Skills & Competencies for Insurance Claim Service Manager I

Insurance Claim Service Manager I job profile

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JOB 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%
$98,884
TOTAL 50%
$111,743
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

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 Insurance Claim Service Manager I skill and competencie below to view definitions.
INDUSTRY COMPETENCIES CORE COMPETENCIES
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8 hard skills or competencies (industry competencies) for Insurance Claim Service Manager I

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)
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 -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)
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 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
Skill definition-Proactively defining, analyzing, and streamlining existing business processes within an organization to meet new quotas or standards of quality.
Level 1 Behaviors
(General Familiarity)
Cites basic business process improvement techniques and processes.
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Level 2 Behaviors
(Light Experience)
Assists in preparing flow charts to visualize each step in the new workflow.
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Level 3 Behaviors
(Moderate Experience)
Consults in the identification and resolution of process issues.
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Level 4 Behaviors
(Extensive Experience)
Deploys cost-effective and time-efficient solutions to business process issues.
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Level 5 Behaviors
(Mastery)
Designs various tools to be used for the business process improvement efforts.
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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)
Discusses the considerations and concerns on applying SOP for the first time.
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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)
Initiates SOP revisions to support continuous improvement of processes.
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Level 4 Behaviors
(Extensive Experience)
Evaluates the benefits and drawbacks of a specific SOP; oversees the corresponding enhancements.
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Level 5 Behaviors
(Mastery)
Establishes formal policies and procedures to guide the our SOP practices.
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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.

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