Senior Claims Examiner (Contribution)
ICW Group · San Diego, CA · 1 wk ago
HybridFinance$68k–$115k/yrFull-time
About the role
The Senior Claims Examiner position at ICW Group handles moderate to complex claims with a focus on providing the highest level of service for policyholders and ICW Group. This role plays a crucial part in transforming the insurance carrier space through innovative solutions and strategic outcomes.
Responsibilities
- Manages all aspects of a moderate to highly 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 governing entity rules and regulations as well as internal claims handling policies and procedures.
- Directs defense counsel throughout the litigation process in line with ICW litigation guidelines while monitoring legal fees and costs.
- All Claims Examiners consistently provide exceptional customer service, effectively collaborate with team members from various departments, and make recommendations for streamlining processes and adopting the industry’s best practices.
- Serves as a technical resource and mentors less experienced team members.
- Serves as a mentor and provides training for less experienced team members.
- Resolves claims fairly and equitably, acting in the best interest of the insured.
- Reports all recoveries to ensure they are credited to the claim file.
- Coordinates the handling of contribution and subrogation recovery with the underlying case.
- Maintains contribution/subrogation logs and records for referrals and recoveries.
- Keeps an active diary and notepad documentation for all contribution/subrogation files.
- Maintains diaries of important deadlines on cases.
Requirements
- Bachelor's degree (or equivalent combination of education and experience) required.
- A minimum of 5+ years' related claims handling experience required; complex litigated claims experience is highly preferred.
Qualifications
- Good understanding of laws and jurisdictional restraints to manage claims.
- Excellent verbal communication skills, time management, attention to detail, and organizational skills.
- Adept at learning new technology.
- Flexibility to adapt to changes in a fast-paced environment.
- The ability to read, analyze, and interpret technical and legal documents.
- The ability to write reports and business correspondence.
- The ability to present information at meetings, to management, and clients.
- The ability to solve practical problems and deal with a variety of variables in situations where limited standardization exists.
Skills
- Advanced knowledge of workers’ compensation claims handling, reserving, litigation management, and resolution strategies.
- Good understanding of Workers’ Compensation and Personal Injury Laws and jurisdictional restraints to manage subrogation claims.
Benefits
ICW Group offers a competitive benefits package, including generous medical, dental, and vision plans, a 401K retirement plan, and company match. Bonus potential for all positions, paid time off, paid holidays throughout the calendar year, and opportunities for continued learning. Join a company committed to creating a diverse environment and celebrating success.
Pay
$68,481.25 - $115,489.01
Schedule
Full-time