Senior Claims Examiner
ICW Group Insurance Companies is recognized nationally as an insurance leader in helping policyholders achieve fewer and less costly claims in both Property & Workers' Compensation. We are looking to add a Sr. Claims Examiner to our team. As a Sr. Claims Examiner you will administer benefits to injured workers in accordance with statutory and case law as well as pertinent regulations. Reserve, manage and bring Workers' Compensation claims to an equitable conclusion within the Company standards and best practices guidelines. Our Sr. Claims Examiners work more independently than a Claims Examiner and handle more complex cases and a higher caseload.
About your Job:
• Administer benefits to injured workers
• Create and adjust reserves in a timely manner to ensure reserving activities consistent with company policies.
• Communicate with insureds to obtain information necessary for processing claims.
• Confer with legal counsel on claims requiring litigation.
• Attend depositions and hearings as often as workload allows.
• Contact and/or interview claimants, doctors, medical specialists, or employers to get additional information.
• Examine claims investigated by outside adjusters, further investigating questionable claims to determine whether to authorize payments.
• Investigate, evaluate and settle claims, applying technical knowledge and human relations skills to ensure fair and prompt management of cases.
• Pursue subrogation vigorously.
• Participate in claim reviews and service calls with insureds and prospective insureds.
• Manage and approve payment of benefits within designated authority level.
• Present cases and participate in their discussion at claim committee meetings.
• Report overpayments, underpayments and other irregularities.
• Resolve claims fairly and equitably, acting in the best interest of the insured and providing benefits as prescribed by law.
Experience and Education:
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.
Does this Sound Like You? If so, we would love for you to consider us in your next career move!
Bachelors or better.
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