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Claims manager skills for your resume and career

Updated January 8, 2025
4 min read
Claims manager example skills
Below we've compiled a list of the most critical claims manager skills. We ranked the top skills for claims managers based on the percentage of resumes they appeared on. For example, 15.3% of claims manager resumes contained customer service as a skill. Continue reading to find out what skills a claims manager needs to be successful in the workplace.

15 claims manager skills for your resume and career

1. Customer Service

Customer service is the process of offering assistance to all the current and potential customers -- answering questions, fixing problems, and providing excellent service. The main goal of customer service is to build a strong relationship with the customers so that they keep coming back for more business.

Here's how claims managers use customer service:
  • Received recognition plaques and service center awards for consistently exceeding service center goals in productivity, quality and customer service.
  • Improved customer service by objectively listening to customer feedback, anticipating compliance issues and open communication with corporate management.

2. Oversight

Having oversight of someone means to monitor a process or a situation. If someone has oversight of something, they are responsible for the completion of the project. Oversight is usually given to experts as they monitor their juniors or newbies as they go through a project.

Here's how claims managers use oversight:
  • Managed day-to-day operations of claims department and provided general oversight and direction of all claims activity.
  • Improved reserve recognition and reduced adverse reserve development through modified processes and improved oversight.

3. Litigation

Here's how claims managers use litigation:
  • Conduct claims reviews with Litigation business unit to provide feedback for specialty policy interpretation and technical physical damage support.
  • Monitored and reviewed third party litigation in cooperation with Manor Care corporate legal department to control legal costs.

4. Direct Reports

Here's how claims managers use direct reports:
  • Created accountability factors and expectations for managers and direct reports resulting in higher service levels and better statutory compliance.
  • Managed and developed all direct and indirect reports with responsibility for handling inquires and claims processing.

5. Claims Handling

Here's how claims managers use claims handling:
  • Prepared and updated claims handling software data reports, providing clients and insurance professionals with financial data supporting positive trust performance.
  • Reviewed claim payments from disability insurance carrier and third party administrator to confirm accuracy appropriate claims handling.

6. Insurance Claims

Here's how claims managers use insurance claims:
  • Provided support to over 3,000 union members by processing insurance claims and special benefits, verified member eligibility for reimbursements.
  • Managed a group of legal & insurance claims professionals that investigated, negotiated and resolved environmental pollution claims.

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7. General Liability

Here's how claims managers use general liability:
  • Supervised/managed International claims department for (NRA) Non-Resident Auto commercial trucking, commercial bus general liability and personal auto liability.
  • Major Accomplishments: Manage all general liability, casualty investigation, commercial and residential property claims and catastrophic losses.

8. Claims Adjusters

Here's how claims managers use claims adjusters:
  • Organized and implemented training sessions for claims adjusters with emphasis on coverage analysis, mediation participation and injury claim analysis.
  • Managed a team of 6 commercial specialty property and casualty claims adjusters for a recreational specialty managing general underwriter.

9. Process Claims

Process claims refers to the procedure an insurance agent follows once receiving a claim from an insured individual. This often includes reviewing, investigating, and deciding on whether the claim will be accepted or denied depending on the results of the insurer's investigation. This is a common procedure for all kinds of insurance including medical, auto, and liability insurance.

Here's how claims managers use process claims:
  • Contract review prior to implementation to assess ability to process claims without manual intervention.
  • Maintained state specific turnaround times and instructed my team to process claims according to specific guidelines.

10. Term Disability

Here's how claims managers use term disability:
  • Analyzed pertinent medical facts and evidence needed to determine claimant eligibility for Long-Term Disability benefits based on complex contractual language.
  • Maintain tax and benefit deduction controls including short term disability, workers compensation, Social Security Disability and other disability.

11. Performance Management

Here's how claims managers use performance management:
  • Managed office operations including scheduling, supply ordering, and performance management of adjusters.
  • Develop individual development plans to assist with rep performance management and individual development.

12. Liability Claims

Liability claims are insurance claims where the insured is accused of holding responsibility for some damage or loss. Upon hearing or receiving the accusations, the insured reaches out to his or her insurance company for financial or other assistance, at which point the insurance company would determine whether the damage or loss is covered by the insured's policy. If covered, the insurance company may conduct an investigation or manage and legal processes for the insured.

Here's how claims managers use liability claims:
  • Managed five attorneys each with responsibility for approximately 160 lawyers' and accountants' professional liability claims.
  • Managed automobile liability claims department while negotiating these claims with legal acting agents of providers.

13. Quality Standards

Quality standards are a specific level of standards of products that are set by the companies for the customers that have to be met and maintained throughout the process until the time of delivery. Quality standards are information that includes the customer's requirements, guidelines, and characteristics for the needed final product or service.

Here's how claims managers use quality standards:
  • Develop and ensure all individuals understand and meet production/quality standards, and communicate performance regularly up and down.
  • Maintained open communications with claims processors and providers to successfully meet established production and quality standards.

14. Medicaid

Here's how claims managers use medicaid:
  • Developed Medicaid Provider reference manuals encompassing all claim types and provider types.
  • Created departmental policy and procedures based on Medicare and Medicaid regulations.

15. TPA

Here's how claims managers use tpa:
  • Prepared a RFP for our workers compensation program in a monopolistic state and transitioned our claims management to a new TPA.
  • Provided authority, as warranted, on all aspects of nationally handled TPA files, including reserve adequacy and settlement values.
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List of claims manager skills to add to your resume

Claims manager skills

The most important skills for a claims manager resume and required skills for a claims manager to have include:

  • Customer Service
  • Oversight
  • Litigation
  • Direct Reports
  • Claims Handling
  • Insurance Claims
  • General Liability
  • Claims Adjusters
  • Process Claims
  • Term Disability
  • Performance Management
  • Liability Claims
  • Quality Standards
  • Medicaid
  • TPA
  • Defense Counsel
  • Litigation Management
  • HR
  • Process Improvement
  • Performance Reviews
  • Disability Claims
  • Insurance Carriers
  • Auto Liability
  • Arbitration
  • Bodily Injury Claims
  • Workers Compensation Claims
  • Manage Claims
  • Settlement Authority
  • Medical Claims
  • CPT
  • CMS
  • Customer Complaints
  • Casualty Claims
  • Annuities
  • Medical Treatment
  • HIPAA
  • Disciplinary Actions
  • Performance Evaluations
  • Commercial Property
  • SIU
  • ICD-9
  • PIP
  • ERISA
  • Physical Damage
  • FMLA
  • Contractual Language

Updated January 8, 2025

Zippia Research Team
Zippia Team

Editorial Staff

The Zippia Research Team has spent countless hours reviewing resumes, job postings, and government data to determine what goes into getting a job in each phase of life. Professional writers and data scientists comprise the Zippia Research Team.

Updated January 8, 2025

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