Disability Claims Navigator — Hybrid, Impactful Care

Sedgwick; Los Angeles (CA); Hybrid; USD 34,000 - 41,000; Full time

Benefits offered by this job

Stable environment

Training program

Mentor support

Career development

Benefits package

Job summary

Sedgwick seeks a Disability Specialist/Disability Representative in the Los Angeles area (West Hills). The role focuses on disability case management, reviewing medical documentation, and determining benefits due under the applicable plans.

You will work with a dedicated team to support employees and customers, ensuring compliant claim handling and timely decisions, with a strong emphasis on customer service and professional communication.

Qualifications

• High school diploma or GED required.
• Two years of related experience or equivalent combination of education and experience required.
• One year of office or customer service experience required.
• One year of benefits or claims management experience preferred.

Responsibilities

• Makes claim determinations to approve routine disability claims or recommends denial based on the plan.
• Reviews medical information to determine disability status per the plan.
• Determines benefits due and processes timely payments and adjustments.
• Communicates with claimants and providers to set expectations and next steps.
• Coordinates referrals to outside vendors or physician advisors as needed.
• Negotiates return to work with or without accommodations.

Skills

ERISA regulations

FMLA regulations

Medical terminology

Communication

Microsoft Office

Analytical thinking

Teamwork

Decision making

Judgment under supervision

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Sedgwick seeks a Disability Specialist/Disability Representative in the Los Angeles area (West Hills). The role focuses on disability case management, reviewing medical documentation, and determining benefits due under the applicable plans.

You will work with a dedicated team to support employees and customers, ensuring compliant claim handling and timely decisions, with a strong emphasis on customer service and professional communication.