Senior Disability Claims Specialist

NADR; Cedar Rapids (IA); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Equal Opportunity Employer

Drug-Free Workplace

Job summary

Sedgwick is seeking a Sr Disability Representative to manage complex disability claims, reviewing medical documentation and applying disability plan interpretations. You will determine benefits, coordinate payments, and oversee ADA accommodations while engaging with claimants, providers, and internal teams.

Ideal candidates bring ERISA, FMLA, and medical terminology knowledge, plus strong communication and analytical skills.

Qualifications

• High School diploma or GED required; Bachelor’s degree preferred.
• Experience in benefits or disability case management is preferred.
• Knowledge of ERISA, FMLA, and disability management practices.
• Strong written and verbal communication skills; proficient with office software.

Responsibilities

• Makes independent claim determinations to approve complex disability claims or recommends denial.
• Reviews complex medical information to determine disability status.
• Oversees comorbidities, concurrent plans, and ADA accommodations in complex claims.
• Determines benefits due and processes timely payments/adjustments.
• Communicates with claimants and providers to set expectations and status.
• Coordinates referrals to outside vendors or physician reviews as needed.
• Negotiates return to work with or without accommodations.
• Maintains professional client relationships and adheres to quality standards.

Skills

ERISA knowledge

FMLA knowledge

Medical terminology

Communication

MS Office

Analytical thinking

Ambiguity management

Organization

Team player

Decision making

Negotiation

Education

High School diploma or GED

Bachelor’s degree preferred

Tools

Microsoft Office

Job description

Sedgwick is seeking a Sr Disability Representative to manage complex disability claims, reviewing medical documentation and applying disability plan interpretations. You will determine benefits, coordinate payments, and oversee ADA accommodations while engaging with claimants, providers, and internal teams.

Ideal candidates bring ERISA, FMLA, and medical terminology knowledge, plus strong communication and analytical skills.