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

Sedgwick•San Diego, CA

6d•Onsite

About The Position

This entry-level trainee position offers an opportunity to develop a professional career in claims adjusting within a stable 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 for support and guidance, equipped with foundational skills for a successful career in claims adjusting, and have opportunities for growth and advancement within the industry. The next class date is 8/31/26, and the position is located in San Diego, CA, requiring onsite work.

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, which includes: 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.