ICW Group · 1 hour ago
Sr. Payment Recovery Examiner
San Diego, CA
Full-time
Hybrid
Mid, Senior Level
$68K/yr - $115K/yr
5+ years expICW Group is a reputable insurance company headquartered in San Diego, seeking a Sr. Payment Recovery Examiner to enhance their claims process. The role involves identifying subrogation opportunities in Workers’ Compensation claims, managing complex claims inventories, and ensuring compliance with relevant regulations while providing exceptional customer service.
Financial ServicesInsurance
No H1B
Responsibilities
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
Consistently provides exceptional customer service
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
Provides knowledge transfer across the organization
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
Investigates and gathers necessary information to evaluate subrogation potential of assigned claims
Communicates with insureds to obtain information necessary for evaluating subrogation
Directs and manages legal counsel to ensure timely and cost-effective litigation
Attends arbitrations and/or mediations as often as workload allows
Analyzes police reports, investigative reports, policies, construction contracts, and OSHA reports
Pursues subrogation, recoveries and contributions vigorously and within statutory timeframes
Maintains case lists and follows up with claims personnel and outside attorneys
Summarizes and analyzes depositions and medical reports/records
Maintains a calendar of important deadlines on cases
Assists in preparing subrogation department metric reports
Resolves claims fairly and equitably, acting in the best interest of the insured
Reports all recoveries to ensure they are credited to the claim file
Communicates effectively with other Company departments
Qualification
Required
Bachelor's degree from an accredited institution (or equivalent education and experience)
5+ years of related claims experience
Certification that meets the minimum standards of training, experience, and skill required
State Workers Compensation License is required in some branches
Good understanding of Workers' Compensation and Personal Injury Laws and jurisdictional restraints to manage subrogation claims
Knowledge of subrogation process required
Preferred
WCCA and WCCP preferred
Paralegal certificate from an accredited program preferred
Benefits
Generous medical, dental, and vision plans
401K retirement plans and company match
Bonus potential for all positions
Paid Time Off
Paid holidays throughout the calendar year
We’ll support you 100%
Company
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.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Rob deViere
Vice President, Head of Distribution & Marketing
Iva Yuan
Chief Actuary, Head of Reserving, Pricing and Product
Recent News
2025-10-09
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