Workers' Compensation Claims Examiner (Lake Mary)

Location

Lake Mary, FL | United States

Job description

Are you looking for more than just a job? Do you want to have a voice and feel a sense of belonging? At ICW Group , we hire innovative people who consistently adapt, grow and deliver. We believe in hard work, a fun work environment, and embracing creativity that only comes about when talented people collaborate to develop solutions. 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 seven consecutive years as a Top 50 performing P&C company offering the stability of a large, profitable and growing company combined with a small-company entrepreneurial spirit. Our purpose-driven ethos provides team members with opportunities to contribute, develop, and belong.

The Workers' Compensation Claims Examiner 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.

WHAT YOU WILL DO

Manages all aspects of a complex claims inventory.

• 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.

Additional Responsibilities:

• Consistently provides exceptional customer service.
• Effectively collaborates with team members from various departments for project and process discussions.
• Ensures accuracy of data in claims system for compliance with applicable regulatory reporting.
• 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.

WHAT YOU BRING TO THE ROLE

• 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.

CERTIFICATES, LICENSES, REGISTRATIONS

• 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

• Basic understanding of laws and jurisdictional restraints to manage claims.
• Good verbal communication skills, time management, attention to detail and organizational skills required.
• 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 common inquiries or complaints from customers, regulatory agencies, or members of the business community.
• Ability to effectively present information in meetings and to management.
• Must be adept at learning new technology and embrace change.

COMPENSATION

The salary range listed for this position, $59,027.87 to $93,082.44, is exclusive of fringe benefits and potential bonuses. If hired at ICW Group, your final base salary compensation will be determined by factors such as skills, experience and/or education. In addition, we believe in the importance of pay equity and consider internal equity of our current team members as part of any final offer. We typically do not hire at the maximum of the range in order to allow for future and continued salary growth. We also offer a substantial benefits package outlined below.

WHY JOIN ICW GROUP?

• Challenging work and the ability to make a difference
• You will have a voice and feel a sense of belonging
• We offer a competitive benefits package, with generous medical, dental, and vision plans as well as 401K retirement plans and company match
• Bonus potential for all positions
• Paid Time Off with an accrual rate of 5.23 hours per pay period (equal to 17 days per year)
• 10 paid holidays throughout the calendar year
• Want to continue learning? We'll support you 100%

ICW Group is committed to creating a diverse environment and is proud to be an Equal Opportunity Employer. ICW Group will not discriminate against an applicant or employee on the basis of race, color, religion, national origin, ancestry, sex/gender, age, physical or mental disability, military or veteran status, genetic information, sexual orientation, gender identity, gender expression, marital status, or any other characteristic protected by applicable federal, state or local law.

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