The Claims Specialist position 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.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Manages complex claims inventories requiring advanced technical expertise and strategic claim handling  

• 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 Specialists:

• Consistently provides exceptional customer service

• Effectively collaborates with cross-functional Team Members 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. 

• As a SME (subject matter expert), serves as a technical resource and mentors/trains less experienced Team Members

Subrogation/Contribution Claims (Specific Responsibilities):

• Investigates complex claims and gathers key information to assess potential subrogation/contribution actions.

• Communicates with insureds to obtain information necessary for evaluating subrogation/contribution.

• Pursues subrogation, recoveries and contributions within statutory timeframes.

• Directs and manages legal counsel to ensure timely and cost-effective litigation.

• Attends arbitrations and/or mediations virtually.

• Analyzes police reports, investigative reports, policies, construction contracts, and OSHA reports.

• Maintains case lists and follows up with claims personnel and outside attorneys.

• Summarizes and analyzes depositions and medical reports/records.

• Prepares 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.

• Coordinates the handling of contribution and subrogation recovery with the underlying case.

• Maintains contribution/subrogation logs and records for referrals and recoveries.

• Keeps an active diary and notepad documentation for all contribution/subrogation files.

• Maintains diaries of important deadlines on cases.

SUPERVISORY RESPONSIBILITIES

This position has no supervisory responsibility

EDUCATION AND EXPERIENCE

Bachelor's degree (or equivalent combination of education and experience) required along with a minimum of 8 – 10+ years’ related claims handling experience involving complex litigation, reserving, settlement strategy, and high exposure claims. 

CERTIFICATES, LICENSES, REGISTRATIONS

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. Paralegal certificate from an accredited program preferred.

KNOWLEDGE AND SKILLS

• Excellent understanding of laws and jurisdictional restraints to manage claims

• 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

Subrogation/Contribution: Excellent understanding of Workers’ Compensation and Personal Injury Laws and jurisdictional restraints to manage subrogation claims

PHYSICAL REQUIREMENTS 

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.

This description is a general statement of essential job functions and responsibilities. The position may include other duties as assigned.

We are currently not offering employment sponsorship for this opportunity

#LI-ET1 #LI-Hybrid

The current range for this position is

This range is exclusive of fringe benefits and potential bonuses.  If hired at ICW Group, your final base salary compensation will be determined by factors unique to each candidate, including experience, education and the location of the role and considers employees performing substantially similar work.

WHY JOIN ICW GROUP?

• 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% 

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