Senior Disability Claims Specialist

Sedgwick; Chicago (IL); On-site; USD 31,000 - 33,000; Full time

Benefits offered by this job

Medical, dental, vision

401k and matching

PTO

Disability and life insurance

Employee assistance

Job summary

Sedgwick in Chicago, IL is seeking a Senior Disability Representative to provide disability case management and complex claim determinations based on medical documentation and plan interpretation. You will determine benefits, coordinate investigations, and negotiate return-to-work with accommodations, ensuring timely payments and adherence to plan provisions.

The role requires reviewing medical information, managing complex claims, and delivering excellent customer service within a supportive,

Qualifications

• High School diploma or GED required; Bachelor's degree preferred.
• 3 years of benefits or disability case/claims management experience.
• Knowledge of ERISA regulations, FMLA regulations and medical terminology.
• Strong communication, MS Office proficiency, and analytical skills.

Responsibilities

• Makes independent determinations to approve complex disability claims or recommends denial.
• Reviews complex medical information to determine disability status per plan.
• Coordinates investigations, referrals to vendors, and independent reviews.
• Negotiates return to work with or without accommodations via physician and employer.

Skills

ERISA knowledge

FMLA knowledge

Medical terminology

Communication skills

MS Office

Analytical thinking

Teamwork

Decision making

Negotiation

Education

Bachelor's degree

High School diploma or GED

Certification/licensing in statutory leaves

Job description

Sedgwick in Chicago, IL is seeking a Senior Disability Representative to provide disability case management and complex claim determinations based on medical documentation and plan interpretation. You will determine benefits, coordinate investigations, and negotiate return-to-work with accommodations, ensuring timely payments and adherence to plan provisions.

The role requires reviewing medical information, managing complex claims, and delivering excellent customer service within a supportive,