Skills & Competencies for Claims Adjuster II

Claims Adjuster II job profile

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JOB SUMMARY for Claims Adjuster II

Denies, settles, or authorizes payments to routine property/casualty claims based on coverage, appraisal, and verifiable damage.

JOB RESPONSIBILITIES for Claims Adjuster II

Responsible for corresponding with policyholders, claimants, witnesses, attorneys, etc. to gather important information to support contested claims. Prepares reports of investigation findings. May conduct field evaluations to inspect and document damage or loss.

Claims Adjuster II SALARY RANGE

BASE 50%
$70,676
TOTAL 50%
$73,134
Job Level
P02
Job Code
FA06000048
Education/Degree
Bachelor's Degree
Reports To
Supervisor or Manager

Claims Adjuster II Skills and Competencies List

Proficiency Levels and Behavioural Indicators
Salary.com identifies five increasing levels of proficiency for each skill/competency. Some jobs require only a relatively low level of proficiency in each skill/competency, while other jobs will require a more advanced level of proficiency in the same skill/competency. These levels rate the degree of proficiency (skill level, expertise) we expect the incumbent to perform in the given skill/competency for the given job. Note that we intentionally do not associate timeframes or years of experience in performing the skill/competency because that can be misleading. Proficiency levels identify what the incumbent knows and can do rather than how long they have been doing it. Also, note that the proficiency levels are cumulative, e.g., a level 4 proficiency implies the ability to perform all the behaviors at the lower levels.
Check each Claims Adjuster II skill and competencie below to view definitions.
INDUSTRY COMPETENCIES JOB FAMILY COMPETENCIES CORE COMPETENCIES
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11 hard skills or competencies (industry competencies) for Claims Adjuster II

1 Industry Competency – Insurance Industry
Proficiency Level -2
Skill definition-Applying knowledge of the insurance industry to provide risk management services and protection to various individuals from financial loss.
Level 1 Behaviors
(General Familiarity)
Explains the policy conditions of various insurance contracts and products.
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Level 2 Behaviors
(Light Experience)
Provides prompt responses to clients’ insurance-related questions and concerns.
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Level 3 Behaviors
(Moderate Experience)
Reviews and analyzes claim applications to determine coverage eligibility and rates.
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Level 4 Behaviors
(Extensive Experience)
Monitors market trends in insurance services to deliver improved business impacts.
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Level 5 Behaviors
(Mastery)
Establishes and enforces standards for handling claims to maximize insurance workflow efficiency.
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2 Industry Competency – Insurance Legal and Regulatory Environment
Proficiency Level -2
Skill definition-Creating, executing, and adhering to state and federal laws governing insurance operations to ensure financial security and consumer protection.
Level 1 Behaviors
(General Familiarity)
Discusses the importance of insurance regulations in protecting clients' financial security and assets.
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Level 2 Behaviors
(Light Experience)
Gathers and interprets policy contracts to understand insurance legal and regulatory standards.
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Level 3 Behaviors
(Moderate Experience)
Maintains financial and market regulation to validate insurance's accounting methods and procedures.
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Level 4 Behaviors
(Extensive Experience)
Sets guidelines to promote fairness and transparency in financial markets in providing insurance products.
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Level 5 Behaviors
(Mastery)
Develops compliance and risk management standards to manage overall insurance legal and regulatory environment.
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3 Claims Adjuster II - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Claims Adjuster II
Proficiency Level - 4
5 Competency for - Claims Adjuster II
Proficiency Level - 5

1 general skill or competency (Job family competency) for Claims Adjuster II

1 Job Family Competencies – Customer Relations
Proficiency Level -2
Skill definition-Creating mutually beneficial relationships with customers to improve their overall experience.
Level 1 Behaviors
(General Familiarity)
Explains the process of creating and maintaining customer relationships.
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Level 2 Behaviors
(Light Experience)
Selects appropriate resources to understand customer behavior and create good relations.
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Level 3 Behaviors
(Moderate Experience)
Helps in integrating CRM applications to deliver seamless customer service.
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Level 4 Behaviors
(Extensive Experience)
Monitors performance indicators of customer relationship management to support business growth.
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Level 5 Behaviors
(Mastery)
Develops an organizational framework to efficiently manage all relations throughout our customer base.
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3 Claims Adjuster II - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Claims Adjuster II
Proficiency Level - 4
5 Competency for - Claims Adjuster II
Proficiency Level - 5

8 soft skills or competencies (core competencies) for Claims Adjuster II

1 Core Competencies – Gathering Information
Proficiency Level -2
Skill definition-Accumulating necessary information from various resources to clarify the situation or make an informed business decision.
Level 1 Behaviors
(General Familiarity)
Lists the principles and procedures of gathering information.
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Level 2 Behaviors
(Light Experience)
Determines the source of information to verify its reliability.
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Level 3 Behaviors
(Moderate Experience)
Uses survey results to identify areas that need improvement within our business.
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Level 4 Behaviors
(Extensive Experience)
Recommends improvement of our business's records retention program.
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Level 5 Behaviors
(Mastery)
Establishes procedures for gathering information to anticipate future customer or business needs.
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2 Core Competencies – Standard Operating Procedures (SOP)
Proficiency Level -2
Skill definition-A set of written instructions that describes the step-by-step activities to complete tasks in compliance with business standards and industry regulations.
Level 1 Behaviors
(General Familiarity)
Identifies our internal and external sources for the SOPs we need.
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Level 2 Behaviors
(Light Experience)
Gathers information on workflows and business controlling points.
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Level 3 Behaviors
(Moderate Experience)
Maintains the accuracy of SOPs to provide consistent guidance in our workplace.
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Level 4 Behaviors
(Extensive Experience)
Leverages the use of SOPs to solve business and operation problems.
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Level 5 Behaviors
(Mastery)
Keeps abreast of industry regulation and its effect on our internal SOPs.
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3 Claims Adjuster II - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Claims Adjuster II
Proficiency Level - 4
5 Competency for - Claims Adjuster II
Proficiency Level - 5

Summary of Claims Adjuster II skills and competencies

There are 11 hard skills for Claims Adjuster II, Insurance Industry, Insurance Legal and Regulatory Environment, Insurance Products, etc.
1 general skills for Claims Adjuster II, Customer Relations.
8 soft skills for Claims Adjuster II, Gathering Information, Standard Operating Procedures (SOP), Attention to Detail, etc.
While the list totals 20 distinct skills, it's important to note that not all are required to be mastered to the same degree. Some skills may only need a basic understanding, whereas others demand a higher level of expertise.
For instance, as a Claims Adjuster II, he or she needs to be proficient in Gathering Information, be proficient in Standard Operating Procedures (SOP), and be proficient in Attention to Detail.

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