insurance claim representative

Ottawa Family Physicians

Job Overview We are seeking a dedicated and detail-oriented Insurance Claim Representative to join our dynamic team. Responsible for ensuring timely filing of claims for insurance classes, maintaining current accounts on aging reports for designated insurance classes, processing remittances for the different insurance classes, posting payments and adjustments onto the patient's account. Performing other billing office functions as outlined in billing procedures and as requested by the Practice Administrator. The ideal candidate will possess a strong understanding of medical coding, billing, and claims processing, with the ability to evaluate and resolve insurance claims efficiently. Your expertise will contribute to maintaining high standards of service and compliance within our organization.Responsibilities<ul><li>Reviews and edits insurance claim forms and related documents for completeness.</li><li>Corrects incomplete insurance claim information by researching patient charts or contacting patients and updating the computer database when appropriate.</li><li>Submits claim forms to the proper insurance company within 48 working hours.</li><li>Completes all written correspondence and/or forms from insurance companies and telephone inquiries from patients in a timely manner.</li><li>Answers patient questions regarding insurance or payment options.</li><li>Processes remittance advice for payment/adjustment posting received from insurance companies and/or patients and posts amounts to the patient&rsquo;s account.</li><li>Audits and corrects billing deficiencies as necessary and contacts insurance companies.</li><li>Provides daily balancing from responsible insurance companies/patients.</li><li>Strong understanding of medical terminology, medical records management, and healthcare documentation practices.</li><li>Experience with medical billing processes and medical collection procedures.</li><li>Familiarity with EMR systems and EHR platforms for efficient data management.</li><li>Knowledge of insurance policies, claim adjudication processes, and regulatory compliance requirements.</li><li>Excellent analytical skills with attention to detail for reviewing complex claims data.</li><li>Effective communication skills for collaborating with healthcare providers, insurance representatives, and patients. Join our team as an Insurance Claim Representative to play a vital role in ensuring accurate claims processing while supporting our commitment to exceptional healthcare service delivery!</li></ul>Benefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Flexible spending account</li><li>Health insurance</li><li>Health savings account</li><li>Paid time off</li><li>Vision insurance</li></ul>Work Location: In person

Insurance Claim Representative

Great American Insurance Group

<div>Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a &quot;small company&quot; culture where your ideas will be heard with &quot;big company&quot; expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow.
At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.
Corporate Claims is currently seeking a Claims Representative/Senior Claims Representative/Claim Specialist to join the Reinsurance Claims department located in Cincinnati, Ohio. Great American&rsquo;s culture is built on connection, shared learning, and strong relationships. To support this, employees in this role are expected to be on-site four days a week, with the flexibility to work one day remotely. Core in‑office days are Tuesday&ndash;Thursday, with the fourth day determined by business needs. Open to full-time work from home for candidates living outside of greater Cincinnati.
The job grade will be commensurate with the years of experience and skill level of the candidate hired for the position.
Responsibilities
This individual will be part of a team responsible for the daily handling of reinsurance claims, including:<ul><li>
Reviews assumed reinsurance claims comprised primarily of asbestos, environmental, and other long-tail claims.</li><li>
Ensures that reinsurance claim cessions are within applicable contract requirements.</li><li>
Verifies coverage and cession amounts, and requests information from ceding companies to evaluate claim cessions.</li><li>
Prepares claim summaries on billed claims, posts claim reserves and prepares support for claim payments.</li><li>
Identifies potential claims issues and makes recommendations to management regarding claim disposition.</li><li>
Communicates reinsurance coverage positions as directed by management.</li><li>
Alerts management of substantial losses.</li><li>
Assists management with the preparation of summaries on significant losses for monthly reports to senior management.</li><li>
Documents and maintains records of loss submissions, reserves, queries, and payments.</li><li>
Ensure reinsurance claim transactions are recorded in a timely and accurate manner.</li><li>
Participates in reinsurance projects as needed.</li><li>
Provides guidance and assistance to other functional areas.</li><li>
Performs other duties as assigned.</li></ul>
Qualifications<ul><li>
Bachelor&rsquo;s degree or equivalent experience.</li><li>
Experience: 0-10 years of reinsurance claims experience. Some knowledge of reinsurance is preferred.</li><li>
Proficiency in Microsoft365 suite of products, specifically Excel.</li><li>
Familiarity with reinsurance contracts is a plus.</li><li>
Professional writing and oral communication skills.</li><li>
Ability to manage and prioritize concurrent assignments and responsibilities</li></ul>
This job is non-exempt in California and Washington
Business Unit:
Corporate Claims 
Salary Range:
$69,000.00 -$105,000.00
Benefits:
We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits. 
Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at http://www.gaig.com/careers.<ul><li> 
Excludes seasonal employees and interns.</li></ul></div>

