Claims Resume Example for 2024 (Skills & Templates)

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Claims Resume Example
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Claims Resume Example

Welcome to our Claims Resume Example article. Here, you'll find a collection of resumes for claims professionals, with tips and advice on how to create an effective resume that will get you noticed. We'll cover the basics of what to include, how to structure your resume, and best practices for presenting and formatting your information. With these tips, you can craft a resume that will help you stand out from the competition and get you the job you're after.

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 do?

A claims adjuster is responsible for investigating and evaluating insurance claims. They work to determine the validity of a claim and the amount of money that should be paid out. The claims adjuster also negotiates settlements with claimants and works to ensure that claims are settled in a fair and timely manner.

What are some responsibilities of a Claims?

  • Review and investigate claims made by policyholders
  • Evaluate factual evidence presented by the policyholder
  • Identify and assess potential risks of claims
  • Determine the amount of liability for the claim
  • Negotiate settlements with claimants
  • Deny claims if necessary
  • Maintain complete records of claim activity
  • Remain up to date on relevant laws and regulations
  • Provide customer service to policyholders

Sample Claims Resume for Inspiration

Name: John Smith


John Smith is a highly experienced and dedicated Claims Professional with over 8 years of experience in the industry. He has a proven track record of successfully managing and resolving a wide range of claims, from minor to complex. His expertise in researching and analyzing claims to determine the best solutions gives him an edge when it comes to finding the right resolution for each case. He is a confident and reliable problem-solver who is always willing to go the extra mile to ensure each claim is handled in the best possible way.

Work Experience:

  • Claims Representative at ABC Insurance - (Sept 2019 - Present)
  • Claims Adjuster at XYZ Insurance - (Sept 2016 - Aug 2019)
  • Claims Investigator at 123 Insurance - (Sept 2015 - Aug 2016)


  • Bachelor of Science in Business Administration - University of XYZ - (2011-2015)


  • Claims Analysis
  • Customer Service
  • Negotiation
  • Risk Management
  • Problem-Solving
  • Research


  • Certified Claims Professional (CCP)
  • Certified Insurance Counselor (CIC)

Languages: English, Spanish

Resume tips for Claims

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 resume tips.
We collected the best tips from seasoned Claims - 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 your customer service skills and experience.
  • Showcase your problem solving abilities.
  • Include any relevant technical skills or certifications.
  • Demonstrate your knowledge of the insurance industry.
  • Include specific examples of how you have handled claims.

Claims Resume Summary Examples

A claims resume summary or resume objective is a great way to quickly summarize your claims experience and highlight key skills and qualifications. It can also help employers quickly understand what you bring to the table and why you are the best fit for the job. A succinct, well-written summary or objective can be the difference between getting an interview and not.

For Example:

  • Experienced Claims professional with strong customer service background. Skilled in analyzing and resolving complex claims while meeting organizational objectives.
  • Dedicated Claims professional with 10+ years of experience in accurate and timely review of claims and customer service. Highly organized and detail-oriented.
  • Knowledgeable Claims adjuster with strong problem-solving and communication skills. Proven record of success in accurately evaluating and processing claims in accordance with policy.
  • Exceptional Claims expert with advanced knowledge of claim process. Skilled in researching and resolving complex claims. Adept at providing excellent customer service.
  • Results-driven Claims professional with 6+ years of experience in evaluating and processing claims. Possessing in-depth knowledge of legal documents and industry best practices.

Build a Strong Experience Section for Your Claims Resume

Building a strong experience section for a claims resume is important because it gives employers a clear overview of your professional background. It showcases your knowledge of the industry, as well as any relevant skills that you may have acquired over the course of your career. This section should also include any special certifications or awards that you have earned, which can help demonstrate your commitment to the field. Finally, it helps to display how your skills and experience have helped you to successfully manage a variety of claims-related tasks and projects.

For Example:

  • Managed claim adjudication for several insurance companies, ensuring accurate and timely resolution of claims.
  • Researched and processed claims in accordance with appropriate laws, regulations and company policies.
  • Successfully handled complex, high-value claims with a high degree of accuracy and professionalism.
  • Provided detailed and accurate documentation to ensure that all claims are adequately documented.
  • Conducted investigations for complex claims, identifying potential sources of fraud.
  • Advised clients on the claims process and assisted them with the necessary paperwork.
  • Utilized appropriate resources to research and analyze claims information for accuracy.
  • Resolved customer inquiries and complaints regarding claims in a timely manner.
  • Maintained up-to-date knowledge of claims processing policies and procedures.
  • Managed claims-related customer service inquiries in a prompt and courteous manner.

Claims resume education example

Most Claims professionals need at least a bachelor's degree in a field such as business, finance, accounting or insurance. Some employers may also require claims professionals to have a professional designation, such as Certified Professional Claims Adjuster (CPCA) or Associate in Claims (AIC). Additionally, many employers will require claims professionals to gain a certain amount of on-the-job training and experience.

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

  • Bachelor of Science in Business Administration, ABC University, 2020
  • Associate of Science in Claims Processing, XYZ College, 2018
  • Certificate in Claims Management, ABC College, 2016

Claims Skills for a Resume

Adding skills to a Claims Resume is important because it allows the hiring manager to quickly gain an understanding of how your skills and experience can be of value to the company. It also helps to differentiate you from other potential candidates. Skills on a Claims Resume should include both technical and soft skills that are relevant to the position. Technical skills should highlight your ability to analyze, interpret, and process claims data, while soft skills should focus on your communication, problem-solving, and customer service abilities. Including a mix of both will demonstrate your ability to handle both the administrative and interpersonal aspects of the job.

Soft Skills:

  1. Communication Skills
  2. Problem Solving
  3. Organizational Skills
  4. Time Management
  5. Negotiation Skills
  6. Adaptability
  7. Critical Thinking
  8. Interpersonal Skills
  9. Decision Making
  10. Research Skills
Hard Skills:
  1. Claims Handling
  2. Data Analysis
  3. Risk Assessment
  4. Insurance Coverage
  5. Regulatory Compliance
  6. Documentation Skills
  7. Investigation Skills
  8. Negotiation Skills
  9. Computer Literacy
  10. Organizational Skills

Common Mistakes to Avoid When Writing a Claims 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 resume

  • Highlight your experience dealing with insurance policies and claims processes.
  • Showcase your knowledge of medical terminology and insurance terminology.
  • Mention any certifications or licenses you hold that are related to claims.
  • Demonstrate your ability to use various computer systems and software programs.
  • Discuss your experience in customer service and dispute resolution.
  • Highlight your organizational and problem-solving skills.
  • Discuss any experience you have with data entry.
  • Discuss any experience you have with data analysis.
  • Mention any experience you have with training or leading teams.
  • Discuss any experience you have with auditing or medical coding.

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