Sr. Payment Recovery Examiner

ICW Group • San Diego, CA

7d • $68,481 - $115,489 • 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 identify and pursue subrogation opportunities in the Workers’ Compensation claims line of business. The position exists to review claims with subrogation potential, analyze the potential for recovery, file claims with responsible parties and their carriers, and negotiate settlement in accordance with statutory and case law as well as pertinent regulations. This role will determine when litigation is a cost-effective method of seeking recovery and will keep the Workers’ compensation claims examiners informed of any significant developments.

Requirements

• Bachelor's degree from an accredited institution (or equivalent education and experience) along with 5+ years of related claims experience.
• Certification that meets the minimum standards of training, experience, and skill required.
• State Workers Compensation License is required in some branches.
• Good understanding of Workers’ Compensation and Personal Injury Laws and jurisdictional restraints to manage subrogation claims.
• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
• Knowledge of subrogation process required.
• 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

• WCCA and WCCP preferred.
• Paralegal certificate from an accredited program 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.
• Investigates and gathers necessary information to evaluate subrogation potential of assigned claims.
• Communicates with insureds to obtain information necessary for evaluating subrogation.
• Directs and manages legal counsel to ensure timely and cost-effective litigation.
• Attends arbitrations and/or mediations as often as workload allows.
• Analyzes police reports, investigative reports, policies, construction contracts, and OSHA reports.
• Pursues subrogation, recoveries and contributions vigorously and within statutory timeframes.
• Maintains case lists and follows up with claims personnel and outside attorneys.
• Summarizes and analyzes depositions and medical reports/records.
• Maintains a calendar of important deadlines on cases.
• Assists in preparing subrogation department metric reports.
• Resolves claims fairly and equitably, acting in the best interest of the insured .
• Reports all recoveries to ensure they are credited to the claim file.
• Communicates effectively with other Company departments.

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