Assumed Reinsurance Asbestos Claims Representative/Senior Representative

Sedgwick

<div>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there&rsquo;s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
Certified as a Great Place to Work&reg;
Fortune Best Workplaces in Financial Services &amp; Insurance
Claims Representative (IAP) - Workers Compensation Training Program
Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?
<ul><li>A stable and consistent work environment in an office setting.
</li><li>A training program to learn how to investigate and resolve complex situations for employees and customers from some of the world&rsquo;s most reputable brands.
</li><li>Career development and promotional growth opportunities through increasing responsibilities.
</li><li>A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs including medical, dental, vision &amp; 401k.
</li></ul>PRIMARY PURPOSE OF THE ROLE: To be oriented and trained as a new industry professional. This role begins with a comprehensive 4-week concept-based learning and professional training program, followed by a dedicated onboarding experience before entering the on-the-job phase. You will be assigned a mentor and manager that will support and guide you on your career journey and be equipped with the foundational skills needed for a successful career in claims adjusting. While in the program, you&rsquo;ll have the opportunity to grow and advance within the industry. 
 
Next Class Date: 6/8/26 
 
ARE YOU AN IDEAL CANDIDATE? We are seeking enthusiastic and service-oriented individuals for an entry-level trainee position who are:
<ul><li>Strong Communicators
</li><li>Empathetic
</li><li>Multi-Taskers
</li><li>Accountable
</li><li>Structured Thinkers
</li><li>Ambitious
</li><li>Agile Learners
</li><li>Team Collaborators
</li></ul>ESSENTIAL RESPONSIBLITIES INCLUDE
<ul><li>Attendance and completion of designated claims professional training program.
</li><li>Adjusting various levels of workers&rsquo; compensation claims under close supervision, which includes:
<ul><li>Processing and responding to incoming mail, emails and other claim related documents according to status of the claim.
</li><li>Communicating effectively with injured workers, insureds/employers, medical providers, attorneys and carrier representatives, primarily through telephonic, video conference and email.
</li><li>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.
</li><li>Determining coverage, compensability and appropriate benefits in accordance with jurisdictional guidelines and carrier program requirements.
</li><li>Documenting claims files and properly coding claim activity. Preparing detailed reports documenting findings and recommendations.
</li><li>Administering claim benefits i.e., indemnity and medical benefits, through maintenance of calendared claim-related action items, ensuring state compliance.
</li><li>Participating in virtual and/or in-person meetings, claim reviews and business functions as needed for educational training, claim discussions and various meetings.
</li></ul></li></ul>QUALIFICATIONS
Education Requirement &ndash; High School Diploma or GED. 
EXPERIENCE
No experience required.
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 $25.65/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. #claims #entrylevel
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
<h2 class="jobSectionHeader">If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.</h2></div>

Claims Representative (IAP) - Workers Compensation Training Program

<div>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there&rsquo;s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
Certified as a Great Place to Work&reg;
Fortune Best Workplaces in Financial Services &amp; Insurance
Claims Representative (IAP) - Workers Compensation Training Program | Long Beach, CA
Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?
<ul><li>A stable and consistent work environment in an office setting.
</li><li>A training program to learn how to investigate and resolve complex situations for employees and customers from some of the world&rsquo;s most reputable brands.
</li><li>Career development and promotional growth opportunities through increasing responsibilities.
</li><li>A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs including medical, dental, vision &amp; 401k.
</li></ul>PRIMARY PURPOSE OF THE ROLE: To be oriented and trained as a new industry professional. This role begins with a comprehensive 4-week concept-based learning and professional training program, followed by a dedicated onboarding experience before entering the on-the-job phase. You will be assigned a mentor and manager that will support and guide you on your career journey and be equipped with the foundational skills needed for a successful career in claims adjusting. While in the program, you&rsquo;ll have the opportunity to grow and advance within the industry. 
 
