Skills & Competencies for Insurance Claim Service Manager I
Insurance Claim Service Manager I job profile
Book a Demo and Receive a Sample Job ProfileJOB SUMMARY for Insurance Claim Service Manager I
Manages day-to-day service activities for one claim-related function in a contact center setting.
JOB RESPONSIBILITIES for Insurance Claim Service Manager I
Develops and implements claim servicing policies and procedures, and ensures that team members meet or exceed performance standards for quality and volume. Identifies opportunities for system and workflow improvements and recommends changes in operational processes. Ensures compliance with State Insurance Department regulations. May be responsible for reviewing and processing highly complex or high-value claims.
Insurance Claim Service Manager I SALARY RANGE
BASE 50%
$99,130
TOTAL 50%
$112,018
Job Level
M01
Job Code
FA06000983
Education/Degree
Bachelor's Degree
Reports To
Manager or Head of a Department
Insurance Claim Service Manager I Skills and Competencies List
8 hard skills or competencies (industry competencies) for Insurance Claim Service Manager I
1
Industry Competency –
Insurance Industry
Proficiency Level -2
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
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
Insurance Claim Service Manager I
- Skill and Competency
Proficiency Level - 3
4
Skill and Competency -
Insurance Claim Service Manager I
Proficiency Level - 4
5
Competency for -
Insurance Claim Service Manager I
Proficiency Level - 5
11 soft skills or competencies (core competencies) for Insurance Claim Service Manager I
1
Core Competencies –
Business Process Improvement
Proficiency Level -2
Level 1 Behaviors
(General Familiarity)
Describes the core principles of business process improvement.
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Level 2 Behaviors
(Light Experience)
Collects data from various channels to support analysis of business processes.
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Level 3 Behaviors
(Moderate Experience)
Develops alternative solutions to business process improvement and assesses their feasibility.
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Level 4 Behaviors
(Extensive Experience)
Evaluates reported issues and restructures the workflow design.
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Level 5 Behaviors
(Mastery)
Facilitates the implementation of business process improvement strategies.
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2
Core Competencies –
Standard Operating Procedures (SOP)
Proficiency Level -2
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
Insurance Claim Service Manager I
- Skill and Competency
Proficiency Level - 3
4
Skill and Competency -
Insurance Claim Service Manager I
Proficiency Level - 4
5
Competency for -
Insurance Claim Service Manager I
Proficiency Level - 5
Summary of Insurance Claim Service Manager I skills and competencies
There are 8 hard skills for Insurance Claim Service Manager I, Insurance Industry, Insurance Legal and Regulatory Environment, Insurance Products, etc.
0 general skills for Insurance Claim Service Manager I.
11 soft skills for Insurance Claim Service Manager I, Business Process Improvement, Standard Operating Procedures (SOP), Budgeting, etc.
While the list totals 19 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 Insurance Claim Service Manager I, he or she needs to be proficient in Business Process Improvement, be proficient in Standard Operating Procedures (SOP), and be proficient in Budgeting.
0 general skills for Insurance Claim Service Manager I.
11 soft skills for Insurance Claim Service Manager I, Business Process Improvement, Standard Operating Procedures (SOP), Budgeting, etc.
While the list totals 19 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 Insurance Claim Service Manager I, he or she needs to be proficient in Business Process Improvement, be proficient in Standard Operating Procedures (SOP), and be proficient in Budgeting.
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