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Senior Claims Examiner

Employer
ICW Group
Location
Woodland Hills, California
Salary
Not Specified
Closing date
Mar 5, 2019

View more

Category
Claims
Job Type
Not Specified
Career Level
Not Specified

Job Details

At ICW Group our Senior Claims Examiner will administer benefits to injured workers in accordance with statutory and case law as well as pertinent regulations. Reserves, manages and brings Workers Compensation claims to an equitable conclusion within the Company standards and best practices guidelines. Communicates effectively with other Company departments. Maintains a good working relationship with insureds, employers, agents and other employees. Works more independently than a Claims Examiner and handles more complex cases and a higher caseload.

Administers benefits to injured workers
Creates and adjusts reserves in a timely manner to ensure reserving activities consistent with company policies.
Communicates with insureds to obtain information necessary for processing claims.
Confers with legal counsel on claims requiring litigation.
Attends depositions and hearings as often as workload allows.
Contacts and/or interview claimants, doctors, medical specialists, or employers to get additional information.
Examines claims investigated by outside adjusters, further investigating questionable claims to determine whether to authorize payments.
Investigates, evaluates and settles claims, applying technical knowledge and human relations skills to ensure fair and prompt management of cases.
Pursues subrogation vigorously.
Participates in claim reviews and service calls with insureds and prospective insureds.
Manages and approve payment of benefits within designated authority level.
Presents cases and participate in their discussion at claim committee meetings.
Reports overpayments, underpayments and other irregularities.
Resolves claims fairly and equitably, acting in the best interest of the insured and providing benefits as prescribed by law.

High school diploma or general education degree (GED). Bachelor's degree from four-year college or university preferred.

Requires a minimum of 2-4 years of work-related skill and knowledge. All Examiners must receive certification that meets the minimum standards of training, experience and skill. Strong understanding of laws and jurisdictional restraints to manage injuries. WCCA and WCCP helpful. State Workers Compensation License is required in some branches.

Excellent verbal and written communication skills, time management and organizational skills. Requires a high level of attention to detail. Team oriented and a sense of urgency for execution.

Company

 

ICW Header

 

Headquartered in San Diego, ICW Group is a multi-line insurer that provides coverage solutions to businesses through a network of independent agents and brokers. ICW Group offers three types of insurance—workers' compensation, earthquake and auto insurance. Known for meeting the needs of its policyholders, ICW Group prides itself on providing service that is truly customer-centric. In recent years, ICW Group has earned a reputation for helping policyholders achieve fewer and less costly claims. The company accomplishes this through extensive risk management expertise, highly proactive claims handling, and aggressive fraud monitoring.

At ICW Group, our focus and passion is offering great insurance products, services and experiences. We honor our commitments to our customers, our communities and each other to ensure that you have a better today and a safer tomorrow. With our home office in sunny San Diego, CA and with 10 branches across the U.S., ICW Group has over 40 years of experience in property and casualty insurance. Our passionate and creative team members are the power behind our successful business. 

A strategic investment in innovation today is critical to our success in the future. Our leaders welcome people who are eager to bring the power of innovation, the willingness to try something different or adopt a new approach or technology as we evolve to meet the needs of our customers and agents. Our culture fosters experimentation in models, processes, and products in an effort to move forward and help shape not only ICW Group’s future but the insurance marketplace as a whole. 

ICW Group is committed to the satisfaction of our customers and recognizes that satisfied, contributing Team Members are the foundation of a superior customer experience. With a team of 880, our enterprise is sized just right to provide broad challenging job responsibilities in a more personal environment. An important part of this personal approach to your success is our commitment to health and wellness. We provide a comprehensive program to help you maintain your total health because we believe that being at your personal and professional best is important to you and your family. 

Company info
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