Next Class Date: 6/1/26 
 
ARE YOU AN IDEAL CANDIDATE? We are seeking enthusiastic and service-oriented individuals for an entry-level trainee position who are:
<ul><li>Strong Communicators
</li><li>Empathetic
</li><li>Multi-Taskers
</li><li>Accountable
</li><li>Structured Thinkers
</li><li>Ambitious
</li><li>Agile Learners
</li><li>Team Collaborators
</li></ul>ESSENTIAL RESPONSIBLITIES INCLUDE
<ul><li>Attendance and completion of designated claims professional training program.
</li><li>Adjusting various levels of workers&rsquo; compensation claims under close supervision, which includes:
<ul><li>Processing and responding to incoming mail, emails and other claim related documents according to status of the claim.
</li><li>Communicating effectively with injured workers, insureds/employers, medical providers, attorneys and carrier representatives, primarily through telephonic, video conference and email.
</li><li>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.
</li><li>Determining coverage, compensability and appropriate benefits in accordance with jurisdictional guidelines and carrier program requirements.
</li><li>Documenting claims files and properly coding claim activity. Preparing detailed reports documenting findings and recommendations.
</li><li>Administering claim benefits i.e., indemnity and medical benefits, through maintenance of calendared claim-related action items, ensuring state compliance.
</li><li>Participating in virtual and/or in-person meetings, claim reviews and business functions as needed for educational training, claim discussions and various meetings.
</li></ul></li></ul>QUALIFICATIONS
Education Requirement &ndash; High School Diploma or GED. 
EXPERIENCE
No experience required.
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. #claims #entrylevel
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&rsquo; 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.
<h2 class="jobSectionHeader">If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.</h2></div>

Claims Representative (IAP) - Workers Compensation Training Program | Long Beach, CA

Cornerstone Building Brands

<div>
 
 Cornerstone Building Brands is a leading manufacturer of exterior building products for residential and low-rise non-residential buildings in North America. Headquartered in Cary, N.C., we serve residential and commercial customers across the new construction and Repair &amp; Remodel (R&amp;R) markets. Our market-leading portfolio of products spans vinyl windows, vinyl siding, stone veneer, metal roofing, metal wall systems and metal accessories. Cornerstone Building Brands&rsquo; broad, multi-channel distribution platform and expansive national footprint includes more than 18,800 team members at manufacturing, distribution and office locations throughout North America. Corporate stewardship and Environmental, Social and Governance (ESG) responsibility are embedded in our culture. We are committed to contributing positively to the communities where we live, work and play. For more information, visit us at
 
 http://cornerstonebuildingbrands.com
 
 .
 
 
 
 
 
 
 Job Description
 
 
 
 
 
 
 ABOUT THE ROLE
 
 
 
 
 The Claims Representative is responsible for managing warranty claims from initial intake through final resolution while delivering a premier customer experience. This role requires strong analytical skills, clear communication, and the ability to balance accuracy, cost efficiency, and customer satisfaction. The Claims Representative serves as a key partner to customers, internal teams, and service providers, ensuring claims are processed effectively, documented thoroughly, and resolved in alignment with company standards.
 
 
 
 
 
 
 This is a hybrid role based out of our Peachtree City, GA plant requiring 2 days in the office per week.
 
