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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in claims supervision and adjudication, with a strong focus on training, quality assurance, and process improvement. Proven ability to manage multiple teams, analyze claims data, and maintain professional client relationships.
Highest-signal resume keywords
Claims Supervision ExperienceTechnical Direction on Claims AdjudicationProcess Improvement InitiativesLicensing Knowledge in JurisdictionsClaims Analysis and Reporting
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 AdjudicationQuality ReviewsManagement ReportingPerformance Development PlansCoding Claims FilesTroubleshootingProblem SolvingAnalysisStress Management
Soft Skills
LeadershipClear ThinkingExcellent JudgmentMotivationInterpersonal Skills
Tools & Technologies
Computer Keyboarding
Certifications & Qualifications
Professional CertificationsRequired Licensing
Industry Keywords
Workers CompensationClaims ManagementJurisdiction KnowledgeClient RelationshipsContinuous Improvement
About the role
Key responsibilities & impact- Supervise multiple teams of workers compensation examiners and technical operations colleagues
- Monitor workloads and individual claim activities
- Provide training and technical/jurisdictional direction on examiner reports and claims adjudication
- Identify trends, problems, and issues and recommend courses of action
- Coordinate management projects and continuous process improvement initiatives
- Compile, review, and analyze management reports
- Perform quality reviews of claims in accordance with audit, service contract, and quality standards
- Act as second-level appeal authority for client and claimant issues and implement final dispositions
- Review reserves on high-cost and high-authority claims
- Monitor third-party, litigated, serious vocational rehabilitation, questionable, and sensitive claims
- Maintain client contact, promote professional client relationships, and provide claim recommendations and written 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 to maximize performance
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 required
- Two (2) years of claims supervisor experience
- Jurisdiction knowledge: AL, AR, FL, GA, IA, KY, MS
- Required licensing
- Ability to provide technical/jurisdictional direction on claims adjudication
- Ability to supervise multiple teams of examiners and technical staff
- Clear and conceptual thinking ability
- Excellent judgment, troubleshooting, problem solving, analysis, and discretion
- Ability to handle work-related stress and 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 benefits
- 401K on day one
- Work-life balance
- Professional development opportunities
- Flexibility and autonomy in daily work, location, and career path