Claims Representative Resume Example (Free Guide)

Create an Claims Representative resume that lands you the interview with our free examples and writing tips. Use and customize our template and land an interview today.

Claims Representative Resume Example
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Claims Representative Resume Example

Are you looking for a job as a Claims Representative? If so, you need a resume that will stand out from the competition. In this article, we will provide you with a Claims Representative Resume Example that will help you highlight your skills and experience in the best possible way. We will also provide you with some tips and tricks to make sure your resume stands out and helps you get hired. So read on to learn how to create a winning Claims Representative resume.

We will cover:

  • How to write a resume, no matter your industry or job title.
  • What to put on a resume to stand out.
  • The top skills employers from every industry want to see.
  • How to build a resume fast with our professional Resume Builder.
  • What a resume template is, and why you should use it.
Plus, we will provide expert resume writing tips and professional examples to inspire you.

What does a Claims Representative do?

A claims representative is responsible for assessing and processing insurance claims filed by policyholders. They review documentation, assess damages, decide on the amount of money to be paid out, and negotiate settlements. They may also be responsible for conducting investigations, gathering evidence, and responding to inquiries from policyholders.

What are some responsibilities of a Claims Representative?

  • Review and process insurance claims in accordance with company guidelines and applicable laws
  • Investigate and analyze claims data to determine validity and liability
  • Determine coverage and payments for approved claims
  • Negotiate settlements with claimants, attorneys, and other parties as needed
  • Prepare and submit reports to internal and external stakeholders
  • Ensure accurate record-keeping and documentation
  • Collaborate with internal departments to provide the best possible customer service
  • Communicate with claimants and other parties to obtain additional information or answer questions

Sample Claims Representative Resume for Inspiration

Claims Representative

Name: John Doe
Address: 123 Street, City, State, Zip Code
Phone: (123) 456-7890

John Doe is a highly organized and motivated professional with 10+ years of experience in the insurance industry. He has a deep knowledge of claims processing and customer service, and is a reliable asset to any organization.

Work Experience

  • Claims Representative
    ABC Insurance Company, City, State | October 2019 - Present
    • Processed and reviewed inbound claims, ensuring accuracy and completeness of documentation.
    • Provided customer service support to policyholders and claimants, responding to inquiries and resolving issues.
    • Demonstrated strong follow-up and problem solving skills to efficiently complete claims.
    • Maintained accurate records of claim activity in company’s database.
  • Claims Adjuster
    XYZ Insurance Company, City, State | August 2013 - October 2019
    • Reviewed and handled a high volume of inbound claims, adhering to company and state regulations.
    • Evaluated claims and determined coverage eligibility.
    • Researched and investigated claims to verify accuracy and completeness of documentation.
    • Drafted and issued claim payments to claimants.


  • B.S. in Business Administration, ABC University, City, State


  • Claims Processing
  • Customer Service
  • Risk Management
  • Problem Solving
  • Data Entry


  • Certified Insurance Claims Adjuster
  • Certified Risk Management Professional


  • English (Native)
  • Spanish (Fluent)

Resume tips for Claims Representative

Creating a perfect, career-launching resume is no easy task. Following general writing rules can help, but it is also smart to get advice tailored to your specific job search. When you’re new to the employment world, you need Claims Representative resume tips.
We collected the best tips from seasoned Claims Representative - Check out their advice to not only make your writing process easier but also increase your chances of creating a resume that piques the interest of prospective employers.

  • Highlight any customer service experience or training you have in the field.
  • Demonstrate your ability to analyze data and draw conclusions.
  • Showcase your organizational and problem-solving skills.
  • Highlight any relevant technical skills.
  • Show that you are a team player by listing any group projects you have been involved in.

Claims Representative Resume Summary Examples

A claims representative resume summary or resume objective is important for highlighting your qualifications and experience in the field. It is a great way to set yourself apart from other applicants and showcase the skills and qualifications that make you a standout candidate. It can help you stand out from the crowd and show potential employers that you have the necessary skills and experience to be successful in the role. Additionally, it can give employers a better understanding of your qualifications and what you can bring to the company.

For Example:

  • Experienced Claims Representative with 5+ years of experience handling claims for a wide range of products. Proven track record of providing excellent customer service and accurate resolution of customer claims.
  • Highly organized Claims Representative with 3+ years of experience in the insurance industry. Expertise in handling customer inquiries, processing claims, and creating detailed reports.
  • Dynamic Claims Representative with 5+ years of experience in the insurance industry. Skilled in managing complex customer inquiries and resolving customer claims quickly and accurately.
  • Detail-oriented Claims Representative with 2+ years of experience in the insurance industry. Proficient in handling customer inquiries, processing claims, and providing excellent customer service.
  • Dedicated Claims Representative with 5+ years of experience in the insurance industry. Skilled in resolving customer inquiries quickly and accurately. Excellent customer service skills.

