Disability Claims Specialist — Hybrid, Growth & Mentorship

NADR; Cedar Rapids (IA); Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Hybrid work model

Training program

Mentor guidance

Career development

Job summary

Sedgwick in Cedar Rapids, IA is hiring a Disability Representative to join a collaborative team in a hybrid work environment. This role focuses on disability case management, claims determinations, and ensuring timely payments while supporting employees and clients.

The ideal candidate has strong communication, knowledge of ERISA and FMLA, and the ability to coordinate with providers, vendors, and managers to drive positive outcomes and excellent service.

Qualifications

• High school diploma or GED required.
• Two years related experience; one year customer service.
• Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices and Social Security application procedures
• Excellent written and spoken communication; MS Office proficiency.

Responsibilities

• Makes claim determinations and approves routine disability claims or recommends denial based on the disability plan.
• Reviews routine medical information to determine disability per the plan.
• Determines benefits due and processes timely payments/adjustments.
• Informs claimants of required documentation, timelines, and status.
• Communicates with claimants' providers to set expectations on return to work.
• Medically manages routine disability claims ensuring compliance with duration guidelines.
• Communicates with claimant and client on all aspects of the claims process.
• Coordinates outside referrals and physician advisor reviews as needed.
• Negotiates return to work with or without accommodations.
• Meets quality program minimum requirements and provides excellent customer service.

Skills

ERISA regs

FMLA regs

Medical terminology

Communication skills

MS Office

Analytical thinking

Organizational skills

Team player

Decision making

Judgement

Education

High school diploma or GED

Tools

Microsoft Office Suite

Job description

Sedgwick in Cedar Rapids, IA is hiring a Disability Representative to join a collaborative team in a hybrid work environment. This role focuses on disability case management, claims determinations, and ensuring timely payments while supporting employees and clients.

The ideal candidate has strong communication, knowledge of ERISA and FMLA, and the ability to coordinate with providers, vendors, and managers to drive positive outcomes and excellent service.