 
 
 
 
 
 
 
 WHAT YOU&rsquo;LL DO
 
 
 
 
 
 
 
 <ul>
 <li>
 
 Claim Intake &amp; Validation
 
 <ul>
 <li>
 Receive, review, and validate incoming warranty claims to determine accuracy and required information.
 </li>
 <li>
 Initiate clarification calls to customers as needed to complete claim details.
 </li>
 <li>
 Maintain accurate claim documentation and communication updates within Dynamics 365 CRM.
 </li>
 </ul>
 </li>
 <li>
 
 Claim Management &amp; Resolution
 
 <ul>
 <li>
 Create detailed work orders for Cornerstone Building Brands (CBB) Technicians and third-party vendors, optimizing cost, efficiency, and service quality.
 </li>
 <li>
 Monitor claim progress and ensure timely, cost-effective resolutions that enhance customer satisfaction.
 </li>
 <li>
 Host product standards and compliance discussions with customers, helping address concerns professionally and clearly.
 </li>
 <li>
 Administer service reimbursements and prepare settlement letters when applicable.
 </li>
 </ul>
 </li>
 <li>
 
 Quality Review &amp; Root Cause Analysis
 
 <ul>
 <li>
 Conduct research to identify root causes of product or service issues.
 </li>
 <li>
 Collaborate with plant personnel, sales teams, and other departments to support long-term corrective actions and process improvements.
 </li>
 <li>
 Participate in discussions and initiatives aimed at reducing recurring issues and improving overall product and service quality.
 </li>
 </ul>
 </li>
 <li>
 
 Communication &amp; Reporting
 
 <ul>
 <li>
 Prepare clear communications and updates for management regarding claim trends, issues, and opportunities.
 </li>
 <li>
 Ensure documentation and reporting for claims, resolutions, and settlement activities are accurate and complete.
 </li>
 <li>
 Perform additional duties as assigned to support departmental needs.
 </li>
 </ul>
 </li>
 </ul>
 
 
 
 SKILLS &amp; QUALIFICATIONS
 
 
 
 
 
 <ul>
 <li>
 Strong ability to interpret customer claims and apply relevant warranty coverage.
 </li>
 <li>
 Ability to read and interpret product specifications, drawings, and order confirmations.
 </li>
 <li>
 Exceptional analytical and problem-solving skills with the ability to identify root causes and recommend solutions.
 </li>
 <li>
 Strong verbal and written communication skills with a customer-centric approach.
 </li>
 <li>
 Ability to manage difficult discussions and mitigate customer dissatisfaction effectively.
 </li>
 <li>
 Proficiency in Microsoft Excel, Word, and PowerPoint, with the ability to learn new systems quickly.
 </li>
 <li>
 Strong attention to detail and accuracy in a fast-paced environment.
 </li>
 <li>
 Ability to work independently while supporting team and departmental goals.
 </li>
 <li>
 High curiosity, initiative, and willingness to grow in an evolving environment.
 </li>
 </ul>
 
 
 
 WHAT YOU&rsquo;LL NEED
 
 
 
 
 
 <ul>
 <li>
 
 Education:
 
 High School Diploma or equivalent required; Bachelor&rsquo;s degree preferred. Professional experience in a claims or service role, preferably within the building materials industry will be considered in lieu of education.
 </li>
 </ul>
 <ul>
 <li>
 
 Experience/Technical Skills:
 
 <ul>
 <li>
 Experience in Ordering/Quoting systems is desired (AccuQuote preferred).
 </li>
 <li>
 Experience with CRM systems is desired.
 
 
 </li>
 </ul>
 </li>
 </ul>
 
 Additional Information
 
 
 
 
 All your information will be kept confidential according to EEO guidelines.
 
 
 
 
 
 
 
 
 
 Why work for Cornerstone Building Brands?
 
 
 
 
 
 Our teams are at the heart of our purpose to positively contribute to the communities where we
 
 live, work and play
 
 . Full-time* team members receive** medical, dental and vision benefits starting day 1. Other benefits include PTO, paid holidays, FSA, life insurance, LTD, STD, 401k, EAP, discount programs, tuition reimbursement, training, and professional development.
 
 
 
 
 *Full-time is defined as regularly working 30+ hours per week. **Union programs may vary depending on the collective bargaining agreement.
 
 
 
 
 
 
 
 
 
 Cornerstone Building Brands is an Equal Opportunity Employer.
 
