated commercial liability litigation claims with medical providers, attorneys, primary health insurance carriers, and Medicare.
- Investigated and determined issues of auto liability Settled bodily injury cases, medical claims and property damage Prepared cases for litigation
4. Insurance Claims
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims as the Special Investigations Unit Coordinator.
- Acted as Licensed Casualty Adjuster; investigated liability and coverage in auto insurance claims.
5. Bodily Injury Claims
- Conduct prompt and thorough investigations, evaluating and resolving high exposure automobile bodily injury claims while providing quality service to policyholders.
- Settled minor to complex auto Bodily Injury claims after monitoring ongoing medical treatment and/or other ongoing procedures for appropriateness.
6. Automobile Claims
- Handled and investigated a very active pending which consisted of General Liability and Commercial Automobile claims.
- Investigated and settled bodily injury and property damage automobile claims with attorneys and private individuals.
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Police reports, also known as "incident reports," are recorded by members of the police department and detail a (potentially) illegal incident or confrontation. The following information is usually found on a police report: the date and time of the incident, which officers were involved, the address of the incident, what kind of incident (theft, assault, etc.), and how the officers were alerted to the incident.
- Conducted claim investigations including recorded statements, personal interviews, analysis of medical and police reports, and accident scene reconstruction.
- Review and interpret police reports for investigations.
8. Claims Process
- Ensured compliance with contracts and established procedures and generated reporting used to improve overall claims processing efficiency and accuracy.
- Monitored loss ratios to make sure Clients were operating their Workers Compensation Claims process efficiently and effectively.
9. Xactimate
Xactimate is a computer platform used to estimate the cost of room restoration. Users sketch an architectural outline of the room, which offers a close estimation for project costs. Xactimate can connect to the cloud so these plans and estimates can be accessed anywhere on mobile and desktop devices.
- Prepared all structural estimates using Beck estimating software as well as xactimate estimating software.
- Utilized Xactimate estimating system during field inspection to properly evaluate commercial property damages.
10. 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.
- Negotiate settlement or provide appropriate settlement authority to defense counsel when required.
- Direct interaction with independent investigators, defense counsels and medical management personnel.
11. Coverage Analysis
- Provided coverage analysis and issued reservation of rights when warranted.
- Conducted comprehensive accurate coverage analysis.
12. Strong Negotiation
- Executed and facilitated strong negotiation and customer services skills to maintain relationships with claimants while also effecting settlements of claims.
- Developed strong negotiation skills by handling bodily injury settlements.
13. Excellent Negotiation
- Contributed to profitability by reductions of file pending and excellent negotiation of claims.
- Demonstrate excellent negotiation skills as indicated by settlements reached.
14. SR
- Promoted to Bodily Injury Sr.
- Job Title: Sr. Claims Rep 10/95-03/05
15. Coverage Issues
- Recognized coverage issues and insured enforcement of policy terms and conditions via reservation of rights and/or disclaimer where warranted.
- Handled coverage issues, investigated claims, determined liability and negotiated settlements with both claimants and plaintiff attorneys.
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List of senior claims representative skills to add to your resume
The most important skills for a senior claims representative resume and required skills for a senior claims representative to have include:
- Customer Service
- Claims Handling
- Litigation
- Insurance Claims
- Bodily Injury Claims
- Automobile Claims
- Police Reports
- Claims Process
- Xactimate
- Defense Counsel
- Coverage Analysis
- Strong Negotiation
- Excellent Negotiation
- SR
- Coverage Issues
- Policy Coverage
- Arbitration
- Commercial Property
- Liability Claims
- Independent Adjusters
- PIP
- Workers Compensation Claims
- CPT
- Settlement Conferences
- Casualty Claims
- Medical Bills
- Physical Damage
- Insurance Policies
- Policy Language
- Repair Facilities
- Medical Treatment
- Insurance Carriers
- Outbound Calls
- Medical Reports
- Medical Claims
- Party Claims
- Policy Holders
- Property Damage Claims
- Settlement Authority
- Auto Liability
- Schedule Appointments
- Repair Shops
- Body Shop
- Scene Investigations
- Target Dates
- Product Liability
- State Laws
- Injury Claims
Updated January 8, 2025