CLAIMS ASSESSOR SKILLS, EXPERIENCE, AND JOB REQUIREMENTS

The Claims Assessor specializes in the funeral and medical insurance sectors with robust experience in claims management. Brings a combination of high-quality customer service, expert communication skills including empathy and attention to detail, and a profound understanding of complex medical terminologies. Demonstrates strong problem-solving abilities, excellent time management, and a strategic approach to building relationships and delivering solutions in an allied health environment.

Essential Hard and Soft Skills for a Standout Claims Assessor Resume
  • Data Analysis
  • Fraud Detection
  • Medical Terminology Proficiency
  • Insurance Policy Interpretation
  • Legal Compliance
  • Claims Processing Software
  • Financial Acumen
  • Regulatory Knowledge
  • Documentation Management
  • Risk Assessment
  • Empathy
  • Active Listening
  • Problem-Solving
  • Critical Thinking
  • Time Management
  • Multitasking
  • Attention to Detail
  • Communication
  • Relationship Building
  • Strategic Thinking

Summary of Claims Assessor Knowledge and Qualifications on Resume

1. BA in Business Administration with 4 years of Experience

  • Experience in relevant accident and health claims 
  • Strong knowledge of integrated shield claim processes and industry initiatives in managing medical claim cost
  • Strong analytical, written and communication skills
  • Customer -centric and meticulous with the ability to work under pressure
  • Excellent interpersonal skills to effectively communicate with all stakeholders
  • Good medical knowledge and ability to explain medical conditions in insurance context
  • Good business acumen with long term vision and a team player
  • High level of integrity, takes accountability for work and good attitude over teamwork.
  • Exceptional written and verbal communication skills – competent at producing both Trustee Board recommendation reports and documentation for the appeals tribunal.
  • Highly developed business and commercial acumen demonstrated through communication of complex issues, assessment of risk and improvement recommendations.

2. BA in Health Sciences with 3 years of Experience

  • Demonstrated experience in claims assessment and review based on the associated legislation that operates within the superannuation environment.
  • A genuine passion for customer service and the ability to inspire and lead others to outstanding customer experiences.
  • Advanced stakeholder management capability, with experience managing multiple stakeholders, including C-suite and external parties, to influence and negotiate outcomes of a complex nature.
  • Highly developed analytical and problem-solving skills and dispute resolution techniques.
  • Ability to negotiate and liaise at all levels sensitively and appropriately, representing the members and the clients’ interests with integrity.
  • A high level of technical competence in Superannuation and Insurance.
  • Takes initiative to improve current state of things and adaptable to embrace new changes.
  • Excellent attention to detail.
  • Proven experience within Financial Services
  • Solid experience dealing with members/customers / clients

3. BA in Insurance and Risk Management with 5 years of Experience

  • Knowledge of Life Insurance, Terminal Illness, TPD, Income Protection – Ideal
  • Ability to interpret data, legislation and insurance policies and tailor to audience
  • Strong problem solving skills
  • Experience in a customer focus role
  • Ability to work as part of a team and autonomously
  • Strong communication skills – verbal and written
  • Excellent knowledge of MSO suite.
  • In-depth knowledge of all Group Protection products past and present
  • Good understanding of medical conditions and the effect these can have on an individual’s ability to work.
  • Awareness of the investigative and rehabilitation services provided by external organisations.
  • Skills analytical and risk management skills

4. BA in Legal Studies with 6 years of Experience

  • Previous experience in the Funeral and Medical Insurance Industry and experience in Claims
  • Skills client service orientated 
  • Have excellent telephone manners.
  • High-quality customer service skills and great attention to detail
  • Excellent communication, including empathy and great listening skills
  • Expertise in an allied health environment, including knowledge of complex medical terminology
  • Strong problem solving and critical thinking skills
  • Great time management and multi-tasking skills
  • Strong relationship building skills
  • A desire to make a difference and find solutions.
  • Ability to be creative and strategic thinking.

5. BA in Finance with 2 years of Experience

  • Experience within life insurance or related industry.
  • High level of knowledge of the product, claims, medical, system, and legislation/regulations impacting life insurance
  • Genuine interest and desire for the achievement of high standards and process improvement.
  • Strong customer service focus
  • Good analytical skills, high attention to detail, and the ability to analyze data and make recommendations on claim decisions
  • Strong written and verbal communication skills
  • Strong computer skills including Excel, Word, Outlook, and PowerPoint
  • Experience in working in an organized and structured manner.
  • Maintain an excellent attendance record and excellent writing skills.
  • Be a trustworthy person and a person of great integrity.
  • Strong claims assessment skills.