 
 
 
 
 All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, or status as a protected veteran. You can find the Equal Employment Opportunity Poster here. You can also view Your Right to Work Poster here along with This Organizations Participation in E-Verify Poster here. If you'd like to view a copy of the company's affirmative action plan for protected veterans or individuals with disabilities or policy statement, please contact Human Resources at 281-897-7788 or HRCompliance@cornerstone-bb.com. If you have a disability and you believe that you need a reasonable accommodation in order to search for a job opening or to submit an online application, please contact Human Resources at 281-897-7788 or HRCompliance@cornerstone-bb.com. This email is used exclusively to assist disabled job seekers whose disability prevents them from being able to apply online. Only emails received for this purpose will be returned. Messages left for other purposes, such as following up on an application or technical issues not related to a disability, will not receive a response.
 
 
 
 
 
 
 
 
 All your information will be kept confidential according to EEO guidelines.
 
 
 
 
 
 
 
 
 California Consumer Privacy Act (CCPA) of 2018
 
 
 
 
 
 
 
 
 
 Must be at least 18 years of age to apply.
 
 
 
 
 
 
 
 
 
 
 Note to External Recruiters
 
 
 
 
 
 Cornerstone Building Brands does not accept unsolicited resumes and will not pay fees for any candidate submissions that were not expressly authorized.
 
 
 
 
 
 
 
 
 
 Notice of Recruitment Fraud
 
 
 
 
 
 We have been made aware of multiple scams whereby unauthorized individuals are using Cornerstone Building Brand's name and logo to solicit potential job-seekers for employment. In some cases, job-seekers are being contacted directly, both by phone and e-mail. In other instances, these unauthorized individuals are placing advertisements for fake positions with both legitimate websites and fabricated ones. These individuals are typically promising high-paying jobs with the requirement that the job-seeker send money to pay for things such as visa applications or processing fees. Please be advised that Cornerstone Building Brands will never ask potential job-seekers for any sort of advance payment or bank account information as part of the recruiting or hiring process.
 
 
 
</div>

Claims Representative, Warranty

<div>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there&rsquo;s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
Certified as a Great Place to Work&reg;
Fortune Best Workplaces in Financial Services &amp; Insurance
Claims Representative (IAP) - Workers Compensation Training Program | Hampton, VA
Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?
<ul><li>A stable and consistent work environment in an office setting.
</li><li>A training program to learn how to investigate and resolve complex situations for employees and customers from some of the world&rsquo;s most reputable brands.
</li><li>Career development and promotional growth opportunities through increasing responsibilities.
</li><li>A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs including medical, dental, vision &amp; 401k.
</li></ul>PRIMARY PURPOSE OF THE ROLE: To be oriented and trained as a new industry professional. This role begins with a comprehensive 4-week concept-based learning and professional training program, followed by a dedicated onboarding experience before entering the on-the-job phase. You will be assigned a mentor and manager that will support and guide you on your career journey and be equipped with the foundational skills needed for a successful career in claims adjusting. While in the program, you&rsquo;ll have the opportunity to grow and advance within the industry. 
 
Next Class Date: 6/8/26 
 
ARE YOU AN IDEAL CANDIDATE? We are seeking enthusiastic and service-oriented individuals for an entry-level trainee position who are:
<ul><li>Strong Communicators
</li><li>Empathetic
</li><li>Multi-Taskers
</li><li>Accountable
</li><li>Structured Thinkers
</li><li>Ambitious
</li><li>Agile Learners
</li><li>Team Collaborators
</li></ul>ESSENTIAL RESPONSIBLITIES INCLUDE
<ul><li>Attendance and completion of designated claims professional training program.
</li><li>Adjusting various levels of workers&rsquo; compensation claims under close supervision, which includes:
<ul><li>Processing and responding to incoming mail, emails and other claim related documents according to status of the claim.
</li><li>Communicating effectively with injured workers, insureds/employers, medical providers, attorneys and carrier representatives, primarily through telephonic, video conference and email.
</li><li>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.
</li><li>Determining coverage, compensability and appropriate benefits in accordance with jurisdictional guidelines and carrier program requirements.
</li><li>Documenting claims files and properly coding claim activity. Preparing detailed reports documenting findings and recommendations.
</li><li>Administering claim benefits i.e., indemnity and medical benefits, through maintenance of calendared claim-related action items, ensuring state compliance.
</li><li>Participating in virtual and/or in-person meetings, claim reviews and business functions as needed for educational training, claim discussions and various meetings.
</li></ul></li></ul>QUALIFICATIONS
Education Requirement &ndash; High School Diploma or GED. 
EXPERIENCE
No experience required.
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 $25.65/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. #claims #entrylevel
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
<h2 class="jobSectionHeader">If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.</h2></div>