Build a Strong Experience Section for Your Claims Representative Resume

Building a strong experience section for a claims representative resume is important for several reasons. First, employers will want to get a good sense of your past claims handling experience to ensure that you are qualified for the role. Second, employers may use your resume to determine whether you have the necessary skills to succeed in the position. Finally, employers may use your resume to get a better understanding of your professional approach to handling claims and how you interact with clients. All of these reasons make it important to build a strong experience section for a claims representative resume.

For Example:

  • Processed more than 5,000 claims within a 6-month period.
  • Worked with customers to help them understand the claims process, as well as their rights and responsibilities.
  • Investigated and resolved customer complaints in a timely and satisfactory manner.
  • Successfully managed a caseload of over 250 claims simultaneously.
  • Assisted customers with filing out claims forms and answered any questions they had.
  • Conducted research to determine the validity of claims.
  • Resolved over 90% of claims within the first 45 days.
  • Developed and maintained effective working relationships with colleagues, managers, and customers.
  • Provided accurate and timely updates to customers on the status of their claims.
  • Performed administrative tasks, such as data entry, filing, and updating records.

Claims Representative resume education example

A Claims Representative typically needs a high school diploma or equivalent to get started. Many employers prefer candidates with an associate's or bachelor's degree in business, accounting, or a related field. Relevant experience in the insurance industry is also helpful. Claims Representatives should also have a solid understanding of customer service principles and excellent communication skills.

Here is an example of an experience listing suitable for a Claims Representative resume:

  • Bachelor's Degree in Business Administration, New York University
  • Associate Degree in Insurance and Risk Management, ABC College
  • Certified Claims Representative (CCR) designation, XYZ Association

Claims Representative Skills for a Resume

Adding skills to a Claims Representative Resume is important because it allows the employer to quickly assess your qualifications for the job. It also allows you to highlight your most important skills, such as problem-solving and customer service, which can be beneficial in a claims representative role. Examples of skills that may be included are negotiation, communication, organizational, and conflict resolution.

Soft Skills:

  1. Customer Service
  2. Interpersonal Skills
  3. Conflict Resolution
  4. Negotiation Skills
  5. Organizational Skills
  6. Problem-Solving
  7. Time Management
  8. Analytical Thinking
  9. Communication Skills
  10. Attention to Detail
Hard Skills:
  1. Claims processing
  2. Data entry
  3. Risk assessment
  4. Customer service
  5. Investigation
  6. Medical coding
  7. Claims adjudication
  8. Compliance review
  9. Regulatory knowledge
  10. Problem solving

Common Mistakes to Avoid When Writing a Claims Representative Resume

In this competitive job market, employers receive an average of 180 applications for each open position. To process these resumes, companies often rely on automated applicant tracking systems, which can sift through resumes and eliminate the least qualified applicants. If your resume is among the few that make it past these bots, it must still impress the recruiter or hiring manager. With so many applications coming in, recruiters typically give each resume only 5 seconds of their attention before deciding whether to discard it. Considering this, it's best to avoid including any distracting information on your application that could cause it to be thrown away. To help make sure your resume stands out, review the list below of what you should not include on your job application.

  • Not including a cover letter. A cover letter is a great way to explain why you are the best candidate for the job and why you want the position.
  • Using too much jargon. Hiring managers do not want to read a resume full of technical terms that they do not understand.
  • Omitting important details. Make sure to include your contact information, educational background, job history, and any relevant skills and experiences.
  • Using a generic template. Take the time to customize your resume to the job you are applying for. This will show the employer that you are serious about the position.
  • Spelling and grammar errors. Always double-check your resume for typos, spelling mistakes, and grammar errors.
  • Focusing too much on duties. Make sure to include accomplishments and successes to show the employer that you are a great candidate.
  • Including personal information. Avoid including any personal information such as age, marital status, or religious beliefs.

Key takeaways for a Claims Representative resume

  • Highlight your experience with customer service and/or insurance.
  • Showcase your expertise in claims management and dispute resolution.
  • Demonstrate your ability to work with people from all backgrounds.
  • Highlight your knowledge of insurance laws and regulations.
  • Mention any certifications or qualifications you hold.
  • Describe your problem-solving skills and ability to manage multiple tasks.
  • Highlight any awards or recognition you have received.
  • Discuss the technologies and software programs you have used.
  • Include any special training you have completed.

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