Disability Representative Sr

About the role

Join Sedgwick, a company dedicated to helping people facing unexpected challenges. We offer a caring culture and work-life balance, where you can grow your career and make a difference.

Responsibilities

• Makes independent claim determinations based on provided information.
• Reviews and analyzes complex medical information to determine disability eligibility.
• Manages complex claims including comorbidities, concurrent plans, and ADA accommodations.
• Communicates with claimants and their providers to ensure clear understanding of return to work expectations.
• Evaluates and refers claims to external vendors or physician advisors as necessary.
• Negotiates return to work plans with claimants and employers.
• Maintains professional relationships and provides excellent customer service.

Qualifications

• High school diploma or GED required.
• Bachelor's degree from an accredited university or college preferred.
• State certification or licensing in statutory leaves preferred or required based on state regulations.
• Three (3) years of benefits or disability case/claims management experience or equivalent combination of education and experience preferred.

Skills & Knowledge

• Knowledge of ERISA regulations, offsets, duration management, and Social Security application procedures.
• Understanding of state and federal FMLA regulations.
• Proficiency in medical terminology and duration management.
• Excellent communication and presentation skills.
• Computer skills including Microsoft Office.
• Analytical, interpretive, and critical thinking abilities.
• Organizational and multitasking skills.
• Ability to work in a team environment.
• Effective decision-making and negotiation skills.

Work Environment

• Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem-solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
• Physical: Ability to sit at a desk for extended periods while operating a computer and phone system.
• Auditory/Visual: Hearing, vision, and talking.