Senior Workers' Comp Claims Strategist

icwgroup; Pleasanton (CA); On-site; USD 95,000 - 120,000; Full time

Job summary

ICW Group is seeking a Senior Claims Examiner to handle moderate to highly complex workers' compensation claims with a focus on service excellence for policyholders. The role requires navigating complex coverage concepts and coordinating with counsel to reach equitable resolutions.

The position emphasizes timely investigations, accurate reserving, and collaboration with internal teams to improve processes and outcomes.

Qualifications

• Bachelor's degree with 5+ years' claims handling experience
• Complex litigated claims experience is highly preferred
• Workers' Compensation certification preferred; state license may be required in some branches

Responsibilities

• Manages all aspects of a moderate to highly complex claims inventory.
• Communicates with policyholders, agents, attorneys, and witnesses to gather information and provide high-quality service.
• Investigates claims to determine exposure and makes strategic recommendations.
• Directs defense counsel through litigation per ICW Group guidelines and monitors costs.
• Prepares and presents claims status reports for internal and external stakeholders.
• Administers timely and appropriate benefits to injured workers and manages payments.
• Creates and adjusts reserves to align with policy and procedures.

Skills

Communication skills

Time management

Attention to detail

Flexibility

Learning new technology

Education

Bachelor's degree or equivalent

Workers' Compensation Certification (WCCA/WCCP) preferred

Tools

Claims software

Job description

ICW Group is seeking a Senior Claims Examiner to handle moderate to highly complex workers' compensation claims with a focus on service excellence for policyholders. The role requires navigating complex coverage concepts and coordinating with counsel to reach equitable resolutions.

The position emphasizes timely investigations, accurate reserving, and collaboration with internal teams to improve processes and outcomes.