Senior Disability Claims Specialist

Sedgwick; Eden Prairie (MN); Hybrid; USD 29,000 - 34,000; Full time

Benefits offered by this job

Hybrid work model

On-site collaboration

Job summary

Sedgwick in Eden Prairie, MN is seeking a Sr Disability Representative to manage complex disability claims from medical documentation to plan interpretation. You will determine benefits due, coordinate with providers, and ensure timely payments with a focus on return-to-work strategies.

Requirements include a high school diploma or GED (Bachelor's preferred) and at least 3 years of disability claims experience.

Qualifications

• High School diploma or GED required; Bachelor's degree preferred.
• Three years of benefits or disability case/claims management experience.
• Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management.

Responsibilities

• Makes independent claim determinations to approve complex disability claims or recommends denial.
• Reviews complex medical information to determine disability per plan.
• Oversees comorbidities, concurrent plans, and ADA accommodations.
• Determines benefits due and ensures timely payments/adjustments.
• Communicates documentation needs and claim status to claimants.
• Coordinates return-to-work discussions with providers and employers.
• Maintains professional client relationships and meets quality requirements.

Skills

ERISA knowledge

FMLA knowledge

Disability duration management

Communication skills

Analytical skills

Negotiation skills

Team oriented

Education

High School diploma or GED

Bachelor's degree preferred

Job description

Sedgwick in Eden Prairie, MN is seeking a Sr Disability Representative to manage complex disability claims from medical documentation to plan interpretation. You will determine benefits due, coordinate with providers, and ensure timely payments with a focus on return-to-work strategies.

Requirements include a high school diploma or GED (Bachelor's preferred) and at least 3 years of disability claims experience.