Claims Representative – Workers Compensation Training Program

Jobtailor; Northern (KY); Hybrid; USD 40,000 - 55,000; Full time

Job summary

Jobtailor is seeking a driven claims professional in Kentucky to join a structured trainee program. You will complete a designated training track and under supervision adjust workers’ compensation claims across levels, while handling mail, emails, and documents.

Expect robust collaboration with workers, employers, medical providers, attorneys, and carriers and active participation in meetings.

Qualifications

• 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
• 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 ability
• Hearing, vision, and talking abilities

Responsibilities

• 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 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 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
• Complete a 4-week training program, dedicated onboarding, and on-the-job claims adjusting phase with mentor and manager guidance

Skills

Customer service

Communication

Empathy

Multitasking

Accountability

Structured thinking

Agile learning

Team collaboration

Problem solving

Deadline orientation

Judgment

Education

High School Diploma or GED

Bachelor's degree preferred

Tools

Computer keyboarding

Job 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 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 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
• Complete a 4-week training program, dedicated onboarding, and on-the-job claims adjusting phase with mentor and manager guidance

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
• 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 ability
• Hearing, vision, and talking abilities

Core Competencies

Demonstrates strong communication and investigative skills in managing workers' compensation claims, ensuring compliance with jurisdictional guidelines and carrier requirements. Capable of multitasking and maintaining detailed documentation while providing empathetic support to injured workers and stakeholders.

Highest-signal resume keywords

• Claims Adjustment
• Customer Service Experience
• Strong Communication Skills
• Problem-Solving
• Documentation and Reporting

ATS Optimization Keywords

Hard Skills

• Claims Processing
• Investigation of Claims
• Policy Verification
• Coding Claim Activity
• Indemnity and Medical Claim Administration

Soft Skills

• Empathy
• Accountability
• Structured Thinking
• Agile Learning Ability
• Team Collaboration

Industry Keywords

• Workers' Compensation
• Claims Professional Training
• Jurisdictional Guidelines
• Fraud Indicators
• Subrogation Issues

Tools & Technologies

• Computer Keyboarding