Claims Assistant

ICW Group

Posted 2 months ago

Full Time

San Diego, California

Hybrid

Smart Summary

Responsibilities

Provide administrative support to Claims Examiners to ensure the timely payment of benefits and compliance with state laws. Process claims, document conversations in ERP systems, and assist with post-claims resolution and medical appointment scheduling.

Qualifications

The Claims Assistant will provide essential administrative support to Claims Examiners, ensuring efficient claims processing and timely benefit payments. Key responsibilities include contacting involved parties for information, documenting claims in the ERP system, and managing appointment schedules. Ideal candidates possess strong customer service, organizational skills, and intermediate proficiency in Microsoft Office Suite, with a minimum of one year of related experience.

Job Description

Are you looking to make an impactful difference in your work, yourself, and your community? Why settle for just a job when you can land a career? At ICW Group, we are hiring team members who are ready to use their skills, curiosity, and drive to be part of our  journey as we strive to transform the insurance  carrier space. We're proud to be in business for over 50 years, and its change agents like yourself that will help us continue to deliver 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 ten consecutive years as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. It's our team members who make us an employer of choice and the vibrant company we are today. We strive to make both our  internal and external communities better everyday! Learn more about why you want to be here!

PURPOSE OF THE JOB 

The purpose of this job is to provide administrative support and overall assistance to Claims Examiners. This position exists to ensure the timely payment of benefits and administration of claims in compliance with state law.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Delivers basic to intermediate administrative support to Claims Examiners.

  • Contacts insured or other involved persons to obtain necessary information to process claim.
  • Documents conversations or information on appropriate enterprise resource planning (ERP) system.
  • Organizes and works with Examiner using computer to enter, access, search and retrieve data.
  • Stays current with diary tasks and procedural changes.

Imparts exceptional customer service to internal and external customers, including insureds.

  • Provides information to insureds, injured workers or provides referrals to outside vendors as requested by the Examiner.
  • Processes claims for indemnity payments and state mandated forms.
  • Processes non-medical payments.
  • Organizes and works with Examiner using computer to enter, access, search, and retrieve data.

Assists Claims Examiner with complete post-claims resolution and related administrative projects.

  • Schedules appropriate medical appointments, calculates mileage and sends appointment letter reminders.
  • Interacts with nurse on case management regarding return to work status.
  • Supports Claims Examiners in the preparation, processing and monitoring of payments. 

SUPERVISORY RESPONSIBILITIES 

This role does not have supervisory responsibilities.

EDUCATION AND EXPERIENCE 

High school diploma or general education degree (GED) required.  Minimum 1 year of related experience and/or training; or equivalent combination of education and experience. 

CERTIFICATES, LICENSES, REGISTRATIONS 

None required.

KNOWLEDGE AND SKILLS

Basic understanding of office procedures.  Solid customer service, phone and time management skills. Intermediate Microsoft Office Suite:  Outlook, Word, Excel, PowerPoint as well as the ability to learn enterprise resources planning (ERP) software.   Excellent data entry, strong attention to detail and ability to prioritize assignments. Ability to read, write and comprehend simple instructions, short correspondence and memos. Ability to add, subtract, multiply and divide using whole numbers, common fractions and decimals. Ability to compute rate, ratio and percent and to draw and interpret bar graphs. Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions.

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.

We are currently not offering employment sponsorship for this opportunity

#LI-ET1 #LI-Hybrid

The current range for this position is

$19.58 - $30.88

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

  • 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.

___________________

Job Category

Claims

ICW Group

ICW Group Insurance Companies is a top-tier, national, multi-line Property & Casualty insurance company, providing comprehensive coverage to safeguard our customers’ world. Representing a group of carriers, including Insurance Company of the West, Explorer Insurance Company, and VerTerra Insurance, ICW Group is committed to creating the best insurance experience possible for its policyholder customers and network of independent agent and broker partners.
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