Claims Representative (IAP): Workers Compensation Training Program | West Hills, CA

Claims Representative (IAP): Workers Compensation Training Program | West Hills, CA Position located in West Hills, CA as part of the Workers Compensation Training Program. PRIMARY PURPOSE OF THE ROLE The 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 to support and guide you on your career journey and to equip you with foundational skills needed for a successful career in claims adjusting. Next Class Date: August 31, 2026 Location: IN‑OFFICE West Hills, CA ARE YOU AN IDEAL CANDIDATE? Strong Communicator Empathetic Multi‑Tasker Accountable Structured Thinker Ambitious Agile Learner Team Collaborator ESSENTIAL RESPONSIBILITIES INCLUDE Attendance and completion of the designated claims professional training program. Adjusting various levels of workers’ compensation claims under close supervision, including processing and responding to incoming mail, emails, and other claim‑related documents according to claim status. Communicating effectively with injured workers, insureds/employers, medical providers, attorneys, and carrier representatives primarily through telephone, video conference, and email. Investigating new and existing claims by gathering relevant information such as 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 claim 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 and 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 High School Diploma or GED; Bachelor’s degree preferred. Two years of customer service experience or a combination of education and experience. WORK ENVIRONMENT REQUIREMENTS INCLUDE Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work‑related stress; ability to manage multiple priorities simultaneously; ability to meet deadlines. Physical: Computer keyboarding. Auditory/Visual: Hearing, vision, and speaking. 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. The range of starting pay for this role is $27.69/hr. A comprehensive benefits package is offered, including medical, dental, vision, 401(k) and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other voluntary benefits. Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you’re excited about this role but your experience doesn’t align perfectly with every qualification in the job description, consider applying anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles. #J-18808-Ljbffr Segment (Twilio)