FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in claims supervision and management, ensuring compliance with audit and quality standards while fostering professional client relationships. Capable of analyzing claims data and providing strategic recommendations for process improvement and team performance.
Highest-signal resume keywords
Claims Supervision ExperienceClaims AnalysisQuality Review ComplianceClient Relationship ManagementPerformance Development Planning
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 ExperienceClaims AdjudicationData AnalysisQuality Standards CompliancePerformance ManagementProject CoordinationTechnical DirectionLicensing RequirementsCoding Claims FilesContinuous Process Improvement
Soft Skills
Problem SolvingJudgmentDiscretionStress ManagementMulti-Priority Handling
Tools & Technologies
Management Reporting ToolsClaims Management Software
Certifications & Qualifications
Professional CertificationsLicenses as Required
Industry Keywords
Claims ManagementAudit RequirementsService Contract RequirementsVocational RehabilitationClient Contact
About the role
Key responsibilities & impact- Supervise multiple teams of examiners, multiple product line examiners and/or several technical operations colleagues
- Identify and advise management of trends, problems, and issues and recommend courses of action
- Inform management of new procedures and ideas for continuous process improvement
- Coordinate projects with management
- Provide technical and jurisdictional direction on claims adjudication reports
- Compile, review, and analyze management reports and take appropriate action
- Perform quality reviews on claims in compliance with audit requirements, service contract requirements, and quality standards
- Act as second level of appeal for client and claimant issues and implement final appeal 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
- Provide written claim summaries as requested by clients
- Ensure direct reports are properly licensed in jurisdictions serviced
- Ensure claims files are correctly coded and adequately documented
- Administer company personnel policies and follow staffing and training standards
- Interview, hire, and establish performance development plans
- Conduct colleague performance discussions
- Provide support, guidance, leadership, and motivation
- Perform other duties as assigned
- Support the organization's quality programs
Requirements
What you’ll need- Licenses as required
- Six (6) years of claims experience or equivalent combination of education and experience required
- Two (2) years claims supervisor experience
- Bachelor's degree from an accredited college or university preferred
- Professional certifications as applicable to line of business preferred
- Clear and conceptual thinking ability
- Excellent judgment, troubleshooting, problem solving, analysis, and discretion
- Ability to handle work-related stress
- Ability to handle multiple priorities simultaneously
- Ability to meet deadlines
- Computer keyboarding
- Hearing, vision and talking
- Employment may be contingent upon successful completion of a motor vehicle record (MVR) check, where job-related
Benefits
Comp & perks- Flexible work schedule
- Referral incentive program
- Opportunity to work in an agile environment
- Career development and promotional growth opportunities
- Medical, dental, vision, 401K and matching on day one
- PTO
- Disability and life insurance
- Employee assistance
- Flexible spending or health savings account
- Other additional voluntary benefits