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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing complex claims, including litigation and compliance with jurisdictional laws. Proficient in mentoring team members and maintaining effective relationships with clients and colleagues.
Highest-signal resume keywords
State Adjuster LicensesClaims ManagementLegal and Jurisdictional KnowledgeAnalytical and Interpretive SkillsCustomer Service Skills
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 EvaluationFraud EvaluationCase Management ReviewIndemnity AssessmentMedical Report InterpretationSAS/SOX Document ReviewLitigation ManagementPerformance CompetenciesProject TrackingCompliance Monitoring
Soft Skills
Strong Oral CommunicationStrong Written CommunicationPresentation SkillsOrganizational SkillsInterpersonal Skills
Tools & Technologies
Microsoft Office
Certifications & Qualifications
State Adjuster Licenses
Industry Keywords
Complex ClaimsSubrogationCoverage IssuesCustomer RelationshipsTeam CollaborationStatutory GuidelinesFinancial LiabilityPerformance Competencies
About the role
Key responsibilities & impact- Manage claim caseloads involving highly complex claims and coverage issues
- Handle claims of at least one million dollars involving multiple buildings
- Use special account instructions and coordinate specialized services such as subrogation, fraud evaluation, and case management review
- Establish and maintain effective relationships with internal and external customers and colleagues
- Mentor and coach account representatives and account specialists
- Facilitate round table discussions within the assigned team
- Investigate, evaluate, and resolve claims
- Identify potential problems and trends in claim files and take corrective action or make recommendations
- Interpret medical reports, state law, and jurisdictional law in claim handling
- Assess indemnity, medical, and expense exposure and apply insurance coverage appropriately
- Review client files and collaborate with the team on file strategies, claim status, and emerging trends
- Manage litigation with clients and legal representatives to resolve complex litigated claims
- Ensure compliance and minimize financial liability
- Comply with statutory guidelines and licensing requirements
- Monitor jurisdictional compliance reports and assist with team task and project tracking
- Review SAS/SOX documents and assist with takeover and reverse takeover projects
- Support quality programs and perform other duties as assigned
Requirements
What you’ll need- State adjuster licenses required
- Eight (8) years of related experience or equivalent combination of experience and education required
- Thorough legal and jurisdictional knowledge based on line of business
- Strong oral and written communication, including presentation skills
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Strong Customer Service skills
- Excellent interpersonal skills
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies
- Ability to handle multiple priorities simultaneously and meet deadlines
- Ability to travel as required
Benefits
Comp & perks- Work-life balance
- Reasonable accommodations when applicable and appropriate
- Equal Opportunity Employer
- Drug-Free Workplace