Description
By joining Sedgwick, you'll be part of a team that makes a meaningful difference in people's lives.
As a Disability Representative, your primary purpose will be to provide disability case management and routine claim determinations based on medical documentation and applicable disability plan interpretations.
Responsibilities:
- Make claim determinations, approve routine disability claims, and recommend denials based on disability plans
- Review and analyze medical information to determine if claimants are disabled as defined by the disability plan
- Utilize clinical resources in case assessments and make timely claims payments and adjustments
- Communicate with claimants, providers, and clients regarding claims processes and status
- Medically manage routine disability claims, ensure compliance with duration control guidelines and plan provisions
- Coordinate investigative efforts, review contested claims, and negotiate return-to-work arrangements
- Evaluate and arrange referrals of claims to outside vendors or physician advisors
Requirements:
- High school diploma or GED required; state certification or licensing in statutory leaves preferred
- Two years of related experience or equivalent combination of education and experience required
- One year of office or customer service experience required; one year of benefits or claims management experience preferred
- Knowledge of ERISA regulations, disability duration and medical management practices, and Social Security application procedures
- Excellent oral and written communication, analytical, interpretive, and critical thinking skills
- Proficient computer skills, including Microsoft Office
What we offer:
- Stable, consistent work environment
- $21.82 per hour
- Comprehensive training program
- Dedicated mentor and manager
- Career development and promotional opportunities
- Diverse, all-inclusive benefits package