Description
By joining Sedgwick, you'll be part of a global organisation that helps people facing unexpected challenges.
We're looking for a Disability Representative Sr to join our team in Orlando, Florida.
Primary Purpose: Provides disability case management and complex claim determinations based on medical documentation and applicable disability plan interpretation.
Key Responsibilities:
- Makes independent claim determinations to approve complex disability claims or recommends denial based on disability plan
- Reviews and analyses complex medical information to determine claimant disability
- Oversees additional facets of complex claims, including comorbidities and complex ADA accommodations
- Utilises clinical resources in case assessment as needed
- Determines benefits due and makes timely claims payments/approvals and adjustments
- Communicates with claimants, providers, and clients throughout the claims process
- Coordinates investigative efforts and reviews contested claims
- Evaluates and arranges referrals of claims to outside vendors
- Negotiates return to work with or without job accommodations
Requirements:
- High school diploma or GED required; bachelor's degree preferred
- Three years of benefits or disability case/claims management experience preferred
- Knowledge of ERISA regulations, disability duration, and medical management practices
- Excellent oral and written communication skills
- Proficient computer skills, including Microsoft Office
- Analytical, interpretive, and critical thinking skills
Work Environment:
- Hybrid work arrangement with onsite collaboration
- Must live near one of our centres of excellence, including Orlando, FL
Benefits:
- Comprehensive benefits package, including medical, dental, vision, 401k, and matching
- Flexible spending or health savings account
- Employee assistance programme
- Disability and life insurance
Salary Range: $22.00 - $25.00 USD Hourly