Claims Examiner - Workers' Compensation (Remote)

ICW Group; United States; A distancia; USD 62.000 - 98.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Bonus potential

Competitive benefits package

401K retirement with company match

Descripción de la vacante

ICW Group in San Diego, CA, is seeking a Workers’ Compensation Claims Examiner to handle California jurisdiction with training provided. You will manage a moderately complex claims inventory, investigate exposures, and coordinate with counsel to drive fair outcomes.

Qualifications include a bachelor’s degree and 1–4+ years of claims experience; WCCA/WCCP are preferred. The role offers a stable, growth-oriented environment with strong benefits and opportunities for professional development.

Formación

• Bachelor’s degree (or equivalent) required with 1-4+ years of claims handling experience.
• WCCA and WCCP certifications preferred; state workers' compensation license may be required.
• Strong knowledge of laws and jurisdictional constraints in workers’ compensation.

Responsabilidades

• Manages a moderately complex claims inventory with urgency and accuracy.
• Investigates claims, gathers information, and makes strategic recommendations.
• Communicates with policyholders, agents, attorneys, and witnesses to deliver service.
• Creates reserves and administers benefits within authority and policy.

Conocimientos

Legal knowledge

Verbal communication

Time management

Attention to detail

Tech literacy

Educación

Bachelor’s degree

Descripción del empleo

Are you looking to make an impactful difference in your work, yourself, and your community? Why settle for just a job when you can land a career? At ICW Group, we are hiring team members who are ready to use their skills, curiosity, and drive to be part of ourjourney as we strive to transform the insurancecarrier space. We’re proud to be in business for over 50 years, and its change agents like yourself that will help us continue to deliver our mission to create the best insurance experience possible.

Headquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for the twelfth consecutive year in a row and for the 20th time overall as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. It’s our team members who make us an employer of choice and the vibrant company we are today. We strive to make both ourinternal and external communities better everyday!

Seeking Workers’ Compensation Claims Examiners. Training will be provided for handling California jurisdiction.

The Claims Examiner position 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 moderately 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.
• Partners with defense counsel throughout the litigation process in line with ICW litigation guidelines while monitoring legal fees and costs

All Claims Examiners:

• Consistently provides exceptional customer service
• Effectively collaborates with cross-functional Team Members for project and process discussions
• Makes recommendations for streamlining processes
• 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

Workers’ Compensation Claims (Specific Responsibilities):

• 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

EDUCATION AND EXPERIENCE

Bachelor’s degree (or equivalent combination of education and experience) required along with a minimum 1- 4+ years’ related claims or claims handling experience.

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 to good understanding of laws and jurisdictional restraints to manage claims
• Excellent verbal communication skills, time management, attention to detail and organizational skills
• Must be adept at learning new technology
• Flexibility to adapt to changes in a fast-paced environment

Must have the ability to:

• Read, analyze, and interpret technical and legal documents
• Write reports and business correspondence
• Respond to common inquiries or complaints from customers (insured), claimants and regulatory agencies
• Present information at meetings, to management and clients
• Solve practical problems and deal with a variety of variables in situations where limited standardization exists

Workers’ Compensation: Knowledge of workers’ compensation claims handling, reserving, litigation management, and resolution strategies

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.

This description is a general statement of essential job functions and responsibilities. The position may include other duties as assigned.

#LI-ET1 #LI-Remote

The current range for this position is

$61,979.26 - $97,736.56

This range is exclusive of fringe benefits and potential bonuses. If hired at ICW Group, your final base salary compensation will be determined by factors unique to each candidate, including experience, education and the location of the role and considers employees performing substantially similar work.

WHY JOIN ICW GROUP?

• Challenging work and the ability to make a difference
• You will have a voice and feel a sense of belonging
• We offer a competitive benefits package, with generous medical, dental, and vision plans as well as 401K retirement plans and company match
• Bonus potential for all positions
• Paid Time Off
• Paid holidays throughout the calendar year
• Want to continue learning? We’ll support you 100%

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.

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Job Category

Claims