About The Position

This entry-level trainee position offers an opportunity to develop a professional career in claims adjusting. It begins with a comprehensive 4-week concept-based learning and professional training program, followed by a dedicated onboarding experience before entering the on-the-job phase. You will be assigned a mentor and manager for support and guidance, and equipped with foundational skills for a successful career in claims adjusting. The role provides opportunities for growth and advancement within the industry in a stable, office setting. The training program focuses on learning how to investigate and resolve complex situations for employees and customers.

Requirements

  • High School Diploma or GED.
  • No experience required.
  • Strong Communicators
  • Empathetic
  • Multi-Taskers
  • Accountable
  • Structured Thinkers
  • Ambitious
  • Agile Learners
  • Team Collaborators

Responsibilities

  • Attendance and completion of designated claims professional training program.
  • Adjusting various levels of workers’ compensation claims under close supervision.
  • Processing and responding to incoming mail, emails and other claim related documents according to status of the claim.
  • Communicating effectively with injured workers, insureds/employers, medical providers, attorneys and carrier representatives, primarily through telephonic, video conference and email.
  • Thoroughly investigating new and existing claims by gathering relevant information including medical records, employer reports, and witness statements.
  • Investigating employer/employee relationships, policy verification, coverage and any potential for subrogation issues or fraud indicators.
  • Determining coverage, compensability and appropriate benefits in accordance with jurisdictional guidelines and carrier program requirements.
  • Documenting claims files and properly coding claim activity.
  • Preparing detailed reports documenting findings and recommendations.
  • Administering claim benefits i.e., indemnity and medical benefits, through maintenance of calendared claim-related action items, ensuring state compliance.
  • Participating in virtual and/or in-person meetings, claim reviews and business functions as needed for educational training, claim discussions and various meetings.

Benefits

  • medical
  • dental
  • vision
  • 401k and matching
  • PTO
  • disability and life insurance
  • employee assistance
  • flexible spending or health savings account
  • other additional voluntary benefits
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