Claims Specialist
1 month ago
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 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.
The Claims Specialist - Workers' Compensation will be 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.
Ideal candidate will work a hybrid schedule out of our Wayne, PA branch office.
WHAT YOU WILL DO
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.
- 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.
- 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.
- Bachelor's degree from an accredited institution (or equivalent education and experience) along with 8-10 years of related claims experience.
- New York 17-72 Motor Vehicle No-Fault & Work. Comp. Adjuster License preferred.
- WCCA and WCCP preferred.
- 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 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.
- Facilitates and leads meetings across a team of claims professionals for assigned projects.
The current salary range for this position is $74,932.01 to $126,367.76. 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 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)
- 10 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.
#LI-ET1 #LI-Hybrid
We have other current jobs related to this field that you can find below
-
Insurance Claims Coverage Specialist
2 weeks ago
Wayne, United States USLI Full timeEssential functions include: Identify, evaluate, and analyze coverage issues as well as applicable coverages. Draft comprehensive coverage and denial letters. Provide oversight of outside coverage counsel, including the supervision of coverage litigation. Serve as claims counsel. Proactively negotiate settlement of claims within evaluation and designated...
-
Medical A/r Specialist
3 weeks ago
Wayne, United States Basic Home Infusion Full timeBasic Home Infusion is a national home infusion company located in Wayne, NJ that is seeking a **Medical Accounts Receivable Specialist.** We are looking for someone who is eager to learn in a fast growing company. **This is an in-office Monday-Friday 9am-5pm position*.** **Position Overview**: Follow up of aging A/R of assigned payers. Responsible for...
-
Medical Billing Specialist
2 months ago
Wayne, United States QSS Southeast Clinical Services LLC Full timeJob DescriptionJob DescriptionMedical Billing Collections Specialist. Claims follow Up, Working Denials, Reading and interpreting EOBs, Drafting letters for Appeals, Verifying Billing Codes, Calling Insurance Companies, determining next steps based on AR and Aging Reports. Excellent Communication Skills and strong computer skills needed.
-
Medical Billing Specialist
2 months ago
Wayne, United States QSS Southeast Clinical Services LLC Full timeJob DescriptionJob DescriptionMedical Billing Collections Specialist. Claims follow Up, Working Denials, Reading and interpreting EOBs, Drafting letters for Appeals, Verifying Billing Codes, Calling Insurance Companies, determining next steps based on AR and Aging Reports. Excellent Communication Skills and strong computer skills needed.
-
Payroll and Benefits Specialist
2 months ago
Wayne, United States Emerald Business Solutions Full time**Job description** **Payroll and Benefits Specialist** **Job Summary**: The Payroll and Benefits Specialist position manages and maintains payroll for employees, as well as maintaining employee and salary databases. They assist employees with benefits enrollment and questions, verifies all insurance billing, maintains employee database and files, and...
-
Payroll and Benefits Specialist
5 hours ago
Wayne, United States Emerald Business Solutions Full time**Job description** **Payroll and Benefits Specialist** **Job Summary**: The Payroll and Benefits Specialist position manages and maintains payroll for employees, as well as maintaining employee and salary databases. They assist employees with benefits enrollment and questions, verifies all insurance billing, maintains employee database and files, and...
-
Asset Recovery Specialist
4 weeks ago
Wayne, United States Mitchell Martin Full timeOut of Business Specialist Contract to Hire Location: Wayne Pa / Des Moines - Hybrid 2 days onsite As an Out of Business Specialist, you'll handle customers who can no longer meet their contractual obligations. Key tasks include: Verifying out-of-business claims. Ensuring compliance with equipment lease contracts. Coordinating asset returns and...
-
Medical Biller Collections Specialist
2 weeks ago
Wayne, United States HEARTS ENTERAL LLC Full timeJob DescriptionJob DescriptionWe are a boutique Durable Medical Equipment Company that supplies enteral nutrition formulas including medical foods for inborn errors of metabolism. We are seeking a remote experience medical biller collections specialist, preferably with a DME and enteral supplies background.Hearts Enteral is the sister company of our...
-
Medical Biller Collections Specialist
1 day ago
Wayne, United States HEARTS ENTERAL LLC Full timeJob DescriptionJob DescriptionWe are a boutique Durable Medical Equipment Company that supplies enteral nutrition formulas including medical foods for inborn errors of metabolism. We are seeking a remote experience medical biller collections specialist, preferably with a DME and enteral supplies background.Hearts Enteral is the sister company of our...
