Disability Claims Coordination Specialist

Sedgwick; Eden Prairie (MN); Vor Ort; USD 28.000 - 40.000; Vollzeit

Zusammenfassung

Sedgwick in Eden Prairie, Minnesota is seeking an Advocacy Coordination Team Specialist to perform disability claim determinations and coordinate routine approvals based on medical documentation and plan interpretation.

You will negotiate return to work, review medical information, and ensure timely payments while maintaining strong client relationships and complying with ERISA and FMLA guidelines.

Qualifikationen

• Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices.
• Knowledge of state and federal FMLA regulations.
• Working knowledge of medical terminology and duration management.
• Excellent oral and written communication, including presentation skills.
• Proficient with Microsoft Office and data handling.
• Analytical, interpretive and critical thinking skills.
• Strong organizational and multitasking abilities.

Aufgaben

• Makes claim determinations to approve routine disability claims or advises denial based on plan.
• Reviews routine medical information to determine disability status as defined by plan.
• Uses clinical resources for case assessment and duration guidelines.
• Determines benefits due, and processes payments and adjustments for disability offsets.
• Informs claimants of required documentation, time frames, and status via phone or claims system.
• Communicates with providers to set expectations regarding return to work.
• Medically manages routine disability claims in compliance with guidelines.
• Coordinates referrals to outside vendors or physician reviews as needed.
• Negotiates return to work with or without accommodations.
• Maintains quality program standards and professional client relationships.

Kenntnisse

ERISA regulations

FMLA regulations

Medical terminology

Communication skills

Microsoft Office

Analytical thinking

Teamwork

Decision making

Ausbildung

High school diploma or GED

Jobbeschreibung

Sedgwick in Eden Prairie, Minnesota is seeking an Advocacy Coordination Team Specialist to perform disability claim determinations and coordinate routine approvals based on medical documentation and plan interpretation.

You will negotiate return to work, review medical information, and ensure timely payments while maintaining strong client relationships and complying with ERISA and FMLA guidelines.