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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 and improve operational efficiency. Proficient in client relationship management and effective communication, ensuring high-quality claims adjudication and compliance with standards.
Highest-signal resume keywords
Claims ManagementLeadership SkillsAnalytical SkillsCommunication SkillsProcess Improvement
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 ReviewPerformance CompetenciesClaims AnalysisClaims CodingManagement ReportingLicensing ComplianceTechnical DirectionProject CoordinationWorkload Monitoring
Soft Skills
Interpersonal SkillsNegotiation SkillsOrganizational SkillsTeam CollaborationMotivational Skills
Tools & Technologies
Microsoft Office
Certifications & Qualifications
Professional CertificationsLicenses as Required
Industry Keywords
Property ClaimsClaims ExperienceContinuous Process ImprovementClient RelationshipsPerformance Development Plans
About the role
Key responsibilities & impact- Supervise the property claims team and/or several technical operations colleagues
- 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
- Compile, review, and analyze management reports and take appropriate action
- Perform quality reviews on claims according to 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, litigated, serious vocational rehabilitation, questionable, and sensitive claims
- Maintain client contact and promote professional client relationships
- Provide written claim resumes to clients as requested
- Ensure direct reports are properly licensed in serviced jurisdictions
- Ensure claims files are correctly coded and adequately documented
- Administer personnel policies and staffing standards
- Interview, hire, and establish performance development plans
- Conduct performance discussions and provide leadership, guidance, 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
- 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/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 handle work-related stress, multiple priorities, and deadlines
- Computer keyboarding; travel as required
Benefits
Comp & perks- Work-life balance
- Reasonable accommodations when applicable and appropriate
- Equal Opportunity Employer
- Drug-Free Workplace
- Diverse, equitable, and inclusive workplace