Claims Representative - IAP

PRIMARY PURPOSE:  To be oriented and trained as new industry professional with the ability to analyze workers compensation, general liability or disability claims and determine benefits due.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Attendance and completion of designated classroom claims professional training program.
• Performs on-the-job training activities including:
  • Adjusting lost-time workers compensation claims under close supervision.  May be assigned medical only claims.
  • Adjusting low and mid-level liability and/or physical damage claims under close supervision.
  • Processing disability claims of minimal disability duration under close supervision.
  • Documenting claims files and properly coding claim activity.
  • Communicating claim action/processing with claimant and client.
  • Supporting other claims examiners and claims supervisors with larger or more complex claims as assigned.
• Participates in rotational assignments to provide temporary support for office needs.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization's quality program(s).

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred or equivalent experience as outlined below.

Experience
No experience required with college degree.  State license, self-insured certificate, WCCA/WCCP designation, or completion of the Sedgwick Claims Progression Program required without a degree.  Prior claims experience preferred.

Skills and Knowledge

• Excellent oral and written communication, including presentation skills
• PC literate, including Microsoft Office products
• Analytical skills
• Ability to work in a team environment
• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental:  Clear and conceptual thinking ability; excellent judgment and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical:  Computer keyboarding, travel as required

Auditory/Visual:  Hearing, vision and talking

NOTE:  Credit security clearance, confirmed via a background credit check, is required for this position.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description.  They are not intended to constitute a comprehensive list of functions, duties, or local variances.  Management retains the discretion to add or to change the duties of the position at any time.