Skills & Competencies for Disability Claims Examiner, Sr.

Disability Claims Examiner, Sr. job profile

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JOB SUMMARY for Disability Claims Examiner, Sr.

Reviews, evaluates and processes disability insurance claims according to procedure and practice.

JOB RESPONSIBILITIES for Disability Claims Examiner, Sr.

Examines claims material to ensure insurance coverage and validity. Has contact with agents, claimants, and policy holders.

Disability Claims Examiner, Sr. SALARY RANGE

BASE 50%
$65,344
TOTAL 50%
$67,410
Job Level
P02
Job Code
FA06000843
Education/Degree
Bachelor's Degree
Reports To
Supervisor/Manager

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

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)
Describes the current systems and scope of services provided by insurance organizations.
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Level 2 Behaviors
(Light Experience)
Follows industry best practices when preparing reports that detail risk assessment findings in insurance claims.
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Level 3 Behaviors
(Moderate Experience)
Makes necessary adjustments to insurance policies to meet customer needs.
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Level 4 Behaviors
(Extensive Experience)
Handles complex insurance losses through negotiation of favorable claims settlements with insurance companies.
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Level 5 Behaviors
(Mastery)
Develops and establishes risk reduction best practices to prevent fraudulent claims transactions.
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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)
Describes the basic structure of insurance legal and regulatory environment.
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Level 2 Behaviors
(Light Experience)
Complies with insurance legal and regulatory principles to safeguard the rights and interests of the insured.
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Level 3 Behaviors
(Moderate Experience)
Analyzes existing legal and regulatory standards to address errors affecting insurance policies.
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Level 4 Behaviors
(Extensive Experience)
Improves legal procedures for licensing intermediaries or producers to prevent penalties.
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Level 5 Behaviors
(Mastery)
Designs compliance strategies and programs to prevent violations of statutes, regulations, and policies.
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3 Disability Claims Examiner, Sr. - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Disability Claims Examiner, Sr.
Proficiency Level - 4
5 Competency for - Disability Claims Examiner, Sr.
Proficiency Level - 5

10 soft skills or competencies (core competencies) for Disability Claims Examiner, Sr.

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)
Describes the importance of gathering relevant information in making informed business decisions.
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Level 2 Behaviors
(Light Experience)
Checks multiple sources to get complete and accurate information.
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Level 3 Behaviors
(Moderate Experience)
Asks questions and gathers the necessary information to make informed business decisions.
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Level 4 Behaviors
(Extensive Experience)
Monitors the overall process of records retention programs.
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Level 5 Behaviors
(Mastery)
Designs a system for monitoring the effectiveness of data-gathering channels.
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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)
Describes the purposes and benefits of Standard Operating Procedures (SOP).
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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)
Implements the use of SOP throughout our business to drive efficiency.
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Level 4 Behaviors
(Extensive Experience)
Enhances the SOP management system to improve efficiency and user experience.
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Level 5 Behaviors
(Mastery)
Designs a Standard Operating Procedure (SOP) strategy to align with our business objectives.
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3 Disability Claims Examiner, Sr. - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Disability Claims Examiner, Sr.
Proficiency Level - 4
5 Competency for - Disability Claims Examiner, Sr.
Proficiency Level - 5

Summary of Disability Claims Examiner, Sr. skills and competencies

There are 10 hard skills for Disability Claims Examiner, Sr., Insurance Industry, Insurance Legal and Regulatory Environment, Health Insurance, etc.
0 general skills for Disability Claims Examiner, Sr..
10 soft skills for Disability Claims Examiner, Sr., Gathering Information, Standard Operating Procedures (SOP), Risk Management, 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 Disability Claims Examiner, Sr., he or she needs to be proficient in Gathering Information, be proficient in Standard Operating Procedures (SOP), and be proficient in Risk Management.

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