Are you looking for more than just a job? Do you want to have a voice and feel a sense of belonging? At ICW Group, we hire innovative people who consistently adapt, grow and deliver. We believe in hard work, a fun work environment, and embracing creativity that only comes about when talented people collaborate to develop solutions. Our mission is 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 seven consecutive years as a Top 50 performing P&C company offering the stability of a large, profitable and growing company combined with a small-company entrepreneurial spirit. Our purpose-driven ethos provides team members with opportunities to contribute, develop, and belong.PURPOSE OF THE JOBThe Senior Claims Examiner handles moderate to complex claims with a focus on providing the highest level of service for policyholders and ICW Group to independently bring claims to an equitable conclusion within Company standards and best practice guidelines. The Senior 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 RESPONSIBILITIESManages all aspects of a 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.
Directs defense counsel throughout the litigation process in line with ICW litigation guidelines while monitoring legal fees and costs.
Additional Responsibilities:
Consistently provides exceptional customer service.
Effectively collaborates with team members from various departments for project and process discussions.
Acts as a Subject Matter Expert for the department.
Makes recommendations for streamlining processes and adopting the industry’s best practices.
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.
Acts as a mentor and provides training for less experienced team members.
Investigates and gathers necessary information to evaluate subrogation potential of assigned claims.
Communicates with insureds to obtain information necessary for evaluating subrogation.
Directs and manages legal counsel to ensure timely and cost-effective litigation.
Attends arbitrations and/or mediations as often as workload allows.
Analyzes police reports, investigative reports, policies, construction contracts, and OSHA reports.
Pursues subrogation, recoveries and contributions vigorously and within statutory timeframes.
Maintains case lists and follows up with claims personnel and outside attorneys.
Summarizes and analyzes depositions and medical reports/records.
Maintains a calendar of important deadlines on cases.
Assists in preparing subrogation department metric reports.
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.
Communicates effectively with other Company departments.
SUPERVISORY RESPONSIBILITIESThis position has no supervisory responsibility but will serve as a technical leader.EDUCATION AND EXPERIENCEBachelor's degree from an accredited institution (or equivalent education and experience) along with 5+ years of related claims experience.CERTIFICATES, LICENSES, REGISTRATIONSCertification that meets the minimum standards of training, experience, and skill required. WCCA and WCCP preferred. State Workers Compensation License is required in some branches. Paralegal certificate from an accredited program preferred.KNOWLEDGE AND SKILLSGood understanding of Workers’ Compensation and Personal Injury Laws and jurisdictional restraints to manage subrogation claims. Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Knowledge of subrogation process required.PHYSICAL REQUIREMENTSOffice environment – no specific or unusual physical or environmental demands and employees are regularly required to sit, walk, stand, talk, and hear.WORK ENVIRONMENTThis position operates in an office environment and requires the frequent use of a computer, telephone, copier, and other standard office equipment.We are currently not offering employment sponsorship for this opportunity#LI-ET1The current range for this position is$65,220.24 - $109,989.53This 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 with an accrual rate of 5.23 hours per pay period (equal to 17 days per year) 10 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.At ICW Group we offer a work environment that encourages entrepreneurialism and celebrates success. Our team members are hands-on contributors who are given the opportunity to make an impact. It's our people who make us an employer of choice and the vibrant company we are today.
