Hybrid Disability Claims Specialist

Sedgwick; Dubuque (IA); Hybrid; USD 45,000 - 60,000; Full time

Benefits offered by this job

Structured training program

Mentor and manager guidance

Career development opportunities

Comprehensive benefits package

Job summary

Sedgwick in Dubuque, IA is seeking a Disability Representative to provide disability case management and routine claim determinations based on medical documentation and plan interpretation. You will coordinate benefits, make timely payments, and negotiate return-to-work with employers and physicians in a hybrid work environment near Dubuque.

The role emphasizes accurate claims processing, strong communication with claimants and providers, and adherence to ERISA and FMLA guidelines, while

Qualifications

• 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

Responsibilities

• Makes claim determinations and recommends denial or approval based on disability plan
• Reviews medical information and consults with a nurse to determine disability status
• Determines benefits due and processes timely payments and adjustments
• Negotiates return to work with or without accommodations with claimant’s physician and employer

Skills

ERISA knowledge

FMLA regulations

Medical terminology

Communication skills

Microsoft Office

Analytical thinking

Team oriented

Decision making

Judgement under supervision

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Sedgwick in Dubuque, IA is seeking a Disability Representative to provide disability case management and routine claim determinations based on medical documentation and plan interpretation. You will coordinate benefits, make timely payments, and negotiate return-to-work with employers and physicians in a hybrid work environment near Dubuque.

The role emphasizes accurate claims processing, strong communication with claimants and providers, and adherence to ERISA and FMLA guidelines, while