Hybrid Claims Specialist

at ICW Group

• Job title: Claims Specialist
• Job type: Full Time
• Experience level: Senior, Lead
• Salary: $78,678 - $132,686 per year
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Lisle, United States

About the role

• Claims Specialist responsible for managing complex claims, ensuring equitable resolution and exceptional service. Collaborating with stakeholders to drive claims resolution within company standards.

Responsibilities

• 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.
• 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.

Requirements

• Bachelor's degree from an accredited institution (or equivalent education and experience) along with 8-10 years of related claims experience.
• 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.

Benefits

• 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 with an accrual rate of 5.23 hours per pay period (equal to 17 days per year)
• 11 paid holidays throughout the calendar year
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