Skills & Competencies for Insurance Claim Service Representative I

Insurance Claim Service Representative I job profile

JOB SUMMARY for Insurance Claim Service Representative I

Processes, adjusts, and closes simple, low-level claims in a contact center setting.

JOB RESPONSIBILITIES for Insurance Claim Service Representative I

Prepares initial claim reports, records statements from involved parties, and maintains First Notice of Loss (FNOL) information. Incumbents may be enrolled in a formal training program or apprenticeship.

Insurance Claim Service Representative I SALARY RANGE

BASE 50%
$37,488
TOTAL 50%
$38,131
Job Level
A01
Job Code
FA06000979
Education/Degree
High School Diploma or Technical Certificate
Reports To
Supervisor or Manager

Insurance Claim Service Representative 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 Representative I skill and competencie below to view definitions.

8 hard skills or competencies (industry competencies) for Insurance Claim Service Representative I

1 Industry Competency – Insurance Industry
Proficiency Level -1
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)
Explains how reinsurance aids in meeting the long-term debts and financial obligations of a business.
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Level 2 Behaviors
(Light Experience)
Locates resources to acquire updates regarding market shifts and regulatory changes in insurance.
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Level 3 Behaviors
(Moderate Experience)
Prepares insurance plans based on client needs to minimize financial risk or losses during uncertain events.
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Level 4 Behaviors
(Extensive Experience)
Monitors industry changes to improve the strategic directions of insurance operations.
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Level 5 Behaviors
(Mastery)
Develops strategic methods for selling insurance policies to increase the profit of our organization.
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2 Industry Competency – Insurance Legal and Regulatory Environment
Proficiency Level -1
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 importance of compliance programs in maintaining an insurance legal and regulatory environment.
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Level 2 Behaviors
(Light Experience)
Documents compliance complaints to track and escalate possible legal violations and ensure prompt resolution.
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Level 3 Behaviors
(Moderate Experience)
Executes market conduct exams to verify the adherence of insurance operations to laws and regulations.
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Level 4 Behaviors
(Extensive Experience)
Reviews root causes of regulatory deficiencies to create corrective action plans and ensure adherence.
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Level 5 Behaviors
(Mastery)
Develops an insurance regulatory framework to promote consumers' protection and achieve policy objectives.
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3 Insurance Claim Service Representative I - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Insurance Claim Service Representative I
Proficiency Level - 4
5 Competency for - Insurance Claim Service Representative I
Proficiency Level - 5

2 general skills or competencies (Job family competencies) for Insurance Claim Service Representative I

1 Job Family Competencies – Customer Relations
Proficiency Level -1
Skill definition-Creating mutually beneficial relationships with customers to improve their overall experience.
Level 1 Behaviors
(General Familiarity)
Explains the importance of customer relations in delivering good customer service.
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Level 2 Behaviors
(Light Experience)
Reports customer escalations to identify and mitigate negative impacts on customer relations.
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Level 3 Behaviors
(Moderate Experience)
Helps in integrating CRM applications to deliver seamless customer service.
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Level 4 Behaviors
(Extensive Experience)
Monitors performance indicators of customer relationship management to support business growth.
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Level 5 Behaviors
(Mastery)
Develops an organizational framework to efficiently manage all relations throughout our customer base.
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2 Job Family Competencies – Customer Support
Proficiency Level -1
Skill definition-Providing responsive and relevant support to customers to address issues and problems on our products or services and ensure customer satisfaction.
Level 1 Behaviors
(General Familiarity)
Explains the importance of customer support in meeting customer needs and expectations.
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Level 2 Behaviors
(Light Experience)
Identifies customer needs and requirements to meet customer support expectations.
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Level 3 Behaviors
(Moderate Experience)
Leverages tools and resources to provide prompt customer service troubleshooting.
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Level 4 Behaviors
(Extensive Experience)
Recommends improvements to our customer support tools and methods to drive customer satisfaction.
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Level 5 Behaviors
(Mastery)
Establishes best practices in customer support to enhance customer satisfaction and retention.
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3 Insurance Claim Service Representative I - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Insurance Claim Service Representative I
Proficiency Level - 4
5 Competency for - Insurance Claim Service Representative I
Proficiency Level - 5

8 soft skills or competencies (core competencies) for Insurance Claim Service Representative I

1 Core Competencies – Standard Operating Procedures (SOP)
Proficiency Level -1
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)
Maintains the accuracy of SOPs to provide consistent guidance in our workplace.
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Level 4 Behaviors
(Extensive Experience)
Leverages the use of SOPs to solve business and operation problems.
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Level 5 Behaviors
(Mastery)
Keeps abreast of industry regulation and its effect on our internal SOPs.
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2 Core Competencies – Attention to Detail
Proficiency Level -2
Skill definition-Executing and completing a task with a high level of accuracy.
Level 1 Behaviors
(General Familiarity)
Lists the traits of an employee showing great attention to detail.
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Level 2 Behaviors
(Light Experience)
Utilizes specific approaches and tools for checking and cross-checking outputs.
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Level 3 Behaviors
(Moderate Experience)
Uses tools to organize and monitor work progress.
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Level 4 Behaviors
(Extensive Experience)
Manages training to improve staffs' concentration and attention to detail.
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Level 5 Behaviors
(Mastery)
Learns from previous works' strengths and weaknesses to guide new projects.
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3 Insurance Claim Service Representative I - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Insurance Claim Service Representative I
Proficiency Level - 4
5 Competency for - Insurance Claim Service Representative I
Proficiency Level - 5

Summary of Insurance Claim Service Representative I skills and competencies

There are 8 hard skills for Insurance Claim Service Representative I, Insurance Industry, Insurance Legal and Regulatory Environment, Insurance Products, etc.
2 general skills for Insurance Claim Service Representative I, Customer Relations, Customer Support.
8 soft skills for Insurance Claim Service Representative I, Standard Operating Procedures (SOP), Attention to Detail, Time Management, etc.
While the list totals 18 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 Representative I, he or she needs to be proficient in Standard Operating Procedures (SOP), be proficient in Attention to Detail, and be proficient in Time Management.

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