ICW Group
Overview
Join to apply for the
Claims Specialist
role at
ICW Group .
ICW Group is headquartered in San Diego with regional offices across the United States. We have been recognized as a Top 50 performing P&C organization for ten consecutive years and are committed to delivering the best insurance experience. Our team members are encouraged to bring their skills, curiosity, and drive to help transform the insurance carrier space.
Purpose of the Job This Claims Specialist is responsible for handling complex claims with a focus on providing exceptional service for stakeholders to drive claims to an equitable resolution within Company standards. The role requires urgency, understanding of insurance coverage concepts, and the ability to navigate the legal system with counsel support to drive strategic outcomes.
Essential Duties and Responsibilities
Manages all aspects of a California complex claims inventory.
Effectively communicates with policyholders, agents, attorneys, and witnesses to gather information and provide high levels of customer service.
Promptly investigates claims to determine exposure, works with appropriate experts, and makes strategic recommendations.
Utilizes resolution tactics (e.g., mediation, negotiation, denial, litigation or offer) to proactively drive outcomes.
Operates within state and/or governing entity rules and regulations and ICW Group claims handling policies and procedures.
Directs defense counsel during the litigation process in line with ICW guidelines while monitoring legal fees and costs.
Additional Responsibilities
Provide exceptional customer service consistently.
Collaborate with team members from various departments for project and process discussions.
Act as a Subject Matter Expert for the department.
Recommend process improvements and industry best practices.
Ensure data accuracy in the claims system for regulatory reporting compliance.
Share knowledge across the organization and mentor less experienced team members.
Prepare and present claims status reports for internal and external stakeholders.
Administer timely and appropriate benefits to injured workers; manage and approve benefits within authority; comply with state rules and ICW policies.
Create and adjust reserves to align with company policies.
Resolve claims fairly and equitably, ensuring timely benefits as required by law.
Supervisory Responsibilities This position has no supervisory responsibility but will serve as a technical leader.
Education and Experience Bachelor's degree from an accredited institution (or equivalent education and experience) along with 8-10 years of related claims experience.
Certificates, Licenses, Registrations 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.
Knowledge and Skills Thorough understanding of laws and jurisdictional restraints to manage injuries. Excellent verbal and written communication skills, time management, attention to detail, and organizational skills. Ability to read, analyze, and interpret technical journals, financial reports, and legal documents. Ability to write reports, business correspondence, and procedure manuals. Ability to respond to inquiries from customers, regulatory agencies, or the business community. Ability to present information to management, public groups, and/or boards of directors. Proficient in learning new technology and embracing change. Facilitates and leads meetings for assigned projects.
Physical Requirements Office environment with standard duties (sit, walk, stand, talk, hear).
Work Environment Office-based role requiring frequent use of computer, telephone, copier, and other standard office equipment.
Compensation and Benefits We are currently not offering employment sponsorship for this opportunity.
The current salary range is $78,678.61 - $132,686.15 (excluding fringe benefits and bonuses). Final base salary depends on candidate experience, education, and location of the role, with consideration for similar work by other employees.
Why Join ICW Group
Challenging work and the opportunity to make a difference
You will have a voice and a sense of belonging
Competitive benefits package including medical, dental, vision, 401(k) with company match
Bonus potential for all positions
Paid time off and holidays
Commitment to learning and professional growth
Equal Opportunity Employer ICW Group is committed to creating a diverse environment and is proud to be an Equal Opportunity Employer. ICW Group will not discriminate on the basis of race, color, religion, national origin, sex/gender, age, disability, veteran status, or any other protected characteristic.
Job Details
Job Category:
Claims
Job Type:
Full time
Req ID:
JR100861
Referrals increase your chances of interviewing at ICW Group. Get notified about new Claims Specialist jobs in
San Diego, CA .
#J-18808-Ljbffr
Claims Specialist
role at
ICW Group .
ICW Group is headquartered in San Diego with regional offices across the United States. We have been recognized as a Top 50 performing P&C organization for ten consecutive years and are committed to delivering the best insurance experience. Our team members are encouraged to bring their skills, curiosity, and drive to help transform the insurance carrier space.
Purpose of the Job This Claims Specialist is responsible for handling complex claims with a focus on providing exceptional service for stakeholders to drive claims to an equitable resolution within Company standards. The role requires urgency, understanding of insurance coverage concepts, and the ability to navigate the legal system with counsel support to drive strategic outcomes.
Essential Duties and Responsibilities
Manages all aspects of a California complex claims inventory.
Effectively communicates with policyholders, agents, attorneys, and witnesses to gather information and provide high levels of customer service.
Promptly investigates claims to determine exposure, works with appropriate experts, and makes strategic recommendations.
Utilizes resolution tactics (e.g., mediation, negotiation, denial, litigation or offer) to proactively drive outcomes.
Operates within state and/or governing entity rules and regulations and ICW Group claims handling policies and procedures.
Directs defense counsel during the litigation process in line with ICW guidelines while monitoring legal fees and costs.
Additional Responsibilities
Provide exceptional customer service consistently.
Collaborate with team members from various departments for project and process discussions.
Act as a Subject Matter Expert for the department.
Recommend process improvements and industry best practices.
Ensure data accuracy in the claims system for regulatory reporting compliance.
Share knowledge across the organization and mentor less experienced team members.
Prepare and present claims status reports for internal and external stakeholders.
Administer timely and appropriate benefits to injured workers; manage and approve benefits within authority; comply with state rules and ICW policies.
Create and adjust reserves to align with company policies.
Resolve claims fairly and equitably, ensuring timely benefits as required by law.
Supervisory Responsibilities This position has no supervisory responsibility but will serve as a technical leader.
Education and Experience Bachelor's degree from an accredited institution (or equivalent education and experience) along with 8-10 years of related claims experience.
Certificates, Licenses, Registrations 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.
Knowledge and Skills Thorough understanding of laws and jurisdictional restraints to manage injuries. Excellent verbal and written communication skills, time management, attention to detail, and organizational skills. Ability to read, analyze, and interpret technical journals, financial reports, and legal documents. Ability to write reports, business correspondence, and procedure manuals. Ability to respond to inquiries from customers, regulatory agencies, or the business community. Ability to present information to management, public groups, and/or boards of directors. Proficient in learning new technology and embracing change. Facilitates and leads meetings for assigned projects.
Physical Requirements Office environment with standard duties (sit, walk, stand, talk, hear).
Work Environment Office-based role requiring frequent use of computer, telephone, copier, and other standard office equipment.
Compensation and Benefits We are currently not offering employment sponsorship for this opportunity.
The current salary range is $78,678.61 - $132,686.15 (excluding fringe benefits and bonuses). Final base salary depends on candidate experience, education, and location of the role, with consideration for similar work by other employees.
Why Join ICW Group
Challenging work and the opportunity to make a difference
You will have a voice and a sense of belonging
Competitive benefits package including medical, dental, vision, 401(k) with company match
Bonus potential for all positions
Paid time off and holidays
Commitment to learning and professional growth
Equal Opportunity Employer ICW Group is committed to creating a diverse environment and is proud to be an Equal Opportunity Employer. ICW Group will not discriminate on the basis of race, color, religion, national origin, sex/gender, age, disability, veteran status, or any other protected characteristic.
Job Details
Job Category:
Claims
Job Type:
Full time
Req ID:
JR100861
Referrals increase your chances of interviewing at ICW Group. Get notified about new Claims Specialist jobs in
San Diego, CA .
#J-18808-Ljbffr