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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates extensive knowledge of claims management processes and procedures, with strong leadership and analytical skills to supervise teams effectively. Capable of maintaining client relationships and ensuring compliance with quality standards while driving continuous process improvements.
Highest-signal resume keywords
Claims ManagementLeadership SkillsAnalytical SkillsClaims Supervisor ExperienceMicrosoft 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 AdjudicationQuality ReviewsPerformance CompetenciesClaims DocumentationClaims AnalysisTrend IdentificationProject CoordinationLicensing CompliancePerformance Development PlansClaims Coding
Soft Skills
Excellent CommunicationTeam CollaborationJudgement and DiscretionMotivational LeadershipClear Thinking
Certifications & Qualifications
Professional CertificationsLicenses as Required
Industry Keywords
Liability ClaimsHigh-Exposure ClaimsClient RelationshipsContinuous Process ImprovementAudit Compliance
About the role
Key responsibilities & impact- Supervise multiple teams of examiners and technical staff for liability claims
- Monitor colleagues' workloads and individual claim activities
- Provide training and technical/jurisdictional direction on claims adjudication
- Maintain claim diaries, including frequent diaries for complex or high-exposure claims
- Identify trends, problems, and issues and advise management on recommended actions
- Inform management of new procedures and continuous process improvement ideas
- Coordinate projects with management
- Compile, review, and analyze management reports and take appropriate action
- Perform quality reviews on claims in compliance with audit, service contract, and quality standards
- Act as second level of appeal for client and claimant issues and implement final dispositions
- Review reserve amounts on high-cost claims and claims exceeding examiner authority
- Monitor third-party claims and periodically review litigated, serious vocational rehabilitation, questionable, and sensitive claims
- Maintain client contact and promote professional client relationships
- Make recommendations to clients based on claim status and provide written claim summaries as requested
- Ensure direct reports are properly licensed in serviced jurisdictions
- Ensure claims files are correctly coded and adequately documented
- Administer company personnel policies and follow staffing and training standards
- Interview, hire, and establish colleague performance development plans
- Conduct performance discussions and provide leadership, guidance, support, and motivation
- Support the organization's quality programs
- Perform other duties as assigned
Requirements
What you’ll need- Bachelor's degree from an accredited college or university preferred
- Licenses as required
- Professional certifications as applicable to line of business preferred
- Six (6) years of claims experience or equivalent combination of education and experience required
- Two (2) years of claims supervisor experience
- Thorough knowledge of claims management processes and procedures for multiple product lines
- Excellent oral and written communication, including presentation skills
- PC literate, including Microsoft Office products
- Leadership/management skills
- Analytical and interpretive skills
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies
- Ability to perform computer keyboarding
- Hearing, vision and talking ability
- Clear and conceptual thinking ability
- Excellent judgement and discretion
- Ability to meet deadlines
Benefits
Comp & perks- Medical insurance
- Dental insurance
- Vision insurance
- 401(k) plan and matching
- Paid time off (PTO)
- Disability insurance
- Life insurance
- Employee assistance program
- Flexible spending account or health savings account
- Other additional voluntary benefits
- Work-life balance
- Caring culture