Claims Representative – Workers Compensation Training Program

🕒 August 17

🇺🇸 United States – Remote

💵 $25 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

📋 Claims Specialist

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

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Logo of Sedgwick

Sedgwick

10,000+ employees

🏗️ Construction

💼 Consulting

🏥 Healthcare

Construction • Consulting • Healthcare

Sedgwick is a global provider of technology-enabled risk, benefits, and integrated business solutions. They help people and organizations by managing and mitigating risk with solutions in accident, health, disability, unemployment compensation, and liability claims administration, among others. Sedgwick offers services such as claims administration, building consulting, forensic accounting, and forensic engineering. Their specialties include property restoration, brand protection, and loss prevention across several industries, including agriculture, construction, and environmental sectors. The company emphasizes diversity, equity, and inclusion (DEI) as well as environmental, social, and governance (ESG) practices.

📋 Description

• Complete designated claims professional training program • Participate in a comprehensive 4-week concept-based learning and professional training program • Complete a dedicated onboarding experience before entering the on-the-job phase • Adjust various levels of workers’ compensation claims under close supervision • Process and respond to incoming mail, emails, and claim-related documents • Communicate with injured workers, insureds/employers, medical providers, attorneys, and carrier representatives via telephone, video conference, and email • Investigate new and existing claims by gathering medical records, employer reports, and witness statements • Investigate employer/employee relationships, policy verification, coverage, subrogation issues, and fraud indicators • Determine coverage, compensability, and appropriate benefits according to jurisdictional guidelines and carrier program requirements • Document claims files and code claim activity • Prepare detailed reports documenting findings and recommendations • Administer indemnity and medical claim benefits while maintaining calendared claim-related action items and state compliance • Participate in virtual and/or in-person meetings, claim reviews, and business functions for training and claim discussions

🎯 Requirements

• High School Diploma or GED • Bachelor's degree preferred • 2 years of customer service experience and/or combination of education and experience • Strong communication skills • Empathy • Multitasking ability • Accountability • Structured thinking • Ambition • Agile learning ability • Team collaboration • Clear and conceptual thinking ability • Excellent judgment, troubleshooting, problem solving, analysis, and discretion • Ability to handle work-related stress • Ability to handle multiple priorities simultaneously • Ability to meet deadlines • Computer keyboarding • Hearing, vision and talking

🏖️ Benefits

• Career development and promotional growth opportunities • Medical, dental, and vision insurance • 401(k) and matching • Paid time off (PTO) • Disability insurance • Life insurance • Employee assistance program • Flexible spending account or health savings account • Other additional voluntary benefits • Reasonable accommodations • Mentor and manager support • Comprehensive training program

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