-
Asset Recovery Specialist
4 weeks ago
Wayne, United States Mitchell Martin Inc. Full timeOut of Business SpecialistContract to HireLocation: Wayne Pa / Des Moines - Hybrid 2 days onsiteAs an Out of Business Specialist, you'll handle customers who can no longer meet their contractual obligations.Key tasks include:Verifying out-of-business claims.Ensuring compliance with equipment lease contracts.Coordinating asset returns and liquidation value...
-
Asset Recovery Specialist
1 month ago
Wayne, United States Mitchell Martin Inc. Full timeOut of Business SpecialistContract to HireLocation: Wayne Pa / Des Moines - Hybrid 2 days onsiteAs an Out of Business Specialist, you'll handle customers who can no longer meet their contractual obligations.Key tasks include:Verifying out-of-business claims.Ensuring compliance with equipment lease contracts.Coordinating asset returns and liquidation value...
-
Asset Recovery Specialist
4 weeks ago
Wayne, United States Mitchell Martin Inc. Full timeOut of Business SpecialistContract to HireLocation: Wayne Pa / Des Moines - Hybrid 2 days onsiteAs an Out of Business Specialist, you'll handle customers who can no longer meet their contractual obligations.Key tasks include:Verifying out-of-business claims.Ensuring compliance with equipment lease contracts.Coordinating asset returns and liquidation value...
-
Accounts Receivable Specialist
4 weeks ago
Wayne, United States Independence Physician Management Full time**Responsibilities**: **_ This role requires a 3 month training period in office and must be within commuting distance to the Wayne, PA headquarters._** Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics...
-
State Filing Specialist
1 month ago
Wayne, United States United States Liability Insurance Group Full timeBack to Open Opportunities Returning Applicant? Login Now Notice: Applicants must be currently authorized to work in the country where this job is located on a full time basis. View USLI expansive company benefits, perks & more! *Not applicable to External Customer Program State Filing Specialist Location:Wayne, PA Team:Underwriting Claims Audit Job...
-
State Filing Specialist
4 weeks ago
Wayne, United States United States Liability Insurance Group Full timeBack to Open Opportunities Returning Applicant? Login Now Notice: Applicants must be currently authorized to work in the country where this job is located on a full time basis. View USLI expansive company benefits, perks & more! *Not applicable to External Customer Program State Filing Specialist Location:Wayne, PA Team:Underwriting Claims Audit Job...
-
Wayne, United States Professional Partners Group Full timeJob DescriptionJob DescriptionEMPLOYEE BENEFITS CLIENT SERVICE SPECIALISTHybrid: Wayne, PA 19087 (preferable 3 days in office depending on their location)Flexible pay rate.BENEFITS:401kmatchMedical, Dental, Vision InsurancePTOSick timeGrowth opportunitiesCOMPANY OVERVIEW The firm is one of the largest independently owned insurance brokerage firms in the...
-
Wayne, United States Professional Partners Group Full timeJob DescriptionJob DescriptionEMPLOYEE BENEFITS CLIENT SERVICE SPECIALISTHybrid: Wayne, PA 19087 (preferable 3 days in office depending on their location)Flexible pay rate.BENEFITS:401kmatchMedical, Dental, Vision InsurancePTOSick timeGrowth opportunitiesCOMPANY OVERVIEW The firm is one of the largest independently owned insurance brokerage firms in the...
-
Accounts Receivable Specialist
2 weeks ago
Wayne, United States Foundations for Living Full timeResponsibilities This role requires a 3 month training period in office and must be within commuting distance to the Wayne, PA headquarters. Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which...
-
Accounts Resolution Specialist I
2 weeks ago
Wayne, United States Pennsylvania Medicine Full timePenn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn...
-
Medical Credentialing Specialist
6 hours ago
Wayne, United States Coda Staffing Full timeJob DescriptionJob DescriptionWe are seeking a Medical Credentialing Specialist to join our team! You will work alongside other medical professionals to provide exceptional care to patients.Qualifications:· Credentialing Experience and process preferred for managed care companies, hospitals and surgical centers· Medical practice experience required·...
