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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates extensive claims management expertise, including negotiation, liability assessment, and settlement processes. Proficient in managing high exposure claims and maintaining compliance with industry standards and statutory requirements.
Highest-signal resume keywords
Claims Management ExperienceNegotiation SkillsKnowledge of Auto PoliciesState Adjusting LicensesCommunication 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 AdjudicationLiability AssessmentSettlement NegotiationReserve CalculationClaims InvestigationCost Containment TechniquesVendor ManagementStatutory FilingsClaims CodingSubrogation Management
Soft Skills
Oral CommunicationWritten CommunicationTeam CollaborationJudgmentDiscretion
Tools & Technologies
Microsoft Office
Certifications & Qualifications
State Adjusting Licenses
Industry Keywords
Auto Liability ClaimsGeneral Liability ClaimsPersonal Line PoliciesCommercial Line PoliciesLitigation ManagementClient Service RequirementsQuality Programs
About the role
Key responsibilities & impact- Analyze complex or technically difficult auto and general liability claims to determine benefits due
- Work with high exposure claims involving litigation and rehabilitation
- Ensure ongoing adjudication of claims within service expectations, industry best practices, and client service requirements
- Identify subrogation of claims and negotiate settlements
- Investigate and gather information to determine claim exposure
- Manage claims through action plans to timely resolution
- Assess liability and resolve claims within evaluation
- Negotiate settlements within designated authority
- Calculate and assign reserves and manage reserve adequacy
- Calculate and pay benefits, approve claim payments and adjustments, and settle claims
- Prepare necessary state filings within statutory limits
- Manage the litigation process
- Coordinate vendor referrals for investigation and litigation management
- Use cost containment techniques and vendor partnerships
- Manage claim recoveries, including subrogation, Second Injury Fund excess recoveries, and Social Security and Medicare offsets
- Report claims to the excess carrier and respond to direction requests
- Communicate claim activity with claimants and clients
- Maintain professional client relationships
- Ensure claim files are documented and claim coding is correct
- Refer cases to supervisors and management as appropriate
- Support the organization's quality programs
- Perform other duties as assigned
Requirements
What you’ll need- Five (5) years of claims management experience or equivalent combination of education and experience required
- In-depth knowledge of personal and commercial line auto policies, coverages, principles, and laws
- Strong oral and written communication, including presentation skills
- PC literate, including Microsoft Office products
- Ability to work in a team environment
- Secure and maintain the State adjusting licenses as required for the position
- Computer keyboarding
- Hearing, vision, and talking
- Clear and conceptual thinking ability
- Excellent judgment and discretion
- Ability to meet deadlines
Benefits
Comp & perks- Work-life balance
- Caring culture
- Equal Opportunity Employer
- Drug-Free Workplace
- Diverse, equitable, and inclusive workplace