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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in investigating and resolving insurance claims, with a strong focus on accuracy, efficiency, and compliance with industry regulations. Proficient in negotiating settlements and managing caseloads while providing empathetic customer service.
Highest-signal resume keywords
Insurance Claims InvestigationNegotiation SkillsPolicy Review and AnalysisCustomer ServiceState Licensing Requirements
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 ResolutionLiability EvaluationDocument AnalysisBodily Injury Claims AssessmentClaim Reserve Setting
Soft Skills
Effective CommunicationEmpathyTime ManagementPrioritizationNegotiation
Certifications & Qualifications
State Licensing
Industry Keywords
Insurance PoliciesClaims ProcessLegal RequirementsMedical ReportsSettlement Negotiation
About the role
Key responsibilities & impact- Investigate and resolve insurance claims with a focus on accuracy, efficiency, and fair resolution
- Independently manage caseloads and negotiate settlements
- Verify coverage by reviewing policies and interpreting policy terms, conditions, and language
- Evaluate liability using recorded statements, police reports, and other pertinent evidence
- Negotiate or deny liability based on investigation outcomes
- Evaluate physical damage and bodily injury claims using estimates, photos, appraisals, medical reports, medical bills, and other evidence
- Coordinate with medical providers, repair shops, and contractors to facilitate necessary services
- Set appropriate claim reserves based on ongoing liability evaluations
- Negotiate bodily injury settlements with policyholders, claimants, attorneys, and other insurance carriers
- Ensure claims are paid promptly within authorized limits
- Document decisions, communications, and activities throughout the claims process
- Provide empathetic customer service, explain the claims process, communicate updates and decisions, and explain decision rationale
- Ensure compliance with industry regulations, legal requirements, and internal policies
Requirements
What you’ll need- Bachelor’s degree or equivalent work experience
- Minimum 1 year of related work experience
- Ability to obtain and maintain state licensing requirements
- Prior attorney representative experience highly preferred
- Ability to review and analyze detailed documents, insurance policies, coverages, medical bills, and records
- Ability to make appropriate claim decisions, prioritize, and manage workload under time-limit demands
- Effective verbal and written communication skills
- Demonstrated fundamental negotiation skills
Benefits
Comp & perks- Optional work from home on Mondays and Fridays; office collaboration Tuesday through Thursday
- Technology and tools provided for office and home workspace from day one
- Dining stipend for on-site cafeteria or meal allowance, depending on location
- Sentry University and tuition reimbursement program
- Group medical, dental, and vision insurance
- Parental leave
- Pet insurance
- Caregiver leave
- Wellness resources
- HSA, FSA, and Dependent Care FSA options
- Paid Time Off
- Paid Volunteer Time Off
- 100% company match on the first 8% contributed to 401(k) each pay period
- Immediate 401(k) vesting
- Professional development and growth opportunities
