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Example Resume: Quality Review Auditor
[Chronological]

David T. Dahlin * 111 East Main * Chicago, Illinois * 60608 * (773) 555-1256


Summary of Qualifications

Nearly eight years of experience in the insurance field, with emphasis on quality review, Skilled in creating, implementing and conducting internal and external audit programs, including analyzing statistical reports, accounting reviews and conducting staff interviews, Solid training and communication skills.

Experience

Eastern Warren, Inc., Columbia, S.C. (August 1990-current)
(A subsidiary of Eastern Insurance Group)
Director of quality Review (Auditing), (November 1992-current)

Manage department and five professional-level employees. Audit external clients and internal staff to ensure maximum operational efficiency. Develop business plan and department budget.
Handle staff training, administration and programs.

  • Create, test and implement all audit programs.
  • Continually evaluate effectiveness of audit programs and report statistics t Executive Committee.
  • Identified three problem areas for major client and designed specialized audit to monitor progress, which has resulted in improved operations and work flow.
Quality Review Auditor (August 1990-November 1992)

Conducted and reported on various types of internal and external audits, encompassing a variety of operational functions in the insurance field.

  • Conducted on-site aggregate claim audits to determine proper reimbursement to clients by eligibility reviewing claims, premium, eligibility and contract interpretation.
  • Conducted on-site operational audits; used statistical reports, claim, premium, accounting and eligibility reviews, an one-on-one interviews with client's staff.
  • Conducted on-site approval audits, which allowed management committee to evaluate client's abilities and professional competency; used staff interviews, systems reviews and monitored administrative techniques.
Smithton Life Insurance Company of South Carolina, Columbia, S.C.
(A subsidiary of Eastern Insurance Group)
Claims Supervisor (June 1988-August 1990)

Managed department and seven claim examiners and support staff. Administered group and individual life, disability income and medical benefits. Developed business plan and department budget. Handled staff training and administration.

  • Assisted and advised staff in making claim decision and continually evaluated accuracy of decisions.
  • Reviewed and translated insurance contracts.
  • Organized and supervised daily work flows to ensure maximum productivity.
  • Reduced claims response time from 30 days to two days after just six months on the job.

Education

General Studies, University of Florida, Miami, Fia. (1989-1988)
  • 12 credit hours in business administration
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