Advocacy & Disability Claims Specialist

Sedgwick Claims Management Services Ltd; Dubuque (IA); On-site; USD 50,000 - 75,000; Full time

Job summary

Sedgwick is seeking an Advocacy Coordination Team Specialist in Dubuque, IA for a full-time role. You will actively research, resolve, and administer escalated inquiries across lines of business including FMLA, disability, and statutory claims, following regulatory guidelines and client requirements.

You will determine benefits, communicate clearly with claimants and clients, and ensure accurate processing with attention to documentation, payment adjustments, and quality standards.

Qualifications

• High school diploma or GED required.
• Bachelor's degree from an accredited college or university preferred.
• Three years of related experience or equivalent combination of experience and education; disability claims experience.
• Experience with HR systems preferred (SMART, SIR, GAIN).
• Knowledge of ERISA regulations, FMLA, ADAAA, Social Security procedures, offsets and deductions.
• Proficient in Microsoft Office and excellent communication skills.

Responsibilities

• Makes independent claim determinations to approve complex claims or recommends denial.
• Analyzes and authorizes leave, accommodation, disability and statutory claims; determines benefits.
• Enters and adjusts payments; supports payment research and resolution.
• Communicates with claimants and clients by phone, mail, or claims system.
• Facilitates claim resolution and aims for one-call resolution with stakeholders.
• Reviews medical information to determine disability and guides the claims process to completion.

Skills

ERISA knowledge

FMLA knowledge

Disability procedures

Analytical thinking

Communication skills

Microsoft Office

Education

High school diploma

Bachelor's degree preferred

Tools

SMART

SIR

GAIN

juris

viaOne express

mySedgwick

Job description

Sedgwick is seeking an Advocacy Coordination Team Specialist in Dubuque, IA for a full-time role. You will actively research, resolve, and administer escalated inquiries across lines of business including FMLA, disability, and statutory claims, following regulatory guidelines and client requirements.

You will determine benefits, communicate clearly with claimants and clients, and ensure accurate processing with attention to documentation, payment adjustments, and quality standards.