Senior Workers' Comp Claims Examiner - Strategic Resolver

ICW Group; San Diego (CA); Remote; USD 68,000 - 115,000; Full time

Benefits offered by this job

401K retirement plans

Paid time off

Job summary

ICW Group in San Diego, CA seeks a Senior Claims Examiner to manage moderate to highly complex workers’ compensation claims with urgency and sound judgment. You will coordinate with policyholders, attorneys, and witnesses to drive equitable outcomes, while aligning with ICW Group guidelines.

The ideal candidate brings 5+ years of WC claims experience, a relevant license, and stellar communication, organization, and analytical skills.

Qualifications

• Bachelor's degree or equivalent plus 5+ years claims handling experience required; complex litigated claims experience preferred.
• Certification in Workers’ Compensation (WCCA and WCCP preferred). State license may be required in some branches.
• Strong communication, time management, attention to detail, and organizational skills.
• Ability to learn new technology and adapt to fast-paced environment.

Responsibilities

• Manages all aspects of a moderate to highly complex claims inventory.
• Communicates with policyholders, agents, attorneys, and witnesses to gather information and provide customer service.
• Investigates claims to determine exposure and makes strategic recommendations.
• Utilizes resolution tactics (mediation, negotiation, denial, litigation) to drive results.
• Directs defense counsel through litigation in line with ICW guidelines while monitoring costs.
• Provides training and mentorship to junior team members.
• Resolves complex claims with timely benefits and compliant reserving.

Skills

Legal knowledge

Communication skills

Learning new technology

Adaptability

Education

Bachelor's degree or equivalent

Job description

ICW Group in San Diego, CA seeks a Senior Claims Examiner to manage moderate to highly complex workers’ compensation claims with urgency and sound judgment. You will coordinate with policyholders, attorneys, and witnesses to drive equitable outcomes, while aligning with ICW Group guidelines.

The ideal candidate brings 5+ years of WC claims experience, a relevant license, and stellar communication, organization, and analytical skills.