Full-Time

Claims Examiner

Confirmed live in the last 24 hours

ICW Group

ICW Group

1,001-5,000 employees

Financial Services

Compensation Overview

$59k - $93.1kAnnually

+ Bonus

Entry, Junior

No H1B Sponsorship

Pleasanton, CA, USA + 1 more

More locations: Sacramento, CA, USA

Role manages claims in California jurisdiction.

Category
Insurance
Finance & Banking
Required Skills
Customer Service
Requirements
  • Bachelor's degree from an accredited institution (or equivalent education and experience) along with 1+ years of related claims experience or completion of ICW Claims Academy.
  • Workers’ Compensation: 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 in California 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.
  • Works 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 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.
  • 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

N/A

Growth & Insights
Headcount

6 month growth

0%

1 year growth

0%

2 year growth

0%
Simplify Jobs

Simplify's Take

What believers are saying

  • ICW Group's strategic expansion and product diversification, such as the introduction of Surety Bonds, indicate promising growth opportunities.
  • The leadership of experienced professionals like Paul Zamora and Iva Yuan suggests a strong strategic direction and potential for innovation.
  • Recognition as a top-performing P&C company by Ward's 50 enhances ICW Group's credibility and attractiveness to potential employees.

What critics are saying

  • Rapid expansion and diversification could strain resources and lead to operational challenges.
  • The competitive insurance market in New York may pose challenges for ICW Group to establish a strong foothold.

What makes ICW Group unique

  • ICW Group's expansion into New York with a well-established workers' compensation product and value-added services sets it apart from competitors entering the region.
  • The addition of Surety Bonds and Guarantees to their portfolio demonstrates ICW Group's commitment to diversifying its insurance offerings.
  • Being named to Ward's 50 top-performing P&C companies highlights ICW Group's strong performance and reputation in the industry.

Help us improve and share your feedback! Did you find this helpful?