ICW Group · 4 days ago
Senior Claims Examiner
San Diego, CA
Full-time
Onsite
Mid, Senior Level
$68K/yr - $115K/yr
5+ years expICW Group is a well-established insurance carrier that has been in business for over 50 years, focused on transforming the insurance experience. The Senior Claims Examiner is responsible for managing complex claims, providing exceptional service to policyholders, and ensuring claims are resolved equitably while adhering to company standards and legal guidelines.
Financial ServicesInsurance
No H1B
Responsibilities
Manages all aspects of a complex California 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
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
Qualification
Required
Bachelor's degree from an accredited institution (or equivalent education and experience)
5+ years of related claims experience
Certification that meets the minimum standards of training, experience, and skill required for Workers' Compensation
State Workers Compensation License is required in some branches
Good understanding of laws and jurisdictional restraints to manage claims
Excellent 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 at meetings, to management and clients
Must be adept at learning new technology and embrace change
Preferred
WCCA and WCCP preferred
Benefits
Generous medical, dental, and vision plans
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)
11 paid holidays throughout the calendar year
We’ll support you 100%
Company
ICW Group
ICW Group Insurance Companies is a top-tier, national, multi-line Property & Casualty insurance company, providing comprehensive coverage to safeguard our customers’ world.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Rob deViere
Vice President, Head of Distribution & Marketing
Iva Yuan
Chief Actuary, Head of Reserving, Pricing and Product
Recent News
2025-10-09
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