Full-Time

Claims Specialist

Posted on 11/21/2024

ICW Group

ICW Group

1,001-5,000 employees

Financial Services
Healthcare

Compensation Overview

$74.9k - $126.4kAnnually

+ Bonus

Senior

No H1B Sponsorship

Pleasanton, CA, USA + 1 more

More locations: Sacramento, CA, USA

Category
Risk & Compliance
Legal & Compliance
Required Skills
Customer Service
Requirements
  • Bachelor's degree from an accredited institution (or equivalent education and experience) along with 8-10 years of related claims experience.
  • Certification that meets the minimum standards of training, experience, and skill required. WCCA and WCCP preferred. State Workers Compensation License is required in some branches.
Responsibilities
  • Manages all aspects of a complex claims inventory for CA jurisdiction.
  • 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.
  • 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.
  • 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.

Company Stage

N/A

Total Funding

N/A

Headquarters

Round Rock, Texas

Founded

1972

Growth & Insights
Headcount

6 month growth

0%

1 year growth

0%

2 year growth

0%
Simplify Jobs

Simplify's Take

What believers are saying

  • Expansion into New York increases market share in the Northeast.
  • Surety Bonds and Guarantees attract clients in construction and real estate industries.
  • Change4Change program boosts corporate social responsibility and customer loyalty.

What critics are saying

  • New York's complex regulatory environment may impact ICW Group's profitability.
  • Surety Bonds introduce new underwriting risks and potential financial exposure.
  • Charitable initiatives may divert focus from core business operations.

What makes ICW Group unique

  • ICW Group's expansion into New York offers tailored insurance products for regional needs.
  • The addition of Surety Bonds and Guarantees diversifies ICW Group's insurance portfolio.
  • Recognition as a Ward's 50 top-performing company enhances ICW Group's brand reputation.

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