Claims Representative (IAP)

About the Role

Join Sedgwick for an impactful job offering professional career development. This role includes a stable work environment, a comprehensive training program, and career growth opportunities.

Key Responsibilities

• Attendance and completion of the designated claims professional training program.
• Adjusting various levels of claims under close supervision, including:
• Processing and responding to incoming mail, emails, and other claim-related documents.
• Communicating effectively with insureds/employers, medical providers, attorneys, and carrier representatives via telephonic, video conference, and email.
• Investigating claims by gathering relevant information such as medical records, employer reports, and witness statements.
• Investigating employer/employee relationships, policy verification, coverage, and potential subrogation issues or fraud indicators.
• Determining coverage, compensability, and appropriate benefits per jurisdictional guidelines and carrier program requirements.
• Documenting claims files and coding claim activity.
• Preparing detailed reports with findings and recommendations.
• Administering claim benefits (indemnity and medical) and ensuring state compliance.
• Participating in virtual and/or in-person meetings, claim reviews, and business functions for educational training and claim discussions.

Requirements & Tech Stack

• Claims Professional Training Program
• Communication (telephonic, video conference, email)
• Investigation (gathering medical records, employer reports, witness statements)
• Documentation
• Report Preparation

Qualifications

• Education Requirement: High School Diploma or GED.
• Bachelor's degree preferred.
• 2 years of customer service experience and/or a combination of education and experience.
• Strong Communicators
• Empathetic
• Multi-Taskers
• Accountable
• Structured Thinkers
• Ambitious
• Agile Learners
• Team Collaborators

Work Environment Requirements:

• Mental: Clear and conceptual thinking, excellent judgment, troubleshooting, problem-solving, analysis, discretion, ability to handle work-related stress, multiple priorities, and deadlines.
• Physical: Computer keyboarding.
• Auditory/Visual: Hearing, vision, and talking.

Training Program Details

• Duration: Comprehensive 4-week concept-based learning and professional training program, followed by a dedicated 2-week onboarding experience.
• Support: Assigned mentor and manager for guidance.
• Class Dates (2027): 2/8, 2/22, 4/19, 6/14, 8/9, 10/4.
• Locations: Hybrid & Onsite opportunities throughout US cities; some remote opportunities available.

Compensation

• Starting Pay: $25.65/hr (for applicable jurisdictions requiring pay transparency).

Benefits

• Comprehensive benefits package including medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other voluntary benefits.