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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 supervision of teams, training on adjudication processes, and quality compliance. Proven ability to analyze claims data, provide strategic recommendations, and maintain strong client relationships.
Highest-signal resume keywords
Claims Management ProcessesClaims Supervisor ExperienceLeadership And Motivational SkillsAnalytical And Interpretive SkillsExcellent Oral And Written Communication
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 ComplianceClaims CodingPerformance Development PlansManagement ReportingTrend AnalysisThird-Party Claims ReviewHigh-Cost Claims ReviewLicensing RequirementsProcess Improvement Initiatives
Soft Skills
Interpersonal SkillsNegotiation SkillsOrganizational SkillsTeam CollaborationJudgment And Discretion
Tools & Technologies
Microsoft Office ProductsClaims Management Software
Certifications & Qualifications
Licenses As Required
Industry Keywords
Liability ClaimsClaims ExperiencePerformance CompetenciesQuality ProgramsClient Relationships
About the role
Key responsibilities & impact- Supervise multiple teams of examiners and technical staff handling liability claims
- Monitor colleagues’ workloads and individual claim activities
- Provide training and technical/jurisdictional direction on claims adjudication
- Identify trends, problems, and issues and recommend courses of action
- Coordinate management projects and continuous process improvement initiatives
- Compile, review, and analyze management reports
- Perform quality reviews of claims for audit, service contract, and quality compliance
- Act as the second level of appeal for client and claimant issues and implement final appeal dispositions
- Review reserves on high-cost claims and claims exceeding examiner authority
- Monitor third-party claims and review litigated, serious vocational rehabilitation, questionable, and sensitive claims
- Maintain client contact, promote professional client relationships, and provide claim recommendations and written resumes
- Ensure direct reports are properly licensed in serviced jurisdictions
- Ensure accurate claims coding and adequate file documentation
- Administer personnel policies and staffing standards
- Interview, hire, and establish performance development plans
- Conduct colleague performance discussions
- Provide leadership, guidance, motivation, and performance support
- Support the organization's quality programs
- Perform other duties as assigned
Requirements
What you’ll need- Six (6) years of claims experience or equivalent combination of education and experience required, including two (2) years of claims supervisor experience
- Licenses as required
- 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, and motivational skills
- Analytical and interpretive skills
- Strong organizational skills
- Excellent interpersonal skills
- Excellent negotiation 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 judgment and discretion
- Ability to meet deadlines
Benefits
Comp & perks- Work-life balance
- Caring culture
- Career growth opportunities
- Great Place to Work® certified workplace
- Equal Opportunity Employer
- Drug-Free Workplace