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ICW Group
ICW Group
1,001 – 5,000 Employees
H1B Visa SponsorB2BInsuranceSocial Impact
ICW Group is an insurance company serving businesses and their employees through workers’ compensation, catastrophe coverage, and assumed reinsurance. Its work spans claims reporting, risk management, workplace safety, and practical resources that help agents and policyholders manage coverage and claims. The company also supports community-focused philanthropy aimed at improving children’s lives, alongside its broader focus on customer service and safer workplaces.
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Senior Workers' Compensation Claims Examiner – Pleasanton, CA

Lead complex California workers’ compensation claims for ICW Group, an insurance carrier. Manage litigation, reserves, benefits, investigations, and fair claim resolutions.

USUnited StatesCACalifornia
$68,481 – $115,489 / year
On-siteFull-timeSeniorEnglish RequiredClaims Specialist

Description

  • Oversee a caseload of moderate to highly complex claims
  • Communicate with policyholders, agents, attorneys, and witnesses to collect information and deliver customer service
  • Investigate claim exposure, consult experts, and develop strategic recommendations
  • Pursue resolutions through mediation, negotiation, denials, litigation, and settlement offers
  • Apply applicable state or governing-entity regulations alongside internal claims policies
  • Manage defense counsel during litigation and monitor related legal fees and expenses
  • Partner with colleagues across departments on projects and process initiatives
  • Identify process enhancements and recommend relevant industry practices
  • Maintain accurate claims-system information for regulatory reporting
  • Share expertise and mentor or train less experienced team members
  • Develop and present claims-status updates to internal and external stakeholders
  • Administer, manage, and approve injured-worker benefits within assigned authority
  • Establish and modify reserves in accordance with company policy
  • Resolve claims equitably while issuing legally required benefits on time
  • Provide technical direction on complex resolution strategies and specialty-handling initiatives
  • Manage complex medical exposure, litigation, fatality, PTD, life pension, and long-term resolution claims
  • Advance resolution through settlement, reserving, and medical-management strategies
  • Monitor applicable case law and complete job-related training
  • Perform duties in an office setting using computers, telephones, copiers, and other standard equipment

Requirements

  • Bachelor’s degree or an equivalent combination of education and experience
  • At least five years of relevant claims-handling experience
  • Complex litigated claims experience is strongly preferred
  • Workers’ compensation certification that meets required training, experience, and skill standards
  • State workers’ compensation license where required by the branch
  • Advanced expertise in workers’ compensation claims handling, reserving, litigation management, and resolution strategies
  • Working knowledge of applicable laws and jurisdictional restrictions
  • Strong verbal communication, time-management, organizational, and attention-to-detail skills
  • Ability to learn and use new technology effectively
  • Ability to read, analyze, and interpret technical and legal documents
  • Ability to prepare reports and business correspondence
  • Ability to address inquiries or complaints from customers, claimants, and regulatory agencies
  • Ability to present information to meetings, management, and clients
  • Ability to resolve practical problems in situations with limited standardization
  • Ability to adjust effectively in a fast-paced, changing environment
  • Employment sponsorship is not available for this opportunity

Benefits

  • Competitive benefits package
  • Medical, dental, and vision coverage
  • 401(k) retirement plan with company match
  • Potential eligibility for bonuses
  • Paid time off
  • Paid holidays throughout the year
  • Full support for continuing education
  • Work that is challenging and socially meaningful
  • A workplace where employees can contribute their voice and feel they belong
  • Diverse work environment

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