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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 processing complex general liability claims, managing claims through effective action plans, and negotiating settlements within authority. Proficient in applying insurance principles, managing litigation processes, and maintaining professional client relationships.
Highest-signal resume keywords
Claims Management ExperienceNegotiation SkillsInsurance Principles ExpertiseAnalytical SkillsProfessional Certification
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 AnalysisLiability AssessmentCost Containment TechniquesReserve ManagementMedical Management PracticesSubrogation ManagementStatutory FilingsClaim CodingVendor CoordinationPresentation Skills
Soft Skills
Excellent CommunicationStrong Organizational SkillsInterpersonal SkillsTeam CollaborationService Orientation
Tools & Technologies
Microsoft Office
Certifications & Qualifications
Professional CertificationRequired Licensing in Iowa, Texas, or Florida
Industry Keywords
General Liability ClaimsClaim SettlementsLitigation ManagementSocial Security OffsetsMedicare Application Procedures
About the role
Key responsibilities & impact- Analyze and process complex or technically difficult general liability claims
- Investigate and gather information to determine claim exposure
- Manage claims through action plans to timely and appropriate resolution
- Assess liability and resolve claims within evaluation
- Negotiate claim settlements within designated authority
- Calculate and assign timely and appropriate reserves and manage reserve adequacy
- Calculate and pay benefits, approve claim payments and adjustments, and settle claims within authority
- Prepare necessary state filings within statutory limits
- Manage litigation processes for timely and cost-effective resolution
- Coordinate vendor referrals for investigation and litigation management
- Apply cost-containment techniques and strategic vendor partnerships
- Manage claim recoveries, including subrogation, Second Injury Fund excess recoveries, and Social Security and Medicare offsets
- Report claims to excess carriers and respond to direction requests
- Communicate claim activity and processing 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 quality programs and perform other assigned duties
- Travel as required
Requirements
What you’ll need- Bachelor's degree from an accredited college or university preferred
- Professional certification as applicable to line of business preferred
- Five (5) years of claims management experience or equivalent combination of education and experience required
- Subject matter expertise in applicable insurance principles and laws, recoveries, offsets and deductions, claim and disability duration, cost containment principles, medical management practices, and Social Security and Medicare application procedures
- Excellent oral and written communication, including presentation skills
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Good interpersonal skills
- Excellent negotiation skills
- Ability to work in a team environment
- Ability to meet or exceed Service Expectations
- Required licensing in Iowa, Texas, or Florida
Benefits
Comp & perks- Medical insurance
- Dental insurance
- Vision insurance
- 401(k) and matching
- PTO
- Disability insurance
- Life insurance
- Employee assistance
- Flexible spending account or health savings account
- Other additional voluntary benefits
- Reasonable accommodations when applicable and appropriate