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Posted: 10/17/2026Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing complex claims, interpreting legal and medical documents, and ensuring compliance with jurisdictional requirements. Strong ability to mentor team members while maintaining effective relationships with clients and stakeholders.
Highest-signal resume keywords
State Adjuster LicensesClaims ManagementLegal and Jurisdictional KnowledgeAnalytical and Interpretive SkillsCustomer Service Skills
About the role
Key responsibilities & impact- Manage a claim caseload ranging from basic to highly complex claims within granted authority levels, including financial implications
- Mentor and coach Account Representatives and Account Specialists
- Use special account instructions to obtain customer information and coordinate specialized services such as subrogation, fraud evaluation, and case management review
- Establish and maintain effective relationships with internal and external customers and coworkers
- Investigate, evaluate, and resolve claims
- Identify potential problems and trends in claim files and take corrective action or make recommendations
- Interpret medical reports, state law, jurisdictional law, and insurance coverage
- Assess indemnity, medical, and expense exposure for assigned claims
- Review client files and collaborate with the team on file strategies, claim status, and emerging trends
- Proactively manage litigation with clients and legal representatives
- Minimize financial liability and ensure compliance and favorable outcomes
- Compile requirements and ensure accurate, timely state-required documentation
- Monitor reports and document compliance with jurisdictional requirements such as EDI and benefit-payment timeliness
- Assist the Team Lead with tracking team tasks and projects
- Review and timely submit SAS/SOX documents
- Assist with takeover and reverse takeover projects and ensure appropriate claim-file transfer and handling
- Support organizational quality programs
- Perform other assigned duties
Requirements
What you’ll need- Bachelor's degree from an accredited college or university preferred
- State adjuster licenses required
- Six (6) years of related experience and/or training or equivalent combination of education and experience required
- Thorough legal and jurisdictional knowledge based on line of business
- Strong oral and written communication, including presentation skills
- PC literacy, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Excellent interpersonal skills
- Strong customer service skills
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies
- Ability to handle work-related stress and multiple priorities simultaneously
- Ability to meet deadlines
- Computer keyboarding
- Travel as required
Benefits
Comp & perks- Work-life balance
- Caring culture
- Opportunities for career growth
- Reasonable accommodations when applicable and appropriate
- Equal opportunity workplace
- Drug-free workplace
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 InvestigationFinancial Implications AssessmentDocumentation ComplianceSubrogation CoordinationFraud EvaluationCase Management ReviewPerformance CompetenciesSAS/SOX DocumentationIndemnity Exposure AssessmentMedical Report Interpretation
Soft Skills
Strong Oral and Written CommunicationExcellent Interpersonal SkillsStrong Organizational SkillsAbility to Work in a Team EnvironmentAbility to Handle Work-Related Stress
Tools & Technologies
Microsoft Office ProductsPC LiteracyComputer Keyboarding
Certifications & Qualifications
Bachelor's Degree (Preferred)State Adjuster Licenses (Required)
Industry Keywords
Claims Caseload ManagementCustomer Relationship ManagementLitigation ManagementCompliancePerformance Monitoring