Claims Representative (IAP) - Workers Compensation Training Program | Hampton, VA

<div>
 
 Cornerstone Building Brands is a leading manufacturer of exterior building products for residential and low-rise non-residential buildings in North America. Headquartered in Cary, N.C., we serve residential and commercial customers across the new construction and Repair &amp; Remodel (R&amp;R) markets. Our market-leading portfolio of products spans vinyl windows, vinyl siding, stone veneer, metal roofing, metal wall systems and metal accessories. Cornerstone Building Brands&rsquo; broad, multi-channel distribution platform and expansive national footprint includes more than 18,800 team members at manufacturing, distribution and office locations throughout North America. Corporate stewardship and Environmental, Social and Governance (ESG) responsibility are embedded in our culture. We are committed to contributing positively to the communities where we live, work and play. For more information, visit us at
 
 http://cornerstonebuildingbrands.com
 
 .
 
 
 
 
 
 
 Job Description
 
 
 
 
 
 
 ABOUT THE ROLE
 
 
 
 
 The Claims Representative is responsible for managing warranty claims from initial intake through final resolution while delivering a premier customer experience. This role requires strong analytical skills, clear communication, and the ability to balance accuracy, cost efficiency, and customer satisfaction. The Claims Representative serves as a key partner to customers, internal teams, and service providers, ensuring claims are processed effectively, documented thoroughly, and resolved in alignment with company standards.
 
 
 
 
 
 
 This is a hybrid role based out of our Welcome, NC plant requiring 2 days in the office per week.
 
 
 
 
 
 
 
 
 WHAT YOU&rsquo;LL DO
 
 
 
 
 
 
 
 <ul>
 <li>
 
 Claim Intake &amp; Validation
 
 <ul>
 <li>
 Receive, review, and validate incoming warranty claims to determine accuracy and required information.
 </li>
 <li>
 Initiate clarification calls to customers as needed to complete claim details.
 </li>
 <li>
 Maintain accurate claim documentation and communication updates within Dynamics 365 CRM.
 </li>
 </ul>
 </li>
 <li>
 
 Claim Management &amp; Resolution
 
 <ul>
 <li>
 Create detailed work orders for Cornerstone Building Brands (CBB) Technicians and third-party vendors, optimizing cost, efficiency, and service quality.
 </li>
 <li>
 Monitor claim progress and ensure timely, cost-effective resolutions that enhance customer satisfaction.
 </li>
 <li>
 Host product standards and compliance discussions with customers, helping address concerns professionally and clearly.
 </li>
 <li>
 Administer service reimbursements and prepare settlement letters when applicable.
 </li>
 </ul>
 </li>
 <li>
 
 Quality Review &amp; Root Cause Analysis
 
 <ul>
 <li>
 Conduct research to identify root causes of product or service issues.
 </li>
 <li>
 Collaborate with plant personnel, sales teams, and other departments to support long-term corrective actions and process improvements.
 </li>
 <li>
 Participate in discussions and initiatives aimed at reducing recurring issues and improving overall product and service quality.
 </li>
 </ul>
 </li>
 <li>
 
 Communication &amp; Reporting
 
 <ul>
 <li>
 Prepare clear communications and updates for management regarding claim trends, issues, and opportunities.
 </li>
 <li>
 Ensure documentation and reporting for claims, resolutions, and settlement activities are accurate and complete.
 </li>
 <li>
 Perform additional duties as assigned to support departmental needs.
 </li>
 </ul>
 </li>
 </ul>
 
 
 
 SKILLS &amp; QUALIFICATIONS
 
 
 
 
 
