Bodily Injury Claims Specialist managing a large inventory of complex claims for National Interstate Insurance. Conducting investigations and analyzing settlements for compensability and liability issues.
About the role
- Claims Examiner at ICW Group managing complex claims while providing exceptional service. Focused on resolution strategies, collaboration, and regulatory compliance in the insurance sector.
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.
- Works with 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.
Requirements
- Bachelor's degree (or equivalent education and experience) preferred
- Minimum 1+ years of related claims experience or completion of the company’s Claims Academy
- 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
- Basic understanding of laws and jurisdictional restraints to manage claims.
Benefits
- Generous medical, dental, and vision plans
- 401K retirement plans and company match
- Bonus potential for all positions
- Paid Time Off
- Paid holidays throughout the calendar year
- Support for continued learning
Job title
Job type
Experience level
Salary
Degree requirement
Location requirements
Entry - level Claims Representative II Trainee providing foundational claims handling at Inservco Insurance Services. Assisting in basic claims under supervision while learning best practices and customer service.
Sr. Claims Examiner handling litigation losses for insurance brokerage in Garden City, NY. Investigating claims, managing adjusters, and ensuring proper loss reserving in a hybrid work environment.
Claims Representative II managing moderate - to - complex bodily injury and general liability claims. Investigating losses, determining liability, and negotiating settlements in various states of the US.
Claims Representative role in training for workers' compensation at Sedgwick. Involves investigation and resolution of claims with ongoing professional development.
Claims Examiner responsible for adjudicating workers' compensation claims for California clients. Analyzing claims, negotiating settlements, and ensuring compliance with client service requirements and industry standards.
Claims Examiner analyzing complex workers' compensation claims for Sedgwick, a global risk and claims administration leader. Ensuring claims adjudication meets service expectations and client requirements.
Provide P&I and FD&D claims handling services for European Members. Work closely with claims team on complex disputes and resolutions.
Property Claims Representative managing a personal caseload of property claims at Hastings Insurance. Investigating and resolving claims while providing customer support.
STD Claims Examiner II making accurate claim decisions for Short Term Disability claims. Collaborating with team members in a hybrid work environment from South Portland, ME.