Claims Examiner - Workers Remote

Are you looking to make an impactful difference in your work, yourself, and your community? Why settle for just a job when you can land a career? At ICW Group, we are hiring team members who are ready to use their skills, curiosity, and drive to be part of our journey as we strive to transform the insurance carrier space. We're proud to be in business for over 50 years, and its change agents like yourself that will help us continue to deliver our mission 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 the twelfth consecutive year in a row and for the 20th time overall as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. It's our team members who make us an employer of choice and the vibrant company we are today.

We strive to make both our internal and external communities better everyday! Learn more about why you want to be here!

The Claims Examiner position handles a variety of claims with a focus on providing the highest level of service for policyholders and ICW Group to bring claims to an equitable conclusion within Company standards and best practice guidelines. The 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.

• 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.

• Partners with defense counsel throughout the litigation process in line with ICW litigation guidelines while monitoring legal fees and costs

• Consistently provides exceptional customer service

• Effectively collaborates with cross-functional Team Members for project and process discussions

• Makes recommendations for streamlining processes

• 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

• 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 level. Works within applicable state rules, regulations as well as ICW Group’s internal claims handling policies and procedures.

• Creates and adjusts reserves in a timely manner to ensure reserving activities are consistent with company policies

• Resolves claims fairly and equitably, acting in the best interest of the insured while providing timely benefits to injured workers as required by law

This position has no supervisory responsibility

Bachelor's degree (or equivalent combination of education and experience) required along with a minimum 1- 4+…