The Claims Operations division is divided into five claims units, a Customer Service Phone Center, and a Medical Cost Containment Unit. Four of the claims units are assigned claims based primarily on volume of clients from different agencies. Upon receipt of the file, Claims Operations performs the initial investigation of each reported injury claim and determines the compensability. Claims Operations follows all claims until their conclusion to ensure that each injured state worker receives the health care, medical, and income benefits reasonably due, as and when accrued, according to the nature of the injury and periods of disability as appropriate. A fifth claims unit, the Medical Management Team, was formed in August 2002 and is staffed with senior adjusters and nurses. This team identifies problematic claims where all indemnity benefits have been paid but there is extensive ongoing medical. The team reviews the claims to determine the appropriateness of ongoing treatment and take action to defend SORM's position through the use of peer reviews, independent medical examinations, and case management as necessary.

Claims Operations instituted a customer service call center staffed by claims assistants, who are adjuster trainees proficient in SORM's claims management system and can provide claims information assistance to SORM customers. They are also charged with the duty of timely processing claims information.

The Medical Cost Containment Unit provides the operations necessary for the Claims Operations division to process workers' compensation medical claims administrative oversight of the agency's medical cost containment services vendor. The unit consists of three sections. Medical Provider Assistance reviews and monitors the payments of all medical bills received by the agency. Case Management Review, whose coordinator is a registered nurse, researches, reviews, and examines claims information and medical reports for corrective action and/or proper medical treatment plans. Medical Bill Audit's function is to monitor the medical cost containment vendor's performance and to identify potential medical provider fraud and abuse, research those allegations, and refer to SORM investigators as necessary.

Medical Cost Containment Services provides the operations necessary for the Claims Operations division to process workers' compensation claims. The unit consists of three sections. Medical Provider Assistance reviews and monitors the payments of all medical bills received by the agency. Case Management Review, whose coordinator is a certified registered nurse, researches, reviews, and examines claims information and medical reports for corrective action and/or proper medical treatment plans. Medical Audit’s function is to identify potential medical provider fraud and abuse, research those allegations, and refer to SORM investigators as necessary.