Claims Representative – SkillBridge Conversion

This is a fully remote position, open to applicants in Virginia.

📋 Description

• Participate in and complete the assigned training program for claims professionals.

• Adjust various levels of workers’ compensation claims under direct supervision.

• Manage and respond to incoming mail, emails, and documents related to claims.

• Engage in communication with injured workers, insured parties/employers, medical providers, attorneys, and carrier representatives via telephone, video conference, and email.

• Investigate both new and existing claims by collecting medical records, employer reports, and witness statements.

• Examine employer/employee relationships, verify policy details, assess coverage, identify subrogation issues, and detect fraud indicators.

• Assess coverage, compensability, and suitable benefits in accordance with jurisdictional guidelines and carrier program requirements.

• Accurately document claims files and appropriately code claim activities.

• Prepare comprehensive reports detailing findings and recommendations.

• Administer indemnity and medical claim benefits by managing scheduled claim-related action items while ensuring compliance with state regulations.

• Attend virtual and/or in-person meetings, claim reviews, and business functions for training, discussions regarding claims, and other related meetings.

• Complete a 4-week concept-based learning and professional training program, followed by dedicated onboarding.

• Collaborate with an assigned mentor and manager throughout your career development journey.

⛳️ Requirements

• This is an entry-level trainee position.

• High School Diploma or GED is required.

• Excellent communication skills are essential.

• Must possess empathy.

• Ability to manage multiple tasks simultaneously is required.

• Accountability is a must.

• Structured thinking is necessary.

• Ambition to grow and develop.

• Ability to learn quickly and adapt.

• Collaboration within a team is essential.

• Clear and conceptual thinking is required.

• Exceptional judgment, troubleshooting skills, problem-solving abilities, analytical skills, and discretion are needed.

• Capability to manage work-related stress is important.

• Must be able to handle multiple priorities at once.

• Ability to meet deadlines is essential.

• Proficiency in computer keyboarding skills is required.

• Ability to hear, see, and communicate effectively is necessary.

• A Bachelor's degree is preferred.

• Preferred qualifications include 2 years of customer service experience and/or a combination of education and experience.

🏝️ Benefits

• Opportunities for career development and promotion through increasing responsibilities.

• Medical insurance coverage.

• Dental insurance benefits.

• Vision insurance available.

• 401k plan with matching contributions.

• Paid time off (PTO) is provided.

• Disability insurance coverage.

• Life insurance benefits.

• Employee assistance programs.

• Flexible spending or health savings accounts available.

• Additional voluntary benefits offered.

• Reasonable accommodations provided when applicable and appropriate.