Apply Buddy
support@applybuddy.ai | (123) 456-7899 | Silicon Valley, CA
Professional Summary
Senior claims processor with 9+ years leading initiatives focused on claims intake, policy verification, and data accuracy. Drives process improvements, mentors team members, and delivers measurable operational outcomes.
Professional Experience
Senior Claims ProcessorJan 2020 - Present
Heartland Insurance Group, Des Moines, IA
- Handled escalated and high-complexity claims while preserving SLA performance.
- Implemented quality checks that reduced rework and resubmission volume.
- Trained new processors on policy interpretation, documentation standards, and system workflows.
Claims ProcessorJun 2015 - Dec 2019
Prairie Benefit Services, Des Moines, IA
- Processed incoming claims and validated required documentation against policy criteria.
- Updated claim records, payment details, and status notes in claims management systems.
- Communicated claim requirements and status updates to customers and internal stakeholders.
Claims AssistantJul 2011 - May 2015
Midwest Claims Center, Des Moines, IA
- Reviewed claim forms for completeness and routed exceptions for examiner review.
- Coordinated with provider, adjuster, and billing teams to resolve missing information.
- Maintained processing logs and met daily output and turnaround targets.
Skills
Claims Intake, Policy Verification, Data Accuracy, Documentation Review, Workflow Management, Customer Communication, Regulatory Compliance, Claims Systems
Education
A.A.S. Business AdministrationMay 2010
Des Moines Area Community College
Certifications
- Associate in General Insurance (AINS)