Jobs at ICW Group

Support and manage EDI compliance and reporting for workers compensation claims (FROI/SROI, Medicare Section 111). Reconcile and validate EDI transactions, investigate and resolve errors, maintain documentation and workflows, assist audits, support trainings, collaborate with IT/vendors, and provide analytical and project-based support to Claims and stakeholders.

The Claims Specialist handles complex claims, provides exceptional service, manages investigations, and collaborates for equitable resolutions while ensuring compliance and accuracy in claims processing.

The Senior Claims Examiner handles moderate to complex claims, provides high-level service, investigates claims, negotiates outcomes, and ensures compliance with insurance regulations and company policies.

Handle complex California workers' compensation claims from investigation through resolution. Communicate with stakeholders, direct defense counsel, manage reserves and benefits, and use litigation and settlement strategies. Serve as SME, mentor colleagues, support specialty handling for catastrophic or long-duration claims, ensure regulatory compliance and accurate claims data, and continuously improve processes and technical skills.

The Actuarial Specialist produces analyses, manages projects, and oversees team workload to enhance actuarial processes in the organization, ensuring business growth and profitability.