Claims Examiner Trainee (San Diego, CA)
ICW Group
Are you looking for more than just a job? Do you want to have a voice and feel a sense of belonging? At ICW Group, we hire innovative people who consistently adapt, grow and deliver. We believe in hard work, a fun work environment, and embracing creativity that only comes about when talented people collaborate to develop solutions. Our mission is 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 seven consecutive years as a Top 50 performing P&C company offering the stability of a large, profitable and growing company combined with a small-company entrepreneurial spirit. Our purpose-driven ethos provides team members with opportunities to contribute, develop, and belong.
ICW Group’s Claims Academy Examiner Training Program prepares aspiring professionals for a career as a Claims Examiner in the Worker’s Compensation Industry. We are seeking energetic, customer focused individuals with a passionate desire to help others and who are looking to begin an exciting new career.
Trainees will go through a Workers’ Compensation Claims Examiner Training Program. Upon successful completion, they will move into a Claims Examiner Role where they will be managing claims and providing benefits to injured workers.
**The program start date is 4/21/2025**
**PURPOSE OF THE JOB**
The purpose of this job is to learn how to administer benefits to injured workers in accordance with the Labor Code. It exists to learn how to maintain and handle Worker’s Compensation Claims within the Company standards and best practices guidelines.
**ESSENTIAL DUTIES AND RESPONSIBILITIES**
Learns how to investigate and gather necessary information to process and settle claims.
+ Develops skills to be able to communicate with insureds to obtain information necessary for processing claims. Contacts and/or interviews injured workers, medical specialists or employers to obtain necessary information to manage a claim.
+ Develops skills to be able to assist legal counsel to ensure timely and cost-effective litigation. Gains an understanding of when to refer to legal counsel.
+ Develops skills to be able to pursue subrogation, recoveries and contributions vigorously and within statutory timeframes.
Gains technical knowledge to ensure the fair and prompt management of cases.
+ Develops the skills to be able to present cases and participates in their discussion at claim committee meetings.
+ Develops the skills to be able to create and adjust reserves in a timely manner to ensure reserving activities are consistent with company policies.
+ Develops the skills to be able to manage and approve payment of benefits within the designated authority level.
Assists in the operational and administrative duties for the Claims department.
+ Develops the skills to administer benefits to injured workers.
+ Learns to ensure accuracy of data in claims system for compliance with applicable regulatory reporting.
+ Understands how to ensure appropriate referral to preferred vendor partners to comply with cost containment procedures to reduce overall claim cost.
Reviews and understands the medical aspects of claims management.
+ Develops knowledge of medical terminology.
+ Learns the various types of diagnostic studies and how they are utilized.
+ Gains an understanding of the AMA guides and how to apply this knowledge.
**SUPERVISORY RESPONSIBILITIES**
This role does not have supervisory responsibilities.
**EDUCATION AND EXPERIENCE**
+ High School diploma or general education degree (GED) required.
+ Bachelor’s degree from a four-year college or university preferred.
+ Bilingual in Spanish highly preferred.
**CERTIFICATES, LICENSES, REGISTRATIONS**
+ All examiners must receive certification that meets the minimum standards of training, experience and skill.
+ State Worker’s Compensation license is required in some branches.
**KNOWLEDGE AND SKILLS**
+ Excellent verbal and written communication skills, time management and organizational skills.
+ Requires a high level of attention to detail.
+ Must have a sense of urgency for execution.
**PHYSICAL REQUIREMENTS**
Office environment – no specific or unusual physical or environmental demands and employees are regularly required to sit, walk, stand, talk, and hear.
**WORK ENVIRONMENT**
This position operates in an office environment and requires the frequent use of a computer, telephone, copier, and other standard office equipment.
The compensation for this role is a progressive structure over a one-year period based on predetermined qualifications and goals being achieved:
**Stage/Salary**
Start.......................................$31.15
Initial Increase.......................$34.27
Stage 1 Completion*.............$35.29
Stage 2 Completion*.............$36.70
Stage 3 Completion*.............$38.54
*Salary will be reviewed at completion date of each stage upon conclusion of claim file audit by reporting Supervisor/Manager and/or Audit & Compliance team confirming the outlined success measures/KPI have been met.
**We are currently not offering employment sponsorship for this opportunity**
\#LI-ET1 #LI-Hybrid
The current range for this position is
$29.80 - $46.99
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 with an accrual rate of 5.23 hours per pay period (equal to 17 days per year)
• 11 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._
At ICW Group we offer a work environment that encourages entrepreneurialism and celebrates success. Our team members are hands-on contributors who are given the opportunity to make an impact. It's our people who make us an employer of choice and the vibrant company we are today.
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