 <ul>
 <li>
 Strong ability to interpret customer claims and apply relevant warranty coverage.
 </li>
 <li>
 Ability to read and interpret product specifications, drawings, and order confirmations.
 </li>
 <li>
 Exceptional analytical and problem-solving skills with the ability to identify root causes and recommend solutions.
 </li>
 <li>
 Strong verbal and written communication skills with a customer-centric approach.
 </li>
 <li>
 Ability to manage difficult discussions and mitigate customer dissatisfaction effectively.
 </li>
 <li>
 Proficiency in Microsoft Excel, Word, and PowerPoint, with the ability to learn new systems quickly.
 </li>
 <li>
 Strong attention to detail and accuracy in a fast-paced environment.
 </li>
 <li>
 Ability to work independently while supporting team and departmental goals.
 </li>
 <li>
 High curiosity, initiative, and willingness to grow in an evolving environment.
 </li>
 </ul>
 
 
 
 WHAT YOU&rsquo;LL NEED
 
 
 
 
 
 <ul>
 <li>
 
 Education:
 
 High School Diploma or equivalent required; Bachelor&rsquo;s degree preferred. Professional experience in a claims or service role, preferably within the building materials industry will be considered in lieu of education.
 </li>
 </ul>
 <ul>
 <li>
 
 Experience/Technical Skills:
 
 <ul>
 <li>
 Experience in Ordering/Quoting systems is desired (AccuQuote preferred).
 </li>
 <li>
 Experience with CRM systems is desired.
 
 
 </li>
 </ul>
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 Additional Information
 
 
 
 
 All your information will be kept confidential according to EEO guidelines.
 
 
 
 
 
 
 
 
 
 Why work for Cornerstone Building Brands?
 
 
 
 
 
 Our teams are at the heart of our purpose to positively contribute to the communities where we
 
 live, work and play
 
 . Full-time* team members receive** medical, dental and vision benefits starting day 1. Other benefits include PTO, paid holidays, FSA, life insurance, LTD, STD, 401k, EAP, discount programs, tuition reimbursement, training, and professional development.
 
 
 
 
 *Full-time is defined as regularly working 30+ hours per week. **Union programs may vary depending on the collective bargaining agreement.
 
 
 
 
 
 
 
 
 
 Cornerstone Building Brands is an Equal Opportunity Employer.
 
 
 
 
 
 All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, or status as a protected veteran. You can find the Equal Employment Opportunity Poster here. You can also view Your Right to Work Poster here along with This Organizations Participation in E-Verify Poster here. If you'd like to view a copy of the company's affirmative action plan for protected veterans or individuals with disabilities or policy statement, please contact Human Resources at 281-897-7788 or HRCompliance@cornerstone-bb.com. If you have a disability and you believe that you need a reasonable accommodation in order to search for a job opening or to submit an online application, please contact Human Resources at 281-897-7788 or HRCompliance@cornerstone-bb.com. This email is used exclusively to assist disabled job seekers whose disability prevents them from being able to apply online. Only emails received for this purpose will be returned. Messages left for other purposes, such as following up on an application or technical issues not related to a disability, will not receive a response.
 
 
 
 
 
 
 
 
 All your information will be kept confidential according to EEO guidelines.
 
 
 
 
 
 
 
 
 California Consumer Privacy Act (CCPA) of 2018
 
 
 
 
 
 
 
 
 
 Must be at least 18 years of age to apply.
 
 
 
 
 
 
 
 
 
 
 Note to External Recruiters
 
 
 
 
 
 Cornerstone Building Brands does not accept unsolicited resumes and will not pay fees for any candidate submissions that were not expressly authorized.
 
 
 
 
 
 
 
 
 
 Notice of Recruitment Fraud
 
 
 
 
 
 We have been made aware of multiple scams whereby unauthorized individuals are using Cornerstone Building Brand's name and logo to solicit potential job-seekers for employment. In some cases, job-seekers are being contacted directly, both by phone and e-mail. In other instances, these unauthorized individuals are placing advertisements for fake positions with both legitimate websites and fabricated ones. These individuals are typically promising high-paying jobs with the requirement that the job-seeker send money to pay for things such as visa applications or processing fees. Please be advised that Cornerstone Building Brands will never ask potential job-seekers for any sort of advance payment or bank account information as part of the recruiting or hiring process.
 
 
 
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