Claims Representative (IAP) - Workers Compensation Training Program | Concord, CA
About The Position
This entry-level trainee position offers an opportunity to develop a professional career in claims adjusting within a stable, office-based work environment. The role begins with a comprehensive 4-week concept-based learning and professional training program, followed by a dedicated onboarding experience. Upon completion, you will enter the on-the-job phase, supported by a mentor and manager, and equipped with foundational skills for a successful career. The program provides opportunities for growth and advancement within the industry. Sedgwick is recognized as a Great Place to Work® and a Fortune Best Workplace in Financial Services & Insurance.
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.
- 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 potential for subrogation 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 for educational training and claim discussions.
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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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
