Claims Representative (IAP) - SkillBridge Conversion

Sedgwick; Virginia (MN); Hybrid; USD 29,000 - 42,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) plans

Paid time off

Job summary

Sedgwick is hiring a Claims Representative (IAP) as part of a SkillBridge Conversion to train and grow a professional in claims adjusting. The role starts with a 4-week concept-based learning and onboarding, then transitions to on-the-job work with mentorship and structured development.

Ideal candidates are strong communicators who are empathetic, multi-taskers, and accountable, with a drive to learn and collaborate within a team. Training leads to career growth and comprehensive benefits.

Qualifications

• Education: High School Diploma or GED required.
• Bachelor's degree preferred with 2 years customer service experience.

Responsibilities

• Attend and complete the designated claims professional training program.
• Adjust workers' compensation claims under supervision, handling mail, emails and related documents.
• Communicate effectively with injured workers, insureds/employers, medical providers, attorneys and carrier representatives via phone, video, and email.
• Investigate new and existing claims by gathering medical records, employer reports, and witness statements.
• Determine coverage, compensability and benefits per jurisdictional guidelines and carrier requirements.
• Document claims files and code activity; prepare reports with findings and recommendations.
• Administer indemnity and medical benefits; maintain calendars and ensure state compliance.
• Participate in meetings, claim reviews and educational training.

Skills

Strong Communicators

Empathetic

Multi-Taskers

Accountable

Structured Thinkers

Ambitious

Agile Learners

Team Collaborators

Customer service

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Claims Representative (IAP) - SkillBridge Conversion

Are you looking for an impactful job that offers an opportunity to develop a professional career? A stable and consistent work environment in an office setting. A training program to learn how to investigate and resolve complex situations for employees and customers from some of the world's most reputable brands. Career development and promotional growth opportunities through increasing responsibilities. A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs including medical, dental, vision & 401k.

PRIMARY PURPOSE OF THE ROLE: To be oriented and trained as a new industry professional. This 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 that will support and guide you on your career journey and be equipped with the foundational skills needed for a successful career in claims adjusting. While in the program, you'll have the opportunity to grow and advance within the industry.

ARE YOU AN IDEAL CANDIDATE?

• Strong Communicators
• Empathetic
• Multi-Taskers
• Accountable
• Structured Thinkers
• Ambitious
• Agile Learners
• Team Collaborators

ESSENTIAL RESPONSIBILITIES INCLUDE

• 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.

QUALIFICATIONS

• Education Requirement - High School Diploma or GED.
• Bachelor's degree preferred and 2 years of customer service experience and/or combination of education and experience.

WORK ENVIRONMENT REQUIREMENTS INCLUDE

• When applicable and appropriate, consideration will be given to reasonable accommodations.
• Mental: 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; and ability to meet deadlines
• Physical: Computer keyboarding
• Auditory/Visual: Hearing, vision and talking

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $25.65/hr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.