# Advocacy Coordination Team Specialist **Company**: Sedgwick **Location**: Dubuque, IA **Experience**: senior **Job type**: full-time **Category**: Human Resources **Industry**: Insurance **Apply**: https://sedgwick.wd1.myworkdayjobs.com/en-US/Sedgwick/job/Dubuque-IA/Advocacy-Coordination-Team-Specialist_R79819?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply **Canonical**: https://yubhub.co/jobs/job_e3904caa-306 ## 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 an Advocacy Coordination Team Specialist, you will actively research, resolve, and administer escalated inquiries for all lines of business, including Family Medical Leave (FMLA), complex paid and unpaid state, military, and company-specific leaves, accommodations, disability, and statutory claims. You will provide excellent customer service, displaying care and empathy to callers regarding claims, and execute technical and jurisdictional requirements for accurate claims processing, benefit review, and interpretation of regulations. **Responsibilities:** - Make independent claim determinations, based on the information received, to approve complex claims or make a recommendation to team lead to deny claims based on the requirements. - Analyze and authorize leave, accommodation, disability, and statutory claims, and determine benefits due pursuant to client plans, and state and federal regulations. - Enter and adjust payments, and evaluate file interface to support payment research and resolution. - Communicate clearly and professionally with claimants and clients on all aspects of the claims process. - Facilitate claim resolution and handle escalated calls with claimants, human resources managers, treating physicians' offices, clients, or others with a goal of one-call resolution. - Ensure claims files are coded correctly and that adequate documentation is in the claim. - Review and analyze complex medical information to determine if the claimant is disabled as defined by the disability plan. - Inform claimants and clients of documentation required to process claims, required timeframes, payment information, and claims status. - Determine benefits due, make timely and accurate claims payments/approvals, and adjustments for workers' compensation, Social Security Disability Income (SSDI), and other disability offsets. - Maintain professional client relationships and adhere to client-specific requirements. **Qualifications:** - High school diploma or GED required; Bachelor's degree from an accredited college or university preferred. - Three (3) years of related experience or equivalent combination of experience and education required, including two (2) years of disability claims experience. - Knowledge of ERISA regulations, state and federal FMLA, ADAAA, Social Security application procedures, required offsets and deductions, and disability procedures. - Working knowledge of medical terminology and duration management. - Proficient computer skills, including working knowledge of Microsoft Office. - Exemplary call handling and de-escalation skills. - Excellent interpersonal communication skills, oral and written. - Analytical, interpretive, and critical thinking skills. - Effective decision-making. - Ability to manage ambiguity. - Strong organizational and multitasking skills. - Ability to exercise judgment autonomously within established procedures. - Ability to work in a team environment. **Work Environment:** - Required to adhere to a set schedule with established break times. - Ability to sit at a desk for extended periods while operating a computer and phone system. - Travel as required. ## Skills ### Required - ERISA regulations - FMLA - ADAAA - Social Security application procedures - disability procedures - medical terminology - Microsoft Office - call handling - de-escalation skills - interpersonal communication skills - analytical skills - critical thinking skills - decision-making - organizational skills - multitasking skills ### Nice to have - SMART - SIR - GAIN - TAMS - Juris - viaOne express - mySedgwick --- Source: [Apply at sedgwick.wd1.myworkdayjobs.com](https://sedgwick.wd1.myworkdayjobs.com/en-US/Sedgwick/job/Dubuque-IA/Advocacy-Coordination-Team-Specialist_R79819?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)