CASE SPECIALIST RESUME EXAMPLE

Updated: July 23, 2024 - The Case Specialist maintains productive relationships with colleagues and effectively communicates in all interactions, fostering a respectful work environment. Engages actively in internal and external business meetings, collaborates on feedback, and identifies developmental opportunities through monthly one-on-one sessions. Delivers exceptional customer service, manages sensitive financial hardship cases, and ensures compliance with legal standards in documentation and dispute resolution.

Tips for Case Specialist Skills and Responsibilities on a Resume

1. Case Specialist, Allstate Insurance, Chicago, IL

Job Summary: 

  • Direct and execute retail sales calls with the dealership sales team
  • Create and manage customer conquest lists to focus salesmen for the dealers on current end use customer opportunities.
  • Develop and train dealer sales force in product performance and application, focusing on new products.
  • Review and analyze competitive products and pricing details and provide details to field sales team.
  • Provide product demonstrations, working applications, identify product limitations, and non-traditional product usage.
  • Support region sales and market share objectives
  • Act as technical resource to dealer sales professionals and Territory Sales Managers (TSMs) on Case Construction equipment.
  • Serve as liaison between marketing, product management and field sales team.
  • Adhere to all published organizational, safety policies and procedures as described in the JAS Forwarding employee handbook.


Skills on Resume:

  • Retail Sales Execution (Hard Skills)
  • Customer List Management (Hard Skills)
  • Sales Force Training (Hard Skills)
  • Competitive Analysis (Hard Skills)
  • Product Demonstration (Hard Skills)
  • Sales Support (Soft Skills)
  • Technical Resource Provision (Hard Skills)
  • Interdepartmental Liaison (Soft Skills)

2. Case Specialist, Liberty Mutual, Boston, MA

Job Summary: 

  • Maintain positive working relationships with peers, showing respect and communicating openly.
  • Work with internal/external stakeholders and participate in business meetings
  • Engage in the monthly one-on-one process by openly discussing feedback and identifying opportunities for development
  • Providing excellent customer service through all communication channels available to customers.
  • Discussing complex and sensitive matters with customers experiencing financial hardship.
  • Completing hardship assessments and providing quality solutions over the phone.
  • Ensuring all customer contact information and the hardship process complies with legal and regulatory requirements
  • Providing quality resolutions to complex problems, or disputes raised by customers
  • Ensuring all customer contract information and the complaints management process complies with legal and regulatory requirements.


Skills on Resume:

  • Relationship Building (Soft Skills)
  • Stakeholder Engagement (Soft Skills)
  • Development Feedback (Soft Skills)
  • Customer Service Excellence (Hard Skills)
  • Financial Hardship Handling (Hard Skills)
  • Regulatory Compliance (Hard Skills)
  • Dispute Resolution (Hard Skills)
  • Data Accuracy Maintenance (Hard Skills)

3. Case Specialist, Humana Inc., Louisville, KY

Job Summary: 

  • Daily point of contact for JAS queries, issues, and cases
  • Assess and validate new cases for insurance claims support and initiate investigations
  • Check preliminary notices have been issued by origin and destination offices and ascertain the correct subsidiary
  • Log and handle each case for internal reporting as well as with insurance claims handlers
  • Summarize new cases for internal reporting on quarterly log, maintain and keep current all case files and correspondence
  • Document investigations, validations, and liability exposure for each case
  • Administer self-insured cargo claims separately from claims logged through insurance according to established procedures
  • Process and follow up on insurance claims, settlements, and subrogation cases
  • Work with attorneys and insurance companies including legal actions and recoveries
  • Compile monthly and ad hoc data for status reporting under supervision


Skills on Resume:

  • Case Management (Hard Skills)
  • Claims Processing (Hard Skills)
  • Data Logging (Hard Skills)
  • Legal Coordination (Hard Skills)
  • Internal Reporting (Hard Skills)
  • Communication Skills (Soft Skills)
  • Problem Solving (Soft Skills)
  • Detail Orientation (Soft Skills)

4. Case Specialist, UnitedHealth Group, Minneapolis, MN

Job Summary: 

  • Manage a team of several hundred Qualified Caregivers
  • Select, match and staff the best Qualified Caregivers for clients
  • Coordinate schedules with Qualified Caregivers and clients
  • Questions, and concerns, ensuring all issues are resolved.
  • Gather and input Qualified Caregiver time and attendance data in scheduling software 
  • Provide assistance in other processes or procedures as requested by the head of function
  • Thoroughly analyse complex customer inquiries and own the investigation process from start to finish
  • Contact for Legal, Compliance, Complaints, and Customer Service Departments
  • Provide customers with best-in-class services
  • Manage and own projects which aim to streamline processes and oversee the implementation of improvements


