Claims Representative – Workers Compensation Training Program

🕒 August 11

🇺🇸 United States – Remote

💵 $25 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

📋 Claims Specialist

🚫👨‍🎓 No degree required

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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

• Attend and complete the designated claims professional training program • Adjust various levels of workers’ compensation claims under close supervision • Process and respond to incoming mail, emails, and other claim-related documents according to claim status • Communicate with injured workers, insureds/employers, medical providers, attorneys, and carrier representatives through 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, potential subrogation issues, and fraud indicators • Determine coverage, compensability, and appropriate benefits according to jurisdictional guidelines and carrier program requirements • Document claims files and properly code claim activity • Prepare detailed reports documenting findings and recommendations • Administer indemnity and medical claim benefits by maintaining calendared claim-related action items and ensuring state compliance • Participate in virtual and/or in-person meetings, claim reviews, and business functions as needed for training and claim discussions • Complete a 4-week concept-based learning and professional training program followed by dedicated onboarding and on-the-job training • Work with an assigned mentor and manager for career guidance and support

🎯 Requirements

• High school diploma or GED required • Bachelor’s degree preferred • 2 years of customer service experience and/or combination of education and experience • Strong communication skills • Empathy • Ability to multitask • Accountability • Structured thinking • Ambition • Ability to learn quickly and adapt • Ability to collaborate with teams • 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 ability • Hearing, vision, and talking abilities • Ability to participate in virtual and/or in-person meetings and business functions as needed

🏖️ Benefits

• Career development and promotional growth opportunities through increasing responsibilities • Medical insurance • Dental insurance • Vision insurance • 401(k) plan • 401(k) matching • Paid time off (PTO) • Disability insurance • Life insurance • Employee assistance • Flexible spending account or health savings account • Other additional voluntary benefits • Reasonable accommodations when applicable and appropriate

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