Claims Examiner - Workers' Compensation (Florida)

About the role

ICW Group is hiring a Claims Examiner to handle a variety of claims, focusing on providing the highest level of service for policyholders and the company to bring claims to an equitable conclusion within Company standards and best practice guidelines. The role involves working with urgency, understanding insurance coverage concepts, and navigating the legal system with counsel support to drive strategic outcomes.

Responsibilities

• Manages all aspects of a moderately complex claims inventory.
• Effectively communicates with policyholders, agents, attorneys, and witnesses to gather information and provide exceptional customer service.
• Promptly investigates claims to determine exposure, works with appropriate experts, and makes strategic recommendations.
• Utilizes resolution tactics (e.g., mediation, negotiation, denial, litigation, or offer) to proactively drive results.
• Operates within state and governing entity rules, regulations, and internal claims handling policies.
• Partners with defense counsel throughout the litigation process, monitoring legal fees and costs.
• Provides exceptional customer service and collaborates with cross-functional team members.
• Makes recommendations for process improvements and ensures data accuracy in claims systems.
• Provides knowledge transfer across the organization and continuously improves technical skills.

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.
• Works within applicable state rules, regulations, and ICW Group’s internal claims handling policies.
• Creates and adjusts reserves in a timely manner to ensure consistency with company policies.
• Resolves claims fairly and equitably, acting in the best interest of the insured while providing timely benefits as required by law.

Requirements

• Bachelor’s degree (or equivalent combination of education and experience) required.
• Minimum 1–4+ years of related claims or claims handling experience.

Qualifications

• Basic to good understanding of laws and jurisdictional restraints to manage claims.
• Excellent verbal communication, time management, attention to detail, and organizational skills.
• Adept at learning new technology and adapting to changes in a fast-paced environment.
• Ability to read, analyze, and interpret technical and legal documents.
• Ability to write reports, business correspondence, and respond to inquiries from customers, claimants, and regulatory agencies.
• Ability to present information at meetings and solve practical problems with limited standardization.
• Knowledge of workers’ compensation claims handling, reserving, litigation management, and resolution strategies.

Certificates, Licenses, Registrations

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

Work Environment

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

Pay

The salary range for this position is $61,979.26 – $97,736.56, exclusive of fringe benefits and potential bonuses. Final compensation will be determined based on experience, education, and location.

Benefits

• Competitive medical, dental, and vision plans.
• 401K retirement plan with company match.
• Bonus potential for all positions.
• Paid Time Off and holidays throughout the calendar year.
• 100% support for continuing education and professional development.