CLAIMS ASSOCIATE SKILLS, EXPERIENCE, AND JOB REQUIREMENTS

The Claims Associate is adept in financial management methods, insurance risk, reinsurance costs, and underwriting, including claims and reinsurance underwriting. This role requires a deep understanding of insurance industry practices, including coverage analysis, claim investigation, and adjudication, complemented by strong negotiation, selling, and advocacy skills. Detail-oriented and analytically skilled, the associate excels in both written and oral communication, works effectively independently or in a team, and demonstrates exceptional organizational and task management abilities.

Essential Hard and Soft Skills for a Standout Claims Associate Resume
  • Claims Processing
  • Knowledge of Insurance Policies
  • Regulatory Compliance
  • Data Analysis
  • Microsoft Office Proficiency
  • Documentation Skills
  • Use of Claims Management Software
  • Understanding of Medical Terminology
  • Financial Analysis
  • Risk Assessment
  • Communication
  • Attention to Detail
  • Problem-Solving
  • Empathy
  • Customer Service
  • Negotiation
  • Time Management
  • Adaptability
  • Teamwork
  • Decision Making

Summary of Claims Associate Knowledge and Qualifications on Resume

1. BA in Business Administration with 3 years of Experience

  • Experience as a TPA medical claims examiner or Health Insurance Company medical claims examiner
  • Ability to excel in a team-oriented environment
  • Ability to prioritize assigned groups based on claim volume, renewal dates and check cycles
  • Strong analytical and detail-oriented aptitude; a high degree of accuracy
  • Excellent communication and organizational skills
  • Ability to manage time effectively, set priorities and meet deadlines
  • Ability to learn and adapt to change
  • Desire/ability to work successfully in a small, entrepreneurial company environment
  • Experience in Healthcare-related insurance 
  • Experience in claims, insurance, fraud or other related fields

2. BA in Health Administration with 2 years of Experience

  • Strong, independent decision-making skills while maintaining great relationships with the sales department
  • Ability to work quickly and handle requests
  • Capable of meeting multiple deadlines occurring at the same time
  • Ability to prioritize various requests and handle changing priorities
  • Excellent organizational skills with strong attention to detail
  • Good communication skills
  • Strong customer service orientation
  • Excellent customer service orientation
  • Proficient with Microsoft Office Software
  • Good communication skills, both oral and written

3. BA in Economics with 3 years of Experience

  • Knowledge of CIP designation complete or in progress
  • Experience and exposure to financial management methods, the nature of insurance risk and reinsurance costs, underwriting, claims underwriting and reinsurance.
  • Knowledge and applied experience in the insurance industry, insurance coverage, as well as investigation and adjudication of claims
  • Effective and professional negotiation, selling, and advocating skills and the ability to organize and complete work on time and within budget
  • Effective written and oral communication skills
  • Able to work independently as well as with others
  • Able to prioritize tasks and manage work
  • Detail-oriented with analytical ability
  • Ability to obtain licenses
  • Strong planning & organization skills
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