Claims Representative – Workers Compensation Training Program

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

📋 Description

• Attend and complete the assigned training program for claims professionals.

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

• Process and respond to incoming mail, emails, and other documents related to claims based on their status.

• Communicate with injured workers, insured individuals/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 policies, assess coverage, identify potential subrogation issues, and recognize indicators of fraud.

• Determine coverage, compensability, and appropriate benefits in accordance with jurisdictional guidelines and carrier program requirements.

• Document claims files and accurately code claim activities.

• Prepare comprehensive reports that document findings and recommendations.

• Administer indemnity and medical claim benefits by managing calendared action items related to claims and ensuring compliance with state regulations.

• Participate in virtual and/or in-person meetings, claim reviews, and business functions as necessary for training and discussions regarding claims.

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

• Work with an assigned mentor and manager for guidance and support in career development.

⛳️ Requirements

• A high school diploma or GED is required.

• A Bachelor’s degree is preferred.

• Two years of customer service experience and/or a combination of education and experience is required.

• Strong communication skills are essential.

• Demonstrated empathy is necessary.

• Ability to multitask effectively.

• A sense of accountability is important.

• Structured thinking is required.

• Ambition is encouraged.

• Ability to learn quickly and adapt is vital.

• Collaboration with teams is essential.

• Clear and conceptual thinking abilities are required.

• Excellent judgment, problem-solving, analytical skills, and discretion are necessary.

• Capability to handle work-related stress is important.

• Ability to manage multiple priorities at the same time.

• Capability to meet deadlines is required.

• Proficiency in computer keyboarding is necessary.

• Hearing, vision, and speaking abilities are needed.

• Ability to participate in virtual and/or in-person meetings and business functions as needed.

🏝️ Benefits

• Opportunities for career development and promotional growth through increasing responsibilities.

• Medical insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• Access to a 401(k) plan.

• 401(k) matching contributions.

• Paid time off (PTO) available.

• Disability insurance offered.

• Life insurance coverage.

• Employee assistance programs.

• Flexible spending accounts or health savings accounts available.

• Additional voluntary benefits offered.

• Reasonable accommodations provided when applicable and appropriate.