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

Sedgwick•Roseville, 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 includes a comprehensive 4-week training program to learn how to investigate and resolve complex situations for employees and customers of reputable brands. Sedgwick emphasizes career development, promotional growth, and a diverse benefits package covering mental, physical, financial, and professional needs.

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.