Claims Representative – Workers Compensation Training Program

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 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