Claims Specialist

ICW Group • Las Vegas, NV

1d • Hybrid

About The Position

This Claims Specialist is responsible for handling complex claims with a focus on providing exceptional service for stakeholders in order to drive claims to an equitable resolution within Company standards. The Claims Specialist works with a sense of urgency, understands insurance coverage concepts, and navigates the legal system with the support of counsel to drive strategic outcomes.

Requirements

• Bachelor's degree from an accredited institution (or equivalent education and experience) along with 8-10 years of related claims experience.
• 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.
• Thorough understanding of laws and jurisdictional restraints to manage injuries.
• Excellent verbal and written 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 to management, public groups, and/or boards of directors.
• Must be adept at learning new technology and embrace change.
• Facilitates and leads meetings across a team of claims professionals for assigned projects.
• Office environment – no specific or unusual physical or environmental demands and employees are regularly required to sit, walk, stand, talk, and hear.
• This position operates in an office environment and requires the frequent use of a computer, telephone, copier, and other standard office equipment.

Nice To Haves

• WCCA and WCCP preferred.

Responsibilities

• 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.
• 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.

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%

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees