Disability Claims & Case Manager

Sedgwick Claims Management Services Ltd; California (MO); Hybrid; USD 30,307 - 33,062; Full time

Benefits offered by this job

Hybrid work style

Medical insurance

Dental insurance

Vision insurance

401(k) and matching

Paid time off

Job summary

Sedgwick Claims Management Services Ltd is hiring a Disability Representative in West Hills, CA. You will evaluate medical information, determine disability benefits, and coordinate returns to work with employers and physicians.

The role emphasizes adherence to ERISA and FMLA regulations and requires strong communication skills. We offer a stable in-office and virtual hybrid work environment with comprehensive training, mentorship, and opportunities for growth, plus a benefits package that

Qualifications

• Knowledge of ERISA regulations, deductions, disability duration and medical management
• Knowledge of state and federal FMLA regulations
• Strong communication, both oral and written, with clients and claimants
• Proficiency with Microsoft Office and claims workflow systems
• Analytical, interpretive, and multitasking skills

Responsibilities

• Makes disability claim determinations and recommendations for approval/denial
• Reviews medical information to determine disability per plan
• Coordinate return-to-work with employer and physician
• Communicates with claimants, providers and clients throughout claims process
• Medically manages routine disability claims and ensures plan compliance
• Refer cases for external reviews or vendor input as needed
• Maintain quality program standards and professional client relationships

Skills

ERISA regulations

FMLA regulations

Medical terminology

Oral and written communication

Microsoft Office

Analytical thinking

Organization

Teamwork

Negotiation

Decision making

Education

High school diploma or GED

Tools

Microsoft Office Suite

Job description

Sedgwick Claims Management Services Ltd is hiring a Disability Representative in West Hills, CA. You will evaluate medical information, determine disability benefits, and coordinate returns to work with employers and physicians.

The role emphasizes adherence to ERISA and FMLA regulations and requires strong communication skills. We offer a stable in-office and virtual hybrid work environment with comprehensive training, mentorship, and opportunities for growth, plus a benefits package that