Claims Representative (IAP) - Workers Compensation Training Program

Claims Representative (IAP) – Workers Compensation Training Program Are you looking for an impactful job that offers an opportunity to develop a professional career? This entry‑level trainee position offers a 4‑week professional training program, mentorship, and the chance to grow within the industry. Benefits Stable and consistent office work environment. Training program to investigate and resolve complex situations for employees and customers from reputable brands. Career development and promotional growth opportunities through increasing responsibilities. A diverse benefits package covering medical, dental, vision, 401k, etc. Primary Purpose of the Role Orientation and training as a new industry professional. Begins with a 4‑week concept‑based learning and professional training program, followed by a dedicated onboarding experience before the on‑the‑job phase. Next Class Date: 7/20/26 Locations: San Diego or Rancho Cordova, CA – Onsite Ideal Candidate Strong Communicators Empathetic Multi‑Taskers Accountable Structured Thinkers Ambitious Agile Learners Team Collaborators Essential Responsibilities 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 telephone, 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 or a combination of education and experience. Work Environment Requirements When applicable and appropriate, consideration will be given to reasonable accommodations. Mentally: Clear conceptual thinking, excellent judgment, troubleshooting, problem solving, analysis, discretion; ability to handle work‑related stress and meet deadlines. Physically: Computer keyboarding. Auditory/Visual: Hearing, vision, 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 $27.69/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. 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. #J-18808-Ljbffr