Disability Representative Sr

Role: The Disability Representative Senior manages complex disability claims by reviewing medical documentation, determining benefit eligibility, and ensuring timely payments and adjustments. Responsibilities: Make independent claim decisions or recommend denial based on disability plans, analyze medical information, manage comorbidities and ADA accommodations, coordinate investigative efforts, communicate with claimants and providers, facilitate return-to-work negotiations, and refer cases to outside vendors or clinical review teams. Maintain professional relationships and uphold quality standards. Qualifications: High School diploma or GED required; bachelor's preferred. At least three years of benefits or disability claims management experience is ideal. Knowledge of ERISA, FMLA, medical terminology, and social security procedures is essential. Strong communication, analytical, organizational, negotiation, and decision-making skills are necessary. Ability to work independently within established procedures and in a team environment. Skills: Proficiency in Microsoft Office, critical thinking, managing ambiguity, multitasking, and handling work-related stress. Adaptable to various work environments with physical and mental stamina to sit for extended periods, operate computers, and handle travel if needed.