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Online Resumes with "complex claims "



Claims Investigator - 18 Years of Experience - Near 33604

Summary Claims Investigator with over 12 years of experience in investigating and managing various disability claims (Workers Compensation and LTD) which was reinforced by SIU fraud field experience meeting claimants, employers, and physicians in person and obtaining recorded and written statements, as well as arranging/reviewing surveillances and state fraud reporting. Recent employment as a desktop investigator for a Comp...

Tags for this Online Resume: contract interpretation, Management, File Documentation, Worker's Compensation, Database, Research, Field Investigations, Claims, Fraud Investigator, Desktop Investigator, LTD Disability, Interviews statements, Accurint Lexis Nexus, Word Excel powerpoint, Excellent written and oral communication

Insurance Sales Manager - 20 Years of Experience - Near 93720

QUALIFICATIONS SUMMARY * Licensed Life & Health Agent, 16 years in the health insurance industry. * Able to analyze and interpret complex claim, medical and legal issues. * Articulate communication skills express thoughts in a clear and concise manner. * High level of professional commitment enthusiastic and focused. * Professional attitude and appearance.

Tags for this Online Resume: Central valley, outside sales Valley, Medical insurance, Self funded, Customer service, Professional, Data Entry, Insurance, Life Insurance, Management

Claims Adjuster - 6 Years of Experience - Near 95677

AREAS OF EXPERTISE * Adapt easily to new concepts and * Investigative Research * Operations Maintenance * Fraud/DV claims responsibilities * Complex claims * Customer services * Negotiating skills * Field Independent, ability to travel * Technical Proficiency * Self Development * PDR Training * Demonstrate analytical and * Communication skills * Time Management * Claims Adjusting administrative capabilities * Conflict Manag...

Tags for this Online Resume: Analytical Skills, Automotive, Communication Skills, Diversity, Excellent Communication Skills, Management, Microsoft, Microsoft PowerPoint, Microsoft Word, Problem Solving, Adjuster, Trainer, Claims Management

Claims Examiner - 19 Years of Experience - Near 23117

Summary Expert Claims Supervisor with 18 years experience in insurance and claims. Current position includes root-cause analysis, trending, coaching, associate development, knowledge of multi-state claims handling, complex claims handling, and third-party claims settlements. Career Credentials: * First party, third party, and litigation handling * Multi state experience * Currently Telephone Claims Supervisor to 6 associate...

Tags for this Online Resume: Litigation, Insurance, Management, Mba, Risk Management, Settlements

Billing/Coding Specialist - 4 Years of Experience - Near 78242

at Position Description: Reviewing claims working off project list or work queue. Responsible for providing expertise or general support in reviewing, researching. Experience in a production based environment with an emphasis on quality outcomes. Primary Resposabilities: * Reviewing and adjudicating medical claims in accordance with CMS claim processing guidelines. * Processing claims Up to 50K * Provide expertise claims su...

Tags for this Online Resume: Microsoft, Microsoft Outlook, Services, Adobe, Audit, Banking Industry, Benefits, Billing, Call Center, Cardiopulmonary resuscitation (CPR)

Claims Adjuster - 20 Years of Experience - Near 07060

SUMMARY OF QUALIFICATIONS: Dedicated and detail oriented Insurance professional with over 20 years of experience handling simple and complex claims. Possesses excellent customer service and interpersonal skills. Is an attentive listener, able to identify critical information, supporting sound decisions. Able to work independently, while achieving company goals and objectives. Supports the efficient management of sensitive a...

Tags for this Online Resume: Appraisals, Arbitration, Email, Fraud, Insurance, Underwriter, Customer Service, Management, insurance, customer service

Claims Examiner - 20 Years of Experience - Near 85260

Summary: Strong professional background in the field of insurance. High level of experience in claims management, claims administration, claims investigation, litigation management, negotiations, and claims settlement and processing. Strong business and financial aptitude. Focused and concentrated skills in project management, workflow analysis, product development as well as extensive experience in client development, rela...

Tags for this Online Resume: Imaging, Account Manager, Medicare, Project Management, Project Manager, Distribution, Management, Product Design, Best Practices, Compliance, insurance

Claims Investigator - 15 Years of Experience - Near 06457

Accomplished Professional with proven ability to administer comprehensive business plans in the insurance and nonprofit arenas. Creative influencer who approaches management solutions and related problem solving with innovative and quantifiable value-added vision coupled with exacting ethical standards and logistical prowess. Core competencies includes a commitment to teamwork necessary networking and customer relationships...

Tags for this Online Resume: Audit, Arbitration, Litigation, Reinsurance, Management, Novell Netware, Risk Management, Compensation, Workers Compensation, Budgeting

Not Listed - 20 Years of Experience - Near 07670

SUMMARY Accomplished Risk Management and Insurance Professional with an extensive background in global insurance programs, loss prevention, enterprise risk management, insurance brokering and complex claim settlements. Advisor to Senior executives on insurance coverage, risk financing alternatives and emerging risks. Strengths include strategically combining traditional risk transfer capacity with captive programs to balanc...

Tags for this Online Resume: Management, Risk Management, Compensation, Risk Manager, Insurance, Acquisitions, CIO, Due Diligence, Legacy, RIMS, Enterprise Risk skills, risk management, Technical Insurance expertise, Insurance coverage knowledge, Claims management, captive, insurance management, risk consulting, M&A Due diligence

Claims Adjuster - 15 Years of Experience - Near 89101

QUALIFICATIONS I am a licensed Nevada Workers' Compensation Representative since 1993. I have 20+ years experience in the insurance industry including adjusting and litigating claims. Duties: Duties: All aspects of the Workers' Compensation program for four properties During this period I was a one person office performing all tasks of the Companies) Duties: Handled complex claims for the companies assigned. Duties: I start...

Tags for this Online Resume: Compensation, Benefits, Litigation, Risk Manager, Security, Claims Adjuster, Compliance, Computer Aided Software Engineering, Insurance, Management

Claims Adjuster - 11 Years of Experience - Near 75007

Mission-driven Claims Adjuster seeking to leverage expertise in efficiently managing complex claims with accuracy and integrity. Fearless negotiator with experience in high-stress scenarios without compromising customer service

Tags for this Online Resume: Sales, Claims Adjuster, Insurance, Services, Settlements

Financial Manager, Branch or Department - 0 Years of Experience

o Mortgage professional with 4 years' experience in the Loan, Servicing, and Excel. 0 Review of processes, claims and/or loan documentation to assess any potential harm to customers or clients 0 Serve as a second level loan review on highly complex claims completed by Mortgage Claims Analysts 0 Examination of processes, claims and/or documentation to identify potential gaps in the process and ensure servicing standards and...

Tags for this Online Resume: Account Management, Banking Industry, Billing, Fraud, Management, Real Estate, Microsoft Excel, Database, Evaluate, Appraisals