Senior Workers' Compensation Audit & Compliance Specialist

ICW Group • Pleasanton, CA

1d • $78,679 - $132,686 • Hybrid

About The Position

Are you looking to make an impactful difference in your work, yourself, and your community? Why settle for just a job when you can land a career? At ICW Group, we are hiring team members who are ready to use their skills, curiosity, and drive to be part of our journey as we strive to transform the insurance carrier space. We're proud to be in business for over 50 years, and its change agents like yourself that will help us continue to deliver 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 ten consecutive years as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. It's our team members who make us an employer of choice and the vibrant company we are today. We strive to make both our internal and external communities better everyday! Learn more about why you want to be here! PURPOSE OF THE JOB The purpose of this job is to develop audit schedules for financial and procedural claims audits based on various sampling methods. This role exists to conduct quality (double) reviews to ensure continuous calibration and consistent understanding and adherence to claims best practices.

Requirements

• High school diploma or general education degree (GED).
• Minimum 6 years of technical Workers’ Compensation background is required.
• Strong knowledge of Workers’ Compensation insurance principles and practices.
• Excellent verbal communication skills required, as well as time-management, good organizational skills, sense of urgency, and attention to detail.
• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
• Ability to write routine reports and correspondence.
• Ability to speak effectively before groups of customers or employees of organization.
• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
• Office environment – no specific or unusual physical or environmental demands and employees are regularly required to sit, walk, stand, talk, and hear.

Nice To Haves

• Bachelor's degree preferred.

Responsibilities

• Performs financial and procedural claims audits based on various sampling methods.
• Provides analysis and improvement planning based on audit results.
• Conducts double reviews to ensure continuous calibration and consistent understanding and adherence to claims best practices.
• Analyzes quality issues and provides feedback to the auditors.
• Develops audit schedule for the department.
• Develops questionnaires and manages assessments for internal audit tool.
• Oversees and prepares responses to all audits, whether internal or external.
• Participates in CERT development, testing, and audit.
• Develop workflows and implement training for technical and non-technical employees to ensure operational integrity.
• Plans, develops, and provides ongoing technical training and staff development programs.
• Utilizes previous knowledge of the effectiveness of methods such as classroom training, demonstrations, on-the-job training, meetings, conferences, and workshops.
• Updates the claims procedures accordingly on iPortal.
• Manages Reinsurance Program.
• Provides performance and skill assessments to managers and supervisors on an ongoing basis.
• Collaborates with multiple employees on auditing, training and customer service issues for the department.
• Partners with leadership to sustain service and quality levels are within standard operating procedures for department.
• Evaluates log of approved manuscript endorsements and facilitates filing with applicable States, Department of Insurance (DOI).
• Develops and implements formal training programs and workflows for department endeavors.
• Corroborates with department leadership to develop support staff and underwriting with tools to ensure compliance.

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%
• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED