Temporary Workers' Compensation Claims Examiner

Are you looking for more than just a job? Do you want to have a voice and feel a sense of belonging? At ICW Group, we hire innovative people who consistently adapt, grow and deliver.
 

Headquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for seven consecutive years as a Top 50 performing P&C company offering the stability of a large, profitable and growing company combined with a small-company entrepreneurial spirit.

PURPOSE OF THE JOB 

The Claims Examiner handles a variety of claims with a focus on providing the highest level of service for policyholders and ICW Group to bring claims to an equitable conclusion within Company standards and best practice guidelines. The Claims Examiner works with a sense of urgency, understands insurance coverage concepts, and navigates the legal system with the support of counsel to drive strategic outcomes.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Manages all aspects of a complex claims inventory. 

• Effectively communicates with policyholders, agents, attorneys, and witnesses to gather information and provide the highest possible level of customer service.

• Promptly investigates claims to determine exposure, works with appropriate experts and makes strategic recommendations.

• Utilizes appropriate resolution tactics (e.g., mediation, negotiation, denial, litigation or offer) to proactively drive outstanding results.

• Operates within the requirements of related state and/or the governing entity rules and regulations as well as internal claims handling policies and procedures. 

• Works with defense counsel throughout the litigation process in line with ICW litigation guidelines while monitoring legal fees and costs. 

Additional Responsibilities:

• Consistently provides exceptional customer service.

• Effectively collaborates with team members from various departments for project and process discussions.

• Acts as a Subject Matter Expert for the department.

• Makes recommendations for streamlining processes and adopting the industry’s best practices.

• Ensures accuracy of data in claims system for compliance with applicable regulatory reporting.

• Provides knowledge transfer across the organization.

• Continuously seeks to improve technical skills by attending job related training and tracking current case law. 

• Acts as a mentor and provides training for less experienced team members.

• Prepares and presents claims status reports for internal and external stakeholders.

• Administers timely and appropriate benefits to injured workers; manages and approves payment of benefits within designated authority level.  Works within applicable state rules,  regulations as well as ICW Group’s internal claims handling policies and procedures.

• Creates and adjusts reserves in a timely manner to ensure reserving activities are consistent with company policies.

• Resolves claims fairly and equitably, acting in the best interest of the insured while providing timely benefits to injured workers as required by law.

SUPERVISORY RESPONSIBILITIES 

This position has no supervisory responsibility but will serve as a technical leader.

EDUCATION AND EXPERIENCE 

Bachelor's degree from an accredited institution (or equivalent education and experience) along with 1+ years of related claims experience or completion of ICW Claims Academy.  

CERTIFICATES, LICENSES, REGISTRATIONS 

Workers’ Compensation: Certification that meets the minimum standards of training, experience, and skill required. WCCA and WCCP preferred. State Workers Compensation License is required in some branches.

KNOWLEDGE AND SKILLS

Basic understanding of laws and jurisdictional restraints to manage claims. Good verbal communication skills, time management, attention to detail and organizational skills required. Ability to read, analyze, and interpret technical journals, financial reports, and legal documents.  Ability to write reports, business correspondence, and procedure manuals. Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community.  Ability to effectively present information in meetings and to management. Must be adept at learning new technology and embrace change.

PHYSICAL REQUIREMENTS  

Office environment – no specific or unusual physical or environmental demands and employees are regularly required to sit, walk, stand, talk, and hear.  

WORK ENVIRONMENT  

This position operates in an office environment and requires the frequent use of a computer, telephone, copier, and other standard office equipment. 

Please Note: This is a Temporary Position and ICW Group benefits Do Not Apply.

The current range for this position is

ICW Group is committed to creating a diverse environment and is proud to be an Equal Opportunity Employer. ICW Group will not discriminate against an applicant or employee on the basis of race, color, religion, national origin, ancestry, sex/gender, age, physical or mental disability, military or veteran status, genetic information, sexual orientation, gender identity, gender expression, marital status, or any other characteristic protected by applicable federal, state or local law.