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.
As a Disability Representative Sr, your primary purpose will be to provide disability case management and claim determinations based on complex medical documentation and the applicable disability plan interpretation.
Key Responsibilities:
- Analyze, approve, and authorize assigned claims and determine benefits due pursuant to a disability plan.
- Review and analyze complex medical information to determine if the claimant is disabled as defined by the disability plan.
- Utilize clinical resources in case assessment and communicate with claimants' providers to set expectations regarding return to work.
- Determine benefits due, make timely claims payments/approvals and adjustments, and medically manage disability claims.
- Coordinate investigative efforts, thoroughly review contested claims, negotiate return to work with or without job accommodations, and evaluate and arrange appropriate referral of claims to outside vendors.
Additional Responsibilities:
- Perform other duties as assigned and support the organization's quality program(s).
Requirements:
- Bachelor's degree from an accredited university or college preferred.
- Three (3) years of benefits or disability case/claims management experience or equivalent combination of education and experience required.
- Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices, and Social Security application procedures.
- Excellent oral and written communication, analytical and interpretive skills, and strong organizational skills.
Work Environment:
- Consideration will be given to reasonable accommodations.
- Physical demands include computer keyboarding and travel as required.
Benefits:
- 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.
Salary Range: $22.00 - $24.00 USD Hourly