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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in analyzing and managing commercial claims, ensuring compliance with insurance policies and regulations while maintaining effective communication with stakeholders. Proficient in claims investigation, documentation, and resolution processes, with a strong focus on fairness and timeliness.
Highest-signal resume keywords
Commercial Claims Adjusting ExperienceUnfair Claims Practices Act KnowledgeClaims Management Systems FamiliarityStrong Communication SkillsMicrosoft Office Proficiency
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 InvestigationClaims DocumentationClaims ResolutionCoverage EvaluationLiability DeterminationClaims Estimating SoftwareClaims Standards ApplicationClaims Reserve AccuracyGeneral Liability KnowledgeMedical Terminology Literacy
Soft Skills
Effective OrganizationTime ManagementDecision-Making Skills
Tools & Technologies
Claims Management SystemsMicrosoft Office SuiteWindows Operating System
Certifications & Qualifications
Bachelor’s DegreeInsurance Industry Designations
Industry Keywords
Insurance PrinciplesClaims AdjustingCommercial ClaimsPolicy ProvisionsClaims Practices
About the role
Key responsibilities & impact- Analyze new and complex claims for coverage under the appropriate insurance policy and endorsements
- Perform initial and ongoing claims investigations
- Communicate claims decisions and key developments to policyholders, claimants, repair facilities, and attorneys
- Provide clear documentation to ensure the proper functioning of claims adjusting processes
- Manage a claim caseload of moderate to high complexity and exposure, from assignment through resolution
- Carefully investigate and monitor each claim to make sure that settlements are fair and timely
- Act as the primary contact point for the policyholder and third-party claimants during the claims process
- Coordinate internal and external resources in the handling of a claim
- Make appropriate and timely referrals to the subrogation unit and special investigations unit
- Demonstrate proficiency and consistency in applying WCF’s claims standards
- Ensure accuracy of claims reserves, working independently within the appropriate reserve limit
- Investigate, evaluate, and resolve commercial claims by determining coverage, liability, and damages in accordance with policy provisions, company guidelines, and applicable regulations
Requirements
What you’ll need- Bachelor’s degree or appropriate combination of insurance industry designations
- At least two years of commercial claims adjusting experience
- Advanced understanding of the Unfair Claims Practices Act, general liability, and other insurance principles
- Familiarity with claims management systems and claims estimating software systems
- Sound literacy in medical, automotive, and liability terminology and concepts
- Strong communication skills, both verbally and in writing
- Effective organization, time-management, and decision-making skills
- Proficiency in the Microsoft Office suite and Windows operating system
- The employee must meet the job attendance requirements for this position
Benefits
Comp & perks- Medical, dental, and vision insurance
- Company paid life insurance
- 401K with a generous 6% employer match
- Employee Assistance Program (EAP)
- Time off to volunteer in the local community
- All employees earn 4 weeks of vacation their first year