Claims Examiner Resume

Claims Examiners work for life / health insurance companies. They check the correctness of claims made by insurance policy holders. In case the claim is correct, they decide on the amount to be paid for settlement of the claim. When claims are contested, the claim examiner may be required to testify in a court. Insurance companies prefer candidate with any bachelor's degree and knowledge / training in economics, law, math, business or medicine. The candidate in the resume has a bachelor's degree in arts. He has experience as a claims examiner and in training claims examiner recruits.

Gavin Carpenter
2039 McKinney Avenue,
Dallas, Texas 75204
Telephone No: 972-794-1837
Email id: gavin.carpenter@gmail.com

Career Objective

To achieve a demanding as well as responsible place where practices like a Claims Inspector for Medical Support recipients and supplier connection can be made use of in corporation of company objectives.

Academic Background

• Achieved Bachelor of Arts Degree in Political Science from the University of Caldwell, Caldwell, ID, in the year 1994.

Computer Knowledge

• Knowing Office Package: Microsoft Word, Microsoft Excel, Microsoft Access, Microsoft PowerPoint and Microsoft Outlook Express.
• Knowing Operating Systems: Windows9X, Windows2000, Windows ME, Windows XP and Windows Vista.
• Knowing IBM PC, Lotus 1-2-3 and MS-Dos, Logistics Radar Equipment.

Professional Excellence Summary

More than ten years of knowledge and practice in the positions of growing responsibility with speedily growing Health Protection association such as follows:

• Creating and developing policies on behalf of Medical Support association.
• Widespread client service and source communication.
• Employee supervision and synchronization.
• Auditing and excellence control.

Professional Background

Since 2004 working as a Quality Control Coordinator in Dallas HMO, Dallas and is efficiently maintaining statistics on 35 claims examiners on a daily, weekly and monthly basis, reporting claim inaccuracy through document tracking and day to day audit statement. Communicate annually with the State Fitness auditors.

From 2000-2003 worked as deputy Claims Examiner and Senior Unit Leader, and was responsible for training and monitoring five claims examiners, giving out claims for 10.000 Medical Support recipients. Responsibilities integrated organization of benefits, wide-ranging provider associations' purpose of eligibility and client service communication.

From 1997-1999 worked as a Claims Examiner, and was responsible for creating new position, developing and creating policies on behalf of a Medical Support Organization that developed from 500 members in 1990 to its present 10,000.

From 1995-1996 worked as n Assistant Manager in the Power Dressing, Chicago and was responsible for training and organizing a group of 25 employees for men's clothing store.