Triage Examiner

ICW Group

. Manage claims during the early phase of the claim lifecycle, typically the first 10 days .

Posted 9/16/2026full-timeSan Diego • California • United StatesJuniorMid-Level💰 $53,891 - $84,982 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing insurance claims, including initial assessment, documentation, and communication with stakeholders. Proficient in navigating statutory regulations and ensuring compliance while providing support to injured workers.

Highest-signal resume keywords

Insurance Claims ManagementWorkers' Compensation Claims ExperienceBilingual in SpanishSelf Insurance CertificationAttention to Detail

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims Lifecycle ManagementBenefit Eligibility EvaluationClaims DocumentationRisk IdentificationInitial Compensability Recommendations

Soft Skills

Verbal CommunicationWritten CommunicationTime ManagementOrganizational SkillsProblem-Solving

Certifications & Qualifications

Workers' Compensation Claims Examiner DesignationState Workers' Compensation License

Industry Keywords

Statutory Case LawClaims SetupClaim DiariesConflict ResolutionJurisdictional Restraints

About the role

Key responsibilities & impact

Manage claims during the early phase of the claim lifecycle, typically the first 10 days
Administer benefits to injured workers according to statutory case law and regulations
Contact and interview injured workers, witnesses, medical providers, attorneys, agents, and policyholders
Communicate claim activity and processing with injured workers and policyholders
Make initial compensability recommendations and evaluate benefit eligibility
Create reserves in a timely manner
Establish accurate claim setup, including coding, documentation, and file notes
Identify risks, complexities, or escalation needs and refer matters to leadership
Develop initial action plans and set claim diaries
Ensure timely transition of claims to specialized claim examiners with clear documentation and next steps

Requirements

What you’ll need

High school diploma or general education degree (GED) required
Bachelor’s degree from four-year college or university preferred
Minimum 2-3 years’ insurance claims or related experience required
At least 1+ year(s) of experience as a Triage Claims Associate or in a closely related workers’ compensation claim’s role
Bilingual in Spanish preferred
California: Must receive certification (Self Insurance (SIP) or Workers’ Compensation Claims Examiner designation) meeting required standards
Other jurisdictions: State Workers’ Compensation License as required
Must obtain certifications within 1 year of hire
Basic understanding of laws and jurisdictional restraints to manage injuries
Excellent verbal and written communication skills
Time management and organizational skills
High level of attention to detail
Ability to resolve conflicts fairly and equitably
Problem-solving and decision-making ability
We are currently not offering employment sponsorship for this opportunity

Benefits

Comp & perks

Competitive benefits package
Generous medical, dental, and vision plans
401K retirement plan and company match
Bonus potential for all positions
Paid Time Off
Paid holidays throughout the calendar year
100% support for continued learning
Challenging work and the ability to make a difference
Voice and sense of belonging