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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 providing technical direction, ensuring compliance with quality standards, and managing client relationships.
Highest-signal resume keywords
Claims Management ProcessesLeadership SkillsAnalytical SkillsCommunication SkillsPerformance Competencies
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 ReviewsManagement ReportingProcess ImprovementClaims CodingLicensing CompliancePerformance Development PlansNegotiation SkillsMicrosoft OfficeClaims Analysis
Soft Skills
Interpersonal SkillsOrganizational SkillsTeam CollaborationMotivational SkillsStress Management
Certifications & Qualifications
Professional CertificationsLicenses as Required
Industry Keywords
Property ClaimsClient ContactThird-Party ClaimsVocational RehabilitationAudit Standards
About the role
Key responsibilities & impact- Supervise the property claims team and/or several technical operations colleagues
- Monitor colleagues' workloads, provide training, and monitor individual claim activities
- Provide technical and jurisdictional direction on claims adjudication
- Identify and advise management of trends, problems, issues, and recommended actions
- Coordinate management projects and continuous process improvement initiatives
- 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 appeal for client and claimant issues and implement final dispositions
- Review reserves on high-cost claims and claims exceeding examiner authority
- Monitor third-party, litigated, serious vocational rehabilitation, questionable, and sensitive claims
- Maintain client contact, recommend actions based on claim status, and provide written claim summaries
- 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, establish performance development plans, and conduct performance discussions
- Provide support, guidance, leadership, and motivation
- Perform other duties as assigned
- Support the organization's quality programs
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
Benefits
Comp & perks- Work-life balance
- Reasonable accommodations when applicable and appropriate
- Equal Opportunity Employer
- Drug-Free Workplace
- Diversity, equity, and inclusion initiatives