Advocacy & Leaves Claims Specialist

Sedgwick; Chicago (IL); On-site; USD 30,000 - 32,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401k with match

Paid time off

Job summary

Sedgwick is seeking an Advocacy Coordination Team Specialist to actively research, resolve, and administer escalated inquiries for disability and leave claims. You will interpret complex regulations, coordinate with HR and client teams, and ensure accurate processing and timely payments.

You’ll analyze medical information, communicate clearly with claimants, and maintain documentation to support claims decisions.

Qualifications

• Three (3) years of related experience or equivalent combination of experience and education required to include two (2) years of disability claims experience.
• Experience with HR systems preferred such as Juris, viaOne express, and mySedgwick.

Responsibilities

• Makes independent claim determinations and approves complex claims or recommends denial.
• Analyzes and authorizes leave, accommodation, disability, and statutory claims.
• Enters and adjusts payments and supports payment research and resolution.
• Communicates clearly with claimants and clients regarding the claims process.
• Facilitates claim resolution and handles escalated calls with stakeholders.
• Ensures claims files are properly coded and documented.
• Reviews medical information to determine disability status and manage the claims process.
• Informs claimants of documentation, timelines, and status.

Skills

ERISA regulations

FMLA knowledge

Disability claims processing

Customer service

Analytical skills

Education

High school diploma or GED

Bachelor's degree preferred

Tools

SMART

SIR

GAIN

viaOne express

mySedgwick

Job description

Sedgwick is seeking an Advocacy Coordination Team Specialist to actively research, resolve, and administer escalated inquiries for disability and leave claims. You will interpret complex regulations, coordinate with HR and client teams, and ensure accurate processing and timely payments.

You’ll analyze medical information, communicate clearly with claimants, and maintain documentation to support claims decisions.