# Disability Representative Sr **Company**: Sedgwick **Experience**: senior **Job type**: full-time **Salary**: $23.00 - $25.00 USD per hour **Category**: Human Resources **Industry**: Insurance **Apply**: https://sedgwick.wd1.myworkdayjobs.com/en-US/Sedgwick/job/Chicago-IL/Disability-Representative-Sr_R77957-1?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply **Canonical**: https://yubhub.co/jobs/job_90da4490-68e ## Description By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. As a Disability Representative Sr, you will provide disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation. Your responsibilities will include: - Making independent claim determinations to approve complex disability claims or recommending denial of claims based on the disability plan - Reviewing and analyzing complex medical information to determine if the claimant is disabled as defined by the disability plan - Overseeing additional facets of complex claims, including comorbidities, concurrent plans, and complex ADA accommodations - Utilizing clinical resources in case assessment as needed - Determining benefits due and making timely claims payments/approvals and adjustments - Informing claimants of documentation required to process claims and providing payment information and claims status updates - Communicating with claimants' providers to set expectations regarding return to work - Medically managing complex disability claims to ensure compliance with duration control guidelines and plan provisions - Coordinating investigative efforts and thoroughly reviewing contested claims - Evaluating and arranging appropriate referral of claims to outside vendors or physician advisor reviews - Negotiating return to work with or without job accommodations - Referring cases to team lead and clinical case management for additional review when appropriate - Maintaining professional client relationships and providing excellent customer service The ideal candidate will have: - High school diploma or GED required; bachelor's degree preferred - Three years of benefits or disability case/claims management experience or equivalent combination of education and experience - Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices, and Social Security application procedures - Excellent oral and written communication skills, including presentation skills - Proficient computer skills, including working knowledge of Microsoft Office - Analytical, interpretive, and critical thinking skills - Ability to manage ambiguity and strong organizational and multitasking skills We offer 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 other additional voluntary benefits. The starting pay range for this role is $23.00 - $25.00 USD per hour. ## Skills ### Required - ERISA regulations - disability duration and medical management practices - Social Security application procedures - medical terminology - Microsoft Office - analytical skills - critical thinking skills - communication skills ### Nice to have - bachelor's degree - state certification or licensing in statutory leaves --- Source: [Apply at sedgwick.wd1.myworkdayjobs.com](https://sedgwick.wd1.myworkdayjobs.com/en-US/Sedgwick/job/Chicago-IL/Disability-Representative-Sr_R77957-1?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)