Disability Representative Sr

About the role

Joining Sedgwick means becoming part of a dynamic team dedicated to helping people navigate unexpected challenges. We offer a supportive work environment where you can grow your career, experience our caring culture, and maintain a healthy work-life balance. Sedgwick is recognized as a top workplace and is committed to providing exceptional services in disability case management.

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.
• Determines benefits due and makes timely approvals and adjustments.
• Communicates with claimants and their providers regarding return to work.
• Mediates disputes and negotiates return to work with or without accommodations.
• Evaluates and refers claims to external vendors or medical advisors.
• Maintains professional relationships and provides excellent customer service.

Requirements

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

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.
• Strong organizational and multitasking skills.
• Ability to work in a team environment.
• Effective decision-making and negotiation skills.

Additional Functions

• Performs other duties as assigned.

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.

Pay & Benefits

The starting pay range for this role is $22.86 - $24.00 per hour USD. Sedgwick offers a comprehensive benefits package including medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and additional voluntary benefits. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.