Advocacy & Claims Resolution Specialist

Sedgwick Claims Management Services Ltd; Indianapolis (IN); On-site; USD 22,000 - 32,000; Full time

Job summary

Sedgwick Claims Management Services Ltd in Indianapolis seeks an Advocacy Coordination Team Specialist to research, resolve, and administer escalated inquiries across lines of business, including FMLA, disability, and state leaves. You will review medical information, determine benefits, and communicate clearly with claimants and clients to move cases toward resolution.

The role requires strong knowledge of ERISA, FMLA and disability procedures, solid computer skills, and excellent verbal and

Qualifications

• Education & Licensing: High school diploma or GED required; Bachelor's degree preferred.
• Experience: 3 years of related experience; 2 years of disability claims experience.
• Knowledge: ERISA regs, FMLA, ADAAA, Social Security procedures, and disability procedures.
• Skills: Excellent communication, problem solving, and analytical abilities.

Responsibilities

• Make independent claim determinations for complex claims.
• Analyze and authorize leave, disability, and statutory claims.
• Enter and adjust payments; support payment research.
• Communicate with claimants and clients by phone, mail, or claims system.
• Facilitate claim resolution and handle escalated calls with stakeholders.
• Review complex medical information to determine disability status.

Skills

ERISA regulations

FMLA

ADAAA

Social Security procedures

Disability procedures

Medical terminology

Microsoft Office

Call handling

Interpersonal communication

Analytical thinking

Decision making

Ambiguity management

Education

High school diploma

Bachelor’s degree

Tools

SMART

SIR

GAIN

HR systems

TAMS

Juris

viaOne express

mySedgwick

Job description

Sedgwick Claims Management Services Ltd in Indianapolis seeks an Advocacy Coordination Team Specialist to research, resolve, and administer escalated inquiries across lines of business, including FMLA, disability, and state leaves. You will review medical information, determine benefits, and communicate clearly with claimants and clients to move cases toward resolution.

The role requires strong knowledge of ERISA, FMLA and disability procedures, solid computer skills, and excellent verbal and