Workers' Compensation Senior Claims Examiner, Complex & Settlement Focus

ICW Group is hiring a Senior Claims Examiner to manage moderate to complex claims and deliver high service levels to policyholders. The role focuses on resolving claims within company standards and best practice guidelines. Essential Duties and Responsibilities Manages all aspects of a moderate to highly 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. Directs defense counsel throughout the litigation process in line with ICW litigation guidelines while monitoring legal fees and costs. All Claims Examiners Consistently provides exceptional customer service. Effectively collaborates with team members from various departments for project and process discussions. 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. Serves as a technical resource and mentors less experienced Team Members. Workers’ Compensation Claims (Specific Responsibilities) 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. Long-Tailed Claims Provides technical guidance and collaborates with leadership on complex claim resolution strategies and specialty handling initiative. Handles specialized claim inventories involving complex medical exposure, litigation, fatality, PTD, life pension, or long-term resolution strategies. Identifies and drives resolution opportunities on complex or long-duration claims through proactive settlement, reserving, and medical management strategies. Supervisory Responsibilities This position has no supervisory responsibility. Education and Experience

• Bachelor’s degree (or equivalent education and experience) preferred.
• Minimum 5+ years of related claims handling experience, including complex litigated claims (or combination of claims handling and other 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 Good understanding of laws and jurisdictional restraints to manage claim. Excellent verbal communication skills, time management, attention to detail and organizational skills. Must be adept at learning new technology. Flexibility to adapt to changes in a fast‑paced environment. Must Have The Ability To Read, analyze, and interpret technical and legal documents. Write reports and business correspondence. Respond to common inquiries or complaints from customers (insured), claimants and regulatory agencies. Present information at meetings, to management and clients. Solve practical problems and deal with a variety of variables in situations where limited standardization exists. Physical Requirements Office environment – no specific or unusual physical or environmental demands and employees are regularly required to sit, walk, stand, talk, and hear. Work Environment This position operates in an office environment and requires the frequent use of a computer, telephone, copier, and other standard office equipment. Benefits 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. Paid holidays throughout the calendar year. Want to continue learning? We’ll support you 100%. EEO Statement 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. Job Category Claims Job Type Full time Req ID

JR101442

Salary range: $68,481.25 – $115,489.01 (exclusive of fringe benefits and potential bonuses). Final base salary will be determined by factors such as experience, education, and role location. #J-18808-Ljbffr ICW Group