Find out the top 10 core skills you need to master as a claims representative and what hard skills you need to know to succeed in this job.

A claims representative is mandated to examine claims and obtain sound facts to assess loss, liability, and coverage. He/she works with all the involved individuals to come up with a comprehensive report about the claim.

He /she is also responsible for documenting the claim investigation activities accurately and in the right time. In addition, they carry out negotiations with the claimant to arrive at an appropriate settlement. Other duties include taking care of the legal and medical aspects of the process. They also communicate timely with the company and the insured persons. Finally, the representative follows up on the customer after the claim has been covered.

Core Skills Required to be a Claims Representative

Core skills describe a set of non-technical abilities, knowledge, and understanding that form the basis for successful participation in the workplace. Core skills enable employees to efficiently and professionally navigate the world of work and interact with others, as well as adapt and think critically to solve problems.

Core skills are often tagged onto job descriptions to find or attract employees with specific essential core values that enable the company to remain competitive, build relationships, and improve productivity.

A claims representative should master the following 10 core skills to fulfill her job properly.

Organized Workplace:

Organized Workplace is a vital characteristic that helps the business to thrive for long term due to the sense of structure and order which efficiently promotes the team spirit.

A Claims Representative must be organized in the general organizing, planning, communication, time management, scheduling, coordinating resources and meeting deadlines to support the staff in being well structured and run the company successfully.

Negotiation Skills:

Negotiation Skills are a deliberative process by which people settle their differences through an acceptable agreement to both parties to co-exist without argument and dispute in the workplace.

A Claims Representative must learn to resolve any disputes that arise in the workplace using the principles of fairness, seeking mutual benefit and maintaining a cordial relationship that builds a success at the workplace.

Safety at work:

Safety is being protected from hurt or other non-desirable outcomes that may tend to overrule a situation and cause damages of different kinds.

A Claims Representative must learn to keep the organization safe from different risks by developing a high sense of alertness that detects danger from afar and stops it before it causes risk, danger or injury in the organization.

Empathy:

Empathy is the understanding of another person's condition from their perspective by placing yourself in their shoes and feeling what they are feeling.

A Claims Representative ought to practice empathy with his staff by learning to be a good listener and understanding what his employees are going through and choosing to feel it with them through the use of imagination and accommodate them.

Attention to Detail:

Attention to Detail is the capacity to achieve a thoroughness and accuracy when accomplishing a task.

A Claims Representative needs to have this prime characteristic and utilize it in a high performing organization that allows both the customers and staff to understand the need to be keen to all the details required to avoid massive costs for overlooked details that are common in the workplace.

Evaluating Others:

Evaluating others is the capacity to see the individuality in others and recognize a person's unique point of view.

A Claims Representative must master the skills of evaluating others to help his staff members to identify their talents and match those talents to the proper job without trying to judge them by their actions that can create a misinterpretation of who they are.

Goal and Objective Setting:

Goal and Objective Setting is the strategic plan that is set and laid down identifying how goals should be accomplished, by who and by what time.

A Claims Representative must detect and schedule each employee's goals, strategy, and objectives and keep motivating them to ensure all of them are met within the set time bringing growth to both the company and the employee.

Writing Reports and Proposals:

Writing Reports and Proposals is the ability to record business reports and plans for the company or project following the policies and procedures of the company.

A Claims Representative should, therefore, emphasize the need and accuracy of these reports and plans to ensure they are delivered promptly, and the details within are accurate adhering to the company's policies and regulations without compromise.

Analytical Skills:

Analytical Skills is the ability to collect and analyze information, solve problems and make decisions according to the policies and regulations of the business.

A Claims Representative should hire employees who use clear, logical steps and excellent judgment to understand an issue from all angles before executing an action depending on the objective and the methodical approaches to benefit a company's productivity.

Product Knowledge:

Product Knowledge is an essential sales skill to understand the features of your product allowing you to present the benefits compellingly and accurately to the customer.

A Claims Representative should ensure the teams understand the company's goods or services and can quickly take a client through them, therefore, instilling faith, trust and respect in the customers which in turn creates a positive customer experience.

Hard Skills Required to be a Claims Representative

Hard skills are job-specific skill sets, or expertise, that are teachable and whose presence can be tested through exams. While core skills are more difficult to quantify and less tangible, hard skills are quantifiable and more defined.

Hard skills are usually listed on an applicant's resume to help recruiters know the applicant's qualifications for the applied position. A recruiter, therefore, needs to review the applicant's resume and education to find out if he/she has the knowledge necessary to get the job done.

A claims representative should have a good command of the following hard skills to succeed in her job.

Claims Representative: Hard skills list

Accident Investigator
Accounting (Accounting Software)
Adjuster
Adjustment Clerk
Administrative
Analyzing Data or Information
Appraiser
Arson Investigator
Auto Claims Adjuster
Benefit Authorizer
Bodily Injury Adjuster
Building Appraiser
Business
Catastrophe Claims
Claim Adjuster
Claim Agent
Claim Approver
Claim Examiner
Claim Inspector
Claim Investigator
Claim Processor
Claim Representative
Claim Specialist
Claims Adjuster
Claims Adjustor
Claims Analyst
Claims Examiner
Claims Service Adjustor
Claims Specialist
Claims Software
Clerical
Clerical Adjuster
Compensation Adjuster
Computers
Communication
Cost and Benefits
Customer and Personal Service
Deductive Reasoning
Designing Forms
Disability Examiner
Disability Specialist
Documenting
Document management
Estimator
Evaluating information
Examiner
FDA Health Regulations
Field Adjuster
Field Liability Generalist
Finance
Financial Analysis
Fire Adjuster
General Adjuster
General Mathematics
Health Claims Examiner
Identifying Information
Independent Insurance Adjuster
Inductive Reasoning
Inspector
Interpersonal
Interrogation
Insurance Adjuster
Insurance Appraiser
Insurance Claims Adjuster
Insurance Inspector
Interviewing
Investigative
Job Estimator
Law and Government
Litigation Claim Representative
Negotiating
Management of Financial Resources
Material Damage Adjuster
Medical Claims Analyst
Medical Claims Examiner
Medical Claims Specialist
MS Excel
Multi-line Claims Adjuster
Processing Information
Property Adjuster
Property Claims Adjuster
Recording Information
Reporting
Research (detail and substantiate each aspect of the claim and other)
Residential Insurance Inspector
Resource Allocation
Salvage Determiner
Statistical Analysis
Technical and Functional Expertise
Technology
Time Management
Verbal Communication
Written Communication
Writing
Word Processor
Workers Compensation Claims Adjuster

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