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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 fostering professional client relationships while ensuring compliance with licensing and documentation standards.
Highest-signal resume keywords
Claims ManagementLeadership SkillsAnalytical SkillsCommunication SkillsPerformance Development
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 ReviewsClaims AnalysisPerformance CompetenciesDocumentation StandardsLicensing RequirementsProject CoordinationTrend IdentificationReserve ReviewTechnical Direction
Soft Skills
Interpersonal SkillsNegotiation SkillsOrganizational SkillsTeam CollaborationMotivational Skills
Tools & Technologies
Microsoft Office
Certifications & Qualifications
Professional Certifications
Industry Keywords
Property ClaimsClaims ExperienceContinuous Process ImprovementClient RelationshipsPerformance Discussions
About the role
Key responsibilities & impact- Supervise the property claims team and/or several technical operations colleagues
- Monitor workloads, provide training, and monitor individual claim activities
- Provide technical and jurisdictional direction on claims adjudication
- Identify trends, problems, and issues and recommend courses of action
- Inform management of 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
- Act as second level of appeal for client and claimant issues and implement final dispositions
- Review reserve amounts on high-cost and over-authority claims
- Monitor third-party claims and review litigated, serious vocational rehabilitation, questionable, and sensitive claims
- Maintain client contact and promote professional client relationships
- Make recommendations based on claim status and provide written claim resumes as requested
- Ensure direct reports are properly licensed in serviced jurisdictions
- Ensure claims files are correctly coded and adequately documented
- Administer personnel policies and follow staffing and training standards
- Interview, hire, establish performance development plans, and conduct performance discussions
- Provide support, guidance, leadership, 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 and multiple priorities simultaneously
- Ability to meet deadlines
- Computer keyboarding; travel as required
Benefits
Comp & perks- Work-life balance
- Reasonable accommodations when applicable and appropriate
- Equal opportunity workplace
- Drug-free workplace