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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in claims management, including conducting investigations, negotiating settlements, and maintaining compliance with regulatory requirements. Proficient in analyzing claims, managing documentation, and communicating effectively with clients and stakeholders.
Highest-signal resume keywords
Claims ManagementNegotiation SkillsRegulatory ComplianceInvestigative SkillsClaims Analysis
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ExperienceReserve SettingCoverage VerificationSubrogation HandlingData ReportingLegal Expense ReviewLitigation ExperienceClient CommunicationCase DocumentationInvestigation Completion
Soft Skills
Customer ServiceCommunication SkillsInterpersonal SkillsProblem-SolvingAttention to Detail
Certifications & Qualifications
High School DegreeG.E.D.Bachelor's Degree (Preferred)State Licensing
Industry Keywords
Fair Claim Practices ActsState RegulationsClaims ProcessIndemnity IssuesDefense Counsel Management
About the role
Key responsibilities & impact- Adjust assigned claims within delegated limits of authority
- Conduct timely and thorough investigations, including necessary survey arrangements
- Identify indemnity issues and coverage questions
- Analyze cases and initiate reserve changes within assigned authority
- Negotiate claim payments and settlements
- Investigate, evaluate, and resolve moderate-level claims files
- Maintain case diaries, claim documentation, forms, and reports
- Handle subrogation claims within delegated authority
- Assign and monitor defense counsel when required
- Review legal expenses for accuracy and reasonableness
- Service insureds, claimants, brokers, and other customers
- Attend client visitations with underwriters and other parties
- Maintain communication with customers throughout the claims process
- Complete data reports for state reporting agencies
- Maintain compliance with regulatory and company requirements
Requirements
What you’ll need- High School Degree or G.E.D. is required
- Bachelor's degree (B.A.) is preferred
- 5+ years of claims experience
- Ability to successfully negotiate settlements
- Ability to verify coverage
- Ability to appropriately set reserves
- Ability to successfully complete investigations
- Understanding of rules associated with state regulations
- Licensing in other states that would reciprocate to handling claims in West Virginia
- Litigation experience is a plus
- Maintain compliance with all regulatory Fair Claim Practices Acts and state and federal regulations
- Maintain compliance with all state licensing and continuing education requirements
Benefits
Comp & perks- Equal employment opportunity regardless of protected characteristics
- Reasonable accommodations for qualified individuals with disabilities