Senior Disability Claims Specialist

Sedgwick Claims Management Services Ltd; Eden Prairie (MN); Hybrid; USD 34,000 - 44,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401k with company match

Paid time off

Disability insurance

Job summary

Sedgwick is seeking a Disability Representative Sr in Eden Prairie, MN to provide disability case management and determine benefits under complex medical documentation and disability plan interpretation.

You will review medical information, coordinate with providers, negotiate return-to-work accommodations, ensure timely payments, and collaborate with claims teams to support accurate, compliant resolutions.

This role requires strong communication, ERISA knowledge, and careful attention to detail.

Qualifications

• Knowledge of ERISA regulations, required offsets and deductions.
• Working knowledge of medical terminology and duration management.
• Excellent oral and written communication, including presentations.
• Proficient in Microsoft Office and standard PC use.
• Strong analytical and interpretive abilities for claims review.
• Organized with the ability to manage multiple priorities.
• Collaborative team player with client-focused mindset.
• Excellent negotiation skills for return-to-work discussions.
• Ability to meet performance expectations and competencies.

Responsibilities

• Analyze, approve and authorize assigned claims and benefits.
• Review complex medical information to determine disability status.
• Coordinate with clinicians and resources for case assessments.
• Communicate with providers to set return-to-work expectations.
• Ensure timely payments and adjustments for various disability offsets.
• Manage claims in accordance with duration guidelines and plan provisions.
• Inform claimants of required documentation and status updates.
• Coordinate referrals to outside vendors or physician reviews.
• Negotiate return-to-work accommodations with physicians and employers.
• Maintain professional client relationships and team collaboration.

Skills

ERISA regulations

Medical terminology

Oral and written communication

PC literate

Analytical skills

Organizational skills

Team environment

Negotiation skills

Performance competencies

Education

Bachelor's degree

Job description

Sedgwick is seeking a Disability