Skills & Competencies for Claims Adjuster III

Claims Adjuster III job profile

JOB SUMMARY for Claims Adjuster III

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

JOB RESPONSIBILITIES for Claims Adjuster III

Examines claim forms and other records to determine coverage. Responsible for corresponding with policyholders, claimants, witnesses, attorneys, etc. to gather important information to support contested. Conducts field investigations to inspect and document damage or loss. Prepares report of findings of an investigation.

Claims Adjuster III SALARY RANGE

BASE 50%
$86,474
TOTAL 50%
$89,765
Job Level
P03
Job Code
FA06000049
Education/Degree
Bachelor's Degree
Reports To
Manager or Head of a Unit/Department

Claims Adjuster III 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 III skill and competencie below to view definitions.

11 hard skills or competencies (industry competencies) for Claims Adjuster III

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)
Names the commonly used tools and techniques for insurance planning and risk management.
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Level 2 Behaviors
(Light Experience)
Reports any discrepancies encountered in reviewing policy records and documentation.
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Level 3 Behaviors
(Moderate Experience)
Verifies received insurance coverage and damage reports to ensure accurate processing of claims.
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Level 4 Behaviors
(Extensive Experience)
Provides technical guidance to staff on claim investigation to ensure accurate insurance claims processing.
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Level 5 Behaviors
(Mastery)
Pursues creative initiatives that may differentiate our business and give us a competitive advantage.
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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)
Explains the application of insurance regulatory laws to avoid civil penalties and license suspension.
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Level 2 Behaviors
(Light Experience)
Supports the execution of a legal and regulatory framework to promote strict insurance compliance.
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Level 3 Behaviors
(Moderate Experience)
Performs compliance reviews to determine possible violations and deficiencies in insurance regulations.
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Level 4 Behaviors
(Extensive Experience)
Trains teams on new laws and regulations to reduce liability risks and compliance violations.
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Level 5 Behaviors
(Mastery)
Establishes best practices in creating insurance laws and regulations to prevent frauds and malpractices.
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3 Claims Adjuster III - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Claims Adjuster III
Proficiency Level - 4
5 Competency for - Claims Adjuster III
Proficiency Level - 5

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

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)
Lists the pros and cons of using customer relationships management systems.
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Level 2 Behaviors
(Light Experience)
Supports CRM systems and applications to interact with customers.
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Level 3 Behaviors
(Moderate Experience)
Works closely with customers to use their insights in building strong customer relationships.
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Level 4 Behaviors
(Extensive Experience)
Trains staff on best practices in relationship management to establish customer connections.
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Level 5 Behaviors
(Mastery)
Leads our organization in promoting good relations with customers to optimize overall customer experience.
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3 Claims Adjuster III - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Claims Adjuster III
Proficiency Level - 4
5 Competency for - Claims Adjuster III
Proficiency Level - 5

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

1 Core Competencies – Gathering Information
Proficiency Level -3
Skill definition-Accumulating necessary information from various resources to clarify the situation or make an informed business decision.
Level 1 Behaviors
(General Familiarity)
Names commonly used tools and techniques for data collection.
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Level 2 Behaviors
(Light Experience)
Obtains needed information by asking skillful and persistent questions.
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Level 3 Behaviors
(Moderate Experience)
Utilizes various tools and technologies to validate information acquired from different sources.
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Level 4 Behaviors
(Extensive Experience)
Synthesizes information from various sources to enable strategic decision-making by our leadership.
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Level 5 Behaviors
(Mastery)
Takes steps to ensure that the intellectual property rights of others are not violated.
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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)
Lists the typical processes of SOP development.
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Level 2 Behaviors
(Light Experience)
Supports the analysis of our business and operations processes for SOP design and development.
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Level 3 Behaviors
(Moderate Experience)
Researches new tools and techniques for SOP daily management.
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Level 4 Behaviors
(Extensive Experience)
Resolves complex issues arising from SOP practices; develops preventative solutions accordingly.
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Level 5 Behaviors
(Mastery)
Monitors industry for SOP trends and best practices; makes recommendations about those that benefit our business.
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3 Claims Adjuster III - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Claims Adjuster III
Proficiency Level - 4
5 Competency for - Claims Adjuster III
Proficiency Level - 5

Summary of Claims Adjuster III skills and competencies

There are 11 hard skills for Claims Adjuster III, Insurance Industry, Insurance Legal and Regulatory Environment, Insurance Products, etc.
1 general skills for Claims Adjuster III, Customer Relations.
8 soft skills for Claims Adjuster III, 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 III, he or she needs to be skilled in Gathering Information, be proficient in Standard Operating Procedures (SOP), and be skilled in Attention to Detail.

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