Skills on Resume:

  • Team Leadership (Soft Skills)
  • Conflict Resolution (Soft Skills)
  • Project Management (Hard Skills)
  • Staffing Expertise (Hard Skills)
  • Data Management (Hard Skills)
  • Analytical Solving (Hard Skills)
  • Interdepartmental Coordination (Soft Skills)
  • Customer Service (Soft Skills)

5. Case Support Specialist, Blue Cross Blue Shield, Dallas, TX

Job Summary: 

  • Complete up to 15 assessments per day of cases impacted by COVID to determine and address unmet resource needs
  • Provide referrals to community-based organizations and state programs 
  • Maintain up to date and accurate knowledge of resource landscape
  • Utilize organizational and time management skills to effectively work in a fast paced and changing work environment
  • Foster positive relationships with internal and external partners and stakeholders
  • Apply active listening and crisis intervention techniques to cases of distress
  • Build and maintain trust with individuals in quarantine and isolation.
  • Assess the level -and- urgency of need and appropriate support for all cases.
  • Fill out other applications as needed and make referrals on the case's behalf.
  • Verify, maintain, and update data in technology platform.
  • Provide case with information for local, State & Federal resources/programs 
  • Assist with immediate and long-term needs
  • Provide education and guidance to people put in quarantine and isolation.
  • Attend internal and external team meetings.
  • Stay up to date on guidance and resources.


Skills on Resume:

  • Rapid Assessments (Hard Skills)
  • Resource Knowledge (Hard Skills)
  • Organizational Skills (Soft Skills)
  • Time Management (Soft Skills)
  • Relationship Building (Soft Skills)
  • Crisis Intervention (Soft Skills)
  • Data Verification (Hard Skills)
  • Educational Guidance (Hard Skills)

6. Disability Case Specialist, Aetna, Hartford, CT

Job Summary: 

  • Ensure accurate and timely reporting to the provincial workers compensation board.
  • Determine the relationship between the mechanism of injury, the diagnosis and the relationship to entitlement by gathering and analyzing relevant information.
  • Handle confidential and sensitive information, documentation, and files in a professional and appropriate manner by privacy and employment legislation.
  • Responsible for managing occupational injury and/or illness claims to resolution 
  • Implementing, developing, and maintaining outcome-focused case management plans
  • Support recovery and safe and timely return to work.
  • Responsible for creating and updating RTW Plans, preparing written correspondence
  • Requesting medical and functional information from health care providers and Workers Compensation Boards.
  • Recommend and coordinate appropriate assessments and evaluations, including Job Demands Analyses, Functional Capacity Evaluations, and Independent Medical Examinations.
  • Utilize proactive methods to address any barriers throughout the return-to-work process, including early intervention methods when claim progress or recovery stalls.


Skills on Resume:

  • Injury Analysis (Hard Skills)
  • Confidentiality Management (Hard Skills)
  • Case Management (Hard Skills)
  • Recovery Support (Soft Skills)
  • Plan Development (Hard Skills)
  • Medical Coordination (Hard Skills)
  • Assessment Coordination (Hard Skills)
  • Proactive Intervention (Soft Skills)

7. Disability Case Specialist, Anthem Inc., Indianapolis, IN

Job Summary: 

  • Advise managers on best practices for all work-related injuries/illnesses while meeting legislative and contractual requirements.
  • Communicate effectively with a variety of stakeholders including managers, employees, unions, health care professionals, and the provincial Worker’s Compensation Board
  • Support early and safe return to work and/or accommodations in the workplace.
  • Collaborate with managers to develop, implement, and monitor return to work plans based on functional information supplied by heath care providers and/or the Worker’s Compensation Board(s)
  • Focusing on reducing claim duration and encouraging timely recovery.
  • Analyse claims, incidents, and investigation data to illustrate trends and prepare reports. 
  • Work collaboratively with Health & Safety/Quality & Risk teams
  • Identify trends and assist with the development of prevention strategies
  • Maintain accurate documentation, records, and sequence of events throughout the life of the claim.


