Skills & Competencies for Claims Manager

Claims Manager job profile

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JOB SUMMARY for Claims Manager

Manages the operations of an insurance claims department to meet operational, financial, and service requirements.

JOB RESPONSIBILITIES for Claims Manager

Oversees the intake and processing of insurance claims for personal, property, or casualty loss based on coverage, appraisal, and verifiable damage. Manages appraisal and examination staff and processes. Assures timely and proper disposition of claims based on policy provisions. Recommends and implements best practices to ensure complete and thorough claim settlements, legal reviews, and investigations following company policies and insurance industry regulations. Determines the value of settlements for escalated claims. Manages negotiations of settlements and administration of claims in litigation.

Claims Manager SALARY RANGE

BASE 50%
$130,849
TOTAL 50%
$144,203
Job Level
M02
Job Code
FA06000305
Education/Degree
Bachelor's Degree
Reports To
Top Management

Claims Manager 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 Manager skill and competencie below to view definitions.
INDUSTRY COMPETENCIES CORE COMPETENCIES
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10 hard skills or competencies (industry competencies) for Claims Manager

1 Industry Competency – Insurance Industry
Proficiency Level -3
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)
Defines the key terminologies and components of an insurance policy.
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Level 2 Behaviors
(Light Experience)
Enters new information about insurance premiums and payments to update insurance policy records.
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Level 3 Behaviors
(Moderate Experience)
Examines insurance applications and letters from clients to determine necessary policy changes.
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Level 4 Behaviors
(Extensive Experience)
Evaluates existing claims handling process to identify fraud and opportunities for optimization of outcomes.
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Level 5 Behaviors
(Mastery)
Champions the adoption of AI and automation technologies to streamline insurance operations.
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2 Industry Competency – Insurance Legal and Regulatory Environment
Proficiency Level -3
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)
Cites examples of the legal principles of insurance applicable to multiple types of insurance products.
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Level 2 Behaviors
(Light Experience)
Assists in assessing regulatory risks to ensure insurance operations meet compliance and regulatory obligations.
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Level 3 Behaviors
(Moderate Experience)
Adopts legal and regulatory initiatives to assess possible risks and maintain insurance solvency.
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Level 4 Behaviors
(Extensive Experience)
Directs the regulation of insurance products to ensure insurance policy provisions comply with state laws.
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Level 5 Behaviors
(Mastery)
Builds policy and regulatory tools to monitor and assess compliance levels with insurance laws and regulations.
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3 Claims Manager - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Claims Manager
Proficiency Level - 4
5 Competency for - Claims Manager
Proficiency Level - 5

11 soft skills or competencies (core competencies) for Claims Manager

1 Core Competencies – Standard Operating Procedures (SOP)
Proficiency Level -3
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)
Cites examples of SOP practices in our business operations.
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Level 2 Behaviors
(Light Experience)
Compiles and maintains SOPs under our current policies and directions.
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Level 3 Behaviors
(Moderate Experience)
Ensures internal SOPs are in compliance with industry standards and regulations.
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Level 4 Behaviors
(Extensive Experience)
Develops and delivers training programs to ensure our SOPs are fully communicated and adhered to.
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Level 5 Behaviors
(Mastery)
Champions the adoption of SOP to foster efficiency and consistency.
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2 Core Competencies – Budgeting
Proficiency Level -2
Skill definition-Applying specific policies, tools and practices to plan and prepare projected revenues, expenses, cash flows, and capital expenditures.
Level 1 Behaviors
(General Familiarity)
Describes the concepts and principles of budgeting operations.
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Level 2 Behaviors
(Light Experience)
Assists in developing and improving budgeting models, plans, and strategies.
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Level 3 Behaviors
(Moderate Experience)
Compares planned budgets vs. actual expenditures, identifies, reports, and explains variances.
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Level 4 Behaviors
(Extensive Experience)
Determines system capabilities and needs to improve the process for financial budgeting.
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Level 5 Behaviors
(Mastery)
Adapts relevant industry trends on techniques in financial budgeting in our organization.
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3 Claims Manager - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Claims Manager
Proficiency Level - 4
5 Competency for - Claims Manager
Proficiency Level - 5

Summary of Claims Manager skills and competencies

There are 10 hard skills for Claims Manager, Insurance Industry, Insurance Legal and Regulatory Environment, Insurance Products, etc.
0 general skills for Claims Manager.
11 soft skills for Claims Manager, Standard Operating Procedures (SOP), Budgeting, Risk Management, etc.
While the list totals 21 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 Manager, he or she needs to be skilled in Standard Operating Procedures (SOP), be proficient in Budgeting, and be skilled in Risk Management.

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