Skills & Competencies for Insurance Claim Service Representative I
Insurance Claim Service Representative I job profile
Book a Demo and Receive a Sample Job ProfileJOB 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%
$37,391
TOTAL 50%
$38,045
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
8 hard skills or competencies (industry competencies) for Insurance Claim Service Representative I
1
Industry Competency –
Insurance Industry
Proficiency Level -1
Level 1 Behaviors
(General Familiarity)
Identifies the key legislation and regulations governing insurance contracts.
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Level 2 Behaviors
(Light Experience)
Records and maintains insurance policy and claims information in a database system.
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Level 3 Behaviors
(Moderate Experience)
Verifies received insurance coverage and damage reports to ensure accurate processing of claims.
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Level 4 Behaviors
(Extensive Experience)
Provides technical guidance to staff on claim investigation to ensure accurate insurance claims processing.
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Level 5 Behaviors
(Mastery)
Pursues creative initiatives that may differentiate our business and give us a competitive advantage.
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2
Industry Competency –
Insurance Legal and Regulatory Environment
Proficiency Level -1
Level 1 Behaviors
(General Familiarity)
Explains the application of insurance regulatory laws to avoid civil penalties and license suspension.
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Level 2 Behaviors
(Light Experience)
Supports the execution of a legal and regulatory framework to promote strict insurance compliance.
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Level 3 Behaviors
(Moderate Experience)
Performs compliance reviews to determine possible violations and deficiencies in insurance regulations.
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Level 4 Behaviors
(Extensive Experience)
Trains teams on new laws and regulations to reduce liability risks and compliance violations.
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Level 5 Behaviors
(Mastery)
Establishes best practices in creating insurance laws and regulations to prevent frauds and malpractices.
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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
Level 1 Behaviors
(General Familiarity)
Lists the pros and cons of using customer relationships management systems.
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Level 2 Behaviors
(Light Experience)
Supports CRM systems and applications to interact with customers.
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Level 3 Behaviors
(Moderate Experience)
Maintains a high level of engagement with key customers to grow our customer base.
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Level 4 Behaviors
(Extensive Experience)
Plans customer engagement activities to create value in all interactions and increase loyalty.
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Level 5 Behaviors
(Mastery)
Forecasts trends in customer relationship management to adapt our strategies with customer behaviors.
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2
Job Family Competencies –
Customer Support
Proficiency Level -1
Level 1 Behaviors
(General Familiarity)
Lists customer service tools used to track customer interactions and improve service delivery.
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Level 2 Behaviors
(Light Experience)
Supports the planning and execution of customer service tactics to improve service quality.
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Level 3 Behaviors
(Moderate Experience)
Uses metrics in analyzing areas of opportunities for customer service.
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Level 4 Behaviors
(Extensive Experience)
Trains and guides teams on effective techniques in customer service to retain customers and increase value.
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Level 5 Behaviors
(Mastery)
Leads customer support operations to monitor and determine growth opportunities for customer satisfaction.
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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
Level 1 Behaviors
(General Familiarity)
Lists the typical processes of SOP development.
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Level 2 Behaviors
(Light Experience)
Participates in the implementation of new SOPs and enhancement of existing ones.
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Level 3 Behaviors
(Moderate Experience)
Modifies SOPs accordingly to reflect changes in our business practices and policies.
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Level 4 Behaviors
(Extensive Experience)
Optimizes the current SOP development and implementation processes.
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Level 5 Behaviors
(Mastery)
Leads cross-functional efforts to develop and implement SOPs across our organization.
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2
Core Competencies –
Attention to Detail
Proficiency Level -2
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)
Uses checklists to ensure that information goes out error-free.
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Level 3 Behaviors
(Moderate Experience)
Suggests solutions to issues that arise while executing the tasks.
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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.
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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