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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in analyzing and managing workers compensation claims, ensuring timely resolution and adherence to industry best practices. Proficient in negotiation and communication with clients and claimants while maintaining compliance with regulatory requirements.
Highest-signal resume keywords
Claims Management ExperienceNegotiation SkillsCalifornia or Nevada LicenseProfessional CertificationAnalytical Thinking
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 AnalysisClaims ProcessingAdjudicationSettlement NegotiationAction Plan Development
Soft Skills
Excellent JudgmentProblem SolvingDiscretionAbility to Handle StressTime Management
Tools & Technologies
Computer Keyboarding
Certifications & Qualifications
Professional Certification
Industry Keywords
Workers CompensationClaims AdjudicationClient Service RequirementsClaim Exposure InvestigationExcess Carrier Reporting
About the role
Key responsibilities & impact- Analyze workers compensation claims on behalf of valued clients to determine benefits due
- Ensure ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements
- Analyze and process claims through action plans to timely resolution
- Investigate and gather information to determine claim exposure
- Negotiate settlement of claims within designated authority
- Communicate claim activity and processing with claimants and clients
- Report claims to the excess carrier
- Respond to requests for directions professionally and in a timely manner
Requirements
What you’ll need- High School Diploma or GED required
- Bachelor's degree from an accredited college or university preferred
- Professional certification as applicable to line of business preferred
- 5 years of claims management experience or equivalent combination of education and experience required
- Must be licensed in California or Nevada
- 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
Benefits
Comp & perks- Flexible work schedule
- Referral incentive program
- Career development and promotional growth opportunities
- Medical, dental, and vision coverage
- 401K on day one
- 401K matching
- PTO
- Disability and life insurance
- Employee assistance
- Flexible spending or health savings account
- Other additional voluntary benefits