Skills on Resume:

  • Legislative Compliance (Hard Skills)
  • Stakeholder Communication (Soft Skills)
  • Return to Work Support (Soft Skills)
  • Plan Implementation (Hard Skills)
  • Claims Analysis (Hard Skills)
  • Trend Identification (Hard Skills)
  • Documentation Maintenance (Hard Skills)
  • Team Collaboration (Soft Skills)

8. Disability Case Specialist, Cigna Health, Phoenix, AZ

Job Summary: 

  • Prepare claim appeals including performing file reviews and drafting formal employer submissions to support reduction in costs
  • Represent Disability Management at related grievance meetings and arbitrations as the subject-matter expert.
  • Participate in education and training specific to current relevant federal and provincial health and safety legislation, standards, and guidelines
  • Responsible for managing medical LOAs/LTD and return to work process for all medical-related non-occupational leaves.
  • Manage non-occupational medical leaves of absence and long-term disability claims for a large workforce with varying benefit programs and eligibility requirements across multiple provinces.
  • Support the period leading up to LTD benefit eligibility for those of the workforce who are eligible, and proactively manages the transition from LOA (EI) to LTD. 
  • Claim submission, maintaining up to date medical documentation, return to work, and medical accommodations.
  • Arranges assessments such as functional capacity evaluations (FCE) and Independent Medical Evaluations (IME) when appropriate to facilitate successful return to work.
  • Provide reports, statistics,technical guidance and expertise on occupational claims management trends for stakeholders and/or committees.


Skills on Resume:

  • Claim Appeals Preparation (Hard Skills)
  • Grievance Representation (Hard Skills)
  • Legislative Education (Hard Skills)
  • Medical Leave Management (Hard Skills)
  • Benefits Administration (Hard Skills)
  • Transition Management (Hard Skills)
  • Assessment Coordination (Hard Skills)
  • Reporting and Analysis (Hard Skills)

9. Trust and Safety Case Specialist, Kaiser Permanente, Oakland, CA

Job Summary: 

  • Analyse and investigate complicated customer complaints
  • Ensure that each case has been investigated thoroughly and diligently and that a correct solution is given, in accordance with policies and procedures and in respect of all legal requirements.
  • Manage player cases escalated by CS where the player is not satisfied with initial solution.
  • Manage All player escalations that come back to Customer Service after having been raised to other departments (such as RPF or Traders).
  • Review customer complaints and propose to the Trust and Safety Team Manager allowable good will gestures.
  • Review and solve customer claims in a timely manner.
  • Consistently communicates status with all appropriate parties involved with the customer case.
  • Call customers whenever needed in relation to complaint, for follow-up, to diffuse things and communicate the solution.
  • Interact with the customers for SOW, DOC and KYC purposes, via all channels of communication: email, live chat, phone, message, et
  • Maintain an excellent understanding and knowledge of products on the French market, including the specific functions of poker and sports betting as well as the tools used for each product.
  • Being up to date with promotions, competitions and special offers that promote to customers.
  • Reporting of sensitive and high-risk cases to the Trust and Safety Team Manager, the Head of Customer Service Operations and the Customer Service Director.
  • Requesting assistance with requests that one is not able to solve him/herself and escalating 
  • Assisting the Risk & Fraud and Finance Departments with fraud checks and processes
  • Working rotating shifts or specified hours, as needed by the business.


Skills on Resume:

  • Complaint Analysis (Hard Skills)
  • Escalation Management (Hard Skills)
  • Policy Compliance (Hard Skills)
  • Customer Communication (Soft Skills)
  • Goodwill Decision Making (Hard Skills)
  • Product Expertise (Hard Skills)
  • Fraud Detection Assistance (Hard Skills)
  • Shift Flexibility (Soft Skills)

10. Application Case Specialist, Centene Corporation, St. Louis, MO

Job Summary: 

  • Review new business applications for accuracy and timeliness (case mgmt.)
  • Collaborate with distribution partners to obtain missing application information
  • Complete all reissues on active policies for effective date changes, plan corrections, and DOB information
  • Monitor shared email box for reissue requests and complete additional applications for data entry
  • Partner with vendors to complete telephone interviews and RX checks for Underwriting review
  • Review and correct error reports and unassigned lists for additional applications
  • Review and track the unassigned lists for additional applications that are to be data entered
  • Collaborate with Underwriting with additional information for application reissues 
  • Ensure all information is gathered and application is complete for final decision
  • Partner with Call Support reps to answer agent inquiries.
  • Perform quality assurance on new applications and policy file feeds for issuance and accuracy
  • Resolving problems and handling client's issues in a professional and confidential manner


Skills on Resume:

  • Application Accuracy Review (Hard Skills)
  • Partner Collaboration (Soft Skills)
  • Policy Reissuing (Hard Skills)
  • Email Management (Hard Skills)
  • Vendor Coordination (Hard Skills)
  • Error Correction (Hard Skills)
  • Quality Assurance (Hard Skills)
  • Client Issue Resolution (Soft Skills)