Claims Representative (IAP) - Workers Compensation Training Program | Orange, CA

Sedgwick•Orange, CA

5d•Onsite

About The Position

This entry-level trainee position offers an opportunity to develop a professional career in claims adjusting within a stable and consistent office environment. The role 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 to support your career journey and equip you with foundational skills for success in claims adjusting. The program offers opportunities for growth and advancement within the industry.

Requirements

High School Diploma or GED.
2 years of customer service experience and/or combination of education and experience.
Strong Communicators
Empathetic
Multi-Taskers
Accountable
Structured Thinkers
Ambitious
Agile Learners
Team Collaborators

Nice To Haves

Bachelor's degree preferred

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.
Communicating effectively with injured workers, insureds/employers, medical providers, attorneys and carrier representatives via 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 (indemnity and medical) 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.