Skills & Competencies for Top Claims Executive
Top Claims Executive job profile
Book a Demo and Receive a Sample Job ProfileJOB SUMMARY for Top Claims Executive
Plans and directs all aspects of an organization's insurance claims function.
JOB RESPONSIBILITIES for Top Claims Executive
Responsible for managing and implementing claims programs for all lines of insurance. Directs the review and settlement of complex or high dollar claims. Develops procedures and policies to enhance and improve the processing, investigation, and settlement of claims. Ensures legal examinations are made when appropriate.
Top Claims Executive SALARY RANGE
BASE 50%
$239,890
TOTAL 50%
$307,573
Job Level
M05
Job Code
EX05000106
Education/Degree
Bachelor's Degree
Reports To
Top Management
Top Claims Executive Skills and Competencies List
8 hard skills or competencies (industry competencies) for Top Claims Executive
1
Industry Competency –
Insurance Industry
Proficiency Level -3
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 -4
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
Top Claims Executive
- Skill and Competency
Proficiency Level - 3
4
Skill and Competency -
Top Claims Executive
Proficiency Level - 4
5
Competency for -
Top Claims Executive
Proficiency Level - 5
9 soft skills or competencies (core competencies) for Top Claims Executive
1
Core Competencies –
Budgeting
Proficiency Level -4
Level 1 Behaviors
(General Familiarity)
Compiles a list of basic issues and risks for conducting our budget processes.
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Level 2 Behaviors
(Light Experience)
Assists in developing and improving budgeting models, plans, and strategies.
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Level 3 Behaviors
(Moderate Experience)
Compares planned budgets vs. actual expenditures, identifies, reports, and explains variances.
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Level 4 Behaviors
(Extensive Experience)
Anticipates organizational income and expenses to make forecasts and develop budget plans.
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Level 5 Behaviors
(Mastery)
Adapts relevant industry trends on techniques in financial budgeting in our organization.
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2
Core Competencies –
Risk Management
Proficiency Level -4
Level 1 Behaviors
(General Familiarity)
Discusses the difficulties and challenges in risk management.
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Level 2 Behaviors
(Light Experience)
Assists in assessing, selecting, and implementing risk management tools.
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Level 3 Behaviors
(Moderate Experience)
Escalates significant risks to the appropriate management to address issues.
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Level 4 Behaviors
(Extensive Experience)
Creates and updates standard operating procedures (SOP) to improve risk management efficiency and effectiveness.
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Level 5 Behaviors
(Mastery)
Constructs risk management metrics to monitor, evaluate, and improve effectiveness.
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3
Top Claims Executive
- Skill and Competency
Proficiency Level - 3
4
Skill and Competency -
Top Claims Executive
Proficiency Level - 4
5
Competency for -
Top Claims Executive
Proficiency Level - 5
Summary of Top Claims Executive skills and competencies
There are 8 hard skills for Top Claims Executive, Insurance Industry, Insurance Legal and Regulatory Environment, Insurtech, etc.
0 general skills for Top Claims Executive.
9 soft skills for Top Claims Executive, Budgeting, Risk Management, Planning and Organizing, etc.
While the list totals 17 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 Top Claims Executive, he or she needs to be skilled in Budgeting, be skilled in Risk Management, and be skilled in Planning and Organizing.
0 general skills for Top Claims Executive.
9 soft skills for Top Claims Executive, Budgeting, Risk Management, Planning and Organizing, etc.
While the list totals 17 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 Top Claims Executive, he or she needs to be skilled in Budgeting, be skilled in Risk Management, and be skilled in Planning and Organizing.
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