# Disability Specialist

**Company**: Sedgwick
**Location**: West Hills, CA
**Work arrangement**: hybrid
**Experience**: mid
**Job type**: full-time
**Salary**: $25.09
**Category**: Insurance
**Industry**: Insurance

**Apply**: https://sedgwick.wd1.myworkdayjobs.com/en-US/Sedgwick/job/West-Hills-CA---Fallbrook/Disability-Representative_R75846?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/jobs/job_b0b8b287-434

## Description

By joining Sedgwick, you'll be part of a team that makes a meaningful difference in people's lives.

As a Disability Specialist, you will provide disability case management and routine claim determinations based on medical documentation and the applicable disability plan interpretation.

**Responsibilities:**

- Makes claim determinations, based on the information received, to approve routine disability claims or makes a recommendation to team lead to deny claims based on the disability plan.

- Reviews and analyzes routine medical information to determine if the claimant is disabled as defined by the disability plan.

- Utilizes clinical resources in case assessment.

- Determines benefits due, makes timely claims payments and adjustments.

- Informs claimants of documentation required to process claims, required time frames, payment information and claims status.

- Communicates with claimants' providers to set expectations regarding return to work.

- Medically manages routine disability claims ensuring compliance with duration control guidelines and plan provisions.

- Coordinates investigative efforts, thoroughly reviewing contested claims.

- Evaluates and arranges appropriate referral of claims to outside vendors.

- Negotiates return to work with or without job accommodations.

**Requirements:**

- High school diploma or GED required.

- Two (2) years of related experience or equivalent combination of education and experience required.

- One (1) year of office or customer service experience required.

- One (1) year of benefits or claims management experience preferred.

- Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices and Social Security application procedures.

- Excellent oral and written communication, including presentation skills.

- Proficient computer skills including working knowledge of Microsoft Office.

- Analytical, interpretive, and critical thinking skills.

- Strong organizational and multitasking skills.

- Ability to work in a team environment.

**What we offer:**

- A stable, consistent work environment , both in-office and virtual.

- A comprehensive training program to help you support employees and customers from some of the world's most respected brands.

- A dedicated mentor and manager to guide you every step of your career journey.

- Career development and promotional opportunities.

- A diverse, all-inclusive benefits package designed to support your mental, physical, financial, and professional well-being.

## Skills

### Required
- ERISA regulations
- disability duration and medical management practices
- Social Security application procedures
- Microsoft Office
- analytical skills
- communication skills
- organizational skills

### Nice to have
- benefits or claims management experience

---

Source: [Apply at sedgwick.wd1.myworkdayjobs.com](https://sedgwick.wd1.myworkdayjobs.com/en-US/Sedgwick/job/West-Hills-CA---Fallbrook/Disability-Representative_R75846?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)