Senior Workers' Compensation Audit & Compliance Specialist

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 develop audit schedules for financial and procedural claims audits based on various sampling methods. This role exists to conduct quality (double) reviews to ensure continuous calibration and consistent understanding and adherence to claims best practices.

Essential Duties And Responsibilities

Performs financial and procedural claims audits based on various sampling methods.

• Provides analysis and improvement planning based on audit results.
• Conducts double reviews to ensure continuous calibration and consistent understanding and adherence to claims best practices.
• Analyzes quality issues and provides feedback to the auditors.
• Develops audit schedule for the department.
• Develops questionnaires and manages assessments for internal audit tool.
• Oversees and prepares responses to all audits, whether internal or external.
• Participates in CERT development, testing, and audit.
  
  

Develop workflows and implement training for technical and non-technical employees to ensure operational integrity.

• Plans, develops, and provides ongoing technical training and staff development programs.
• Utilizes previous knowledge of the effectiveness of methods such as classroom training, demonstrations, on-the-job training, meetings, conferences, and workshops.
• Updates the claims procedures accordingly on iPortal.
• Manages Reinsurance Program.
• Provides performance and skill assessments to managers and supervisors on an ongoing basis.
  
  

Collaborates with multiple employees on auditing, training and customer service issues for the department.

• Partners with leadership to sustain service and quality levels are within standard operating procedures for department.
• Evaluates log of approved manuscript endorsements and facilitates filing with applicable States, Department of Insurance (DOI).
• Develops and implements formal training programs and workflows for department endeavors.
• Corroborates with department leadership to develop support staff and underwriting with tools to ensure compliance.
  
  

Supervisory Responsibilities

This role does not have supervisory responsibilities but may mentor and/or train junior team members.

Education And Experience

High school diploma or general education degree (GED). Bachelor's degree preferred. Minimum 6 years of technical Workers’ Compensation background is required.

CERTIFICATES, LICENSES, REGISTRATIONS

None required.

Knowledge And Skills

Strong knowledge of Workers’ Compensation insurance principles and practices. Excellent verbal communication skills required, as well as time-management, good organizational skills, sense of urgency, and attention to detail. Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization. Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.

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

The current range for this position is

$78,678.61 - $132,686.15

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.

At ICW Group we offer a work environment that encourages entrepreneurialism and celebrates success. Our team members are hands-on contributors who are given the opportunity to make an impact. It's our people who make us an employer of choice and the vibrant company we are today.

Job Category: Claims

Job Type: Full time

Req ID: JR101163