Triage Examiner
| Company | ICW Group |
|---|---|
| Location | Canoga Park, Los Angeles, CA, USA, Pleasanton, CA, USA, Sacramento, CA, USA, San Diego, CA, USA |
| Salary | $53890.79 – $84981.63 |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Junior |
Requirements
- High school diploma or general education degree (GED) required
- Bachelor’s degree from four-year college or university preferred
- Minimum 1 year of insurance or claims related experience; or equivalent combination of education and experience required
- California Workers’ Compensation Claims Administration (WCCA) and Workers’ Compensation Claim Professional (WCCP) certifications preferred
- State Workers’ Compensation License as required for all other jurisdictions
Responsibilities
- Administers benefits to injured workers in accordance with statutory case law as well as pertinent regulations for the first 10 days of the claim
- Represents the Workers’ Compensation Department and ICW Group when interacting with injured workers
- Communicates with insureds to obtain information necessary for processing claims
- Contacts and/or interviews injured workers, doctors, medical specialists, attorneys, and employers to get additional information
- Communicates claim activity and processing with the injured worker and insured
- Maintains professional client relationships
- Communicates effectively with other Company departments
- Creates reserves in a timely manner to ensure reserving activities are consistent with company standards and best practices guidelines
- Manages and approves payment of benefits within designated authority level
- Assesses claims fairly and equitably, acting in the best interest of all parties and providing benefits as prescribed by law
- Ensures claim files are properly documented and claims coding is correct
- Refers cases as appropriate to supervisor and management
- Prepares an action plan and set diaries, in preparation for assigning the file to an examiner for permanent handling
Preferred Qualifications
- California Workers’ Compensation Claims Administration (WCCA) and Workers’ Compensation Claim Professional (WCCP) certifications preferred