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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, negotiation, and analytical skills, with a strong understanding of insurance principles and laws. Proficient in preparing reports, maintaining client relationships, and managing complex claims within designated authority limits.
Highest-signal resume keywords
Claims Adjuster LicenceChartered Insurance Professional (CIP) ProgramClaims Management ExperienceNegotiation SkillsAnalytical Skills
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 ManagementCoverage DeterminationClaims SettlementReport PreparationLiability AssessmentSubrogation ManagementFile DocumentationPolicy InterpretationBilling ManagementClaims Negotiation
Soft Skills
Interpersonal SkillsCommunication SkillsOrganizational SkillsTeam CollaborationPresentation Skills
Tools & Technologies
Microsoft OfficeOutlookWeb ApplicationsPC Proficiency
Certifications & Qualifications
Claims Adjuster LicenceChartered Insurance Professional (CIP)Quebec Claims Adjuster Licence (AMF)
Industry Keywords
Insurance PrinciplesClaims AdjustingCommercial ClaimsCost-Containment PrinciplesField Claims AdjustingThird-Party Administrator (TPA)
About the role
Key responsibilities & impact- Independently investigate assigned claims by telephone
- Gather relevant information regarding losses
- Determine coverage and claim validity
- Communicate with insureds, claimants, and clients
- Prepare reports and negotiate settlements
- Maintain concise records in internal computer systems
- Review and interpret policy wording to confirm and apply coverage
- Manage billing for assigned files within prescribed timelines
- Maintain client relationships
- Participate in ongoing training on issues, legislative changes, and industry trends
- Identify needs and coordinate the assignment of mandates to field claims adjusters
- Manage intermediate- and complex-level commercial and personal automobile claims
- Gather information to determine exposure and establish reserves
- Make payments and settle claims within designated authority limits
- Assess liability and resolve claims within the scope of the evaluation
- Approve and process assigned claims, determine benefits, and manage the action plan
- Manage subrogation and negotiate settlements
- Ensure proper file documentation and accurate coding
- Travel as required
- Perform other related duties as assigned
Requirements
What you’ll need- Hold the required claims adjuster licence in the applicable province
- Obtain the required licence in the local province or a combination of other provinces within six months of the date of hire
- Hold a four-year university degree or equivalent, relevant claims-adjusting experience, or a two-year college diploma in a related field
- Be enrolled in or have completed the Chartered Insurance Professional (CIP) program
- Quebec claims adjuster licence (AMF) required, or ability to obtain one
- Experience adjusting commercial claims and/or a Quebec commercial claims adjuster licence is considered a significant asset
- Successful completion of Sedgwick’s trainee program or prior experience with a third-party administrator (TPA), field claims adjusting, or an insurer
- One to three years of claims management and settlement experience
- Excellent claims-adjusting, negotiation, and analytical skills
- Excellent interpersonal and communication skills
- Advanced proficiency with computer tools, including Microsoft Office, Outlook, and web applications
- Subject-matter expertise in the insurance principles and laws applicable to the line of business handled, recoveries, offsets and deductions, claim and disability duration, and cost-containment principles as applicable to the line of business
- Excellent oral and written communication skills, including presentation skills
- Proficiency with PCs, including Microsoft Office products
- Strong analytical and interpretive skills
- Strong organizational skills
- Excellent interpersonal skills
- Excellent negotiating skills
- Ability to create and complete comprehensive, accurate, and constructive written reports
- Ability to work in a team environment
- Ability to meet or exceed performance competencies
- Four years of claims management experience or an equivalent combination of education and experience required
- Obtain and maintain state adjusting licences as required for the position
Benefits
Comp & perks- Work-life balance
- Caring culture
- Inclusive, barrier-free recruitment and selection process
- Accommodation measures available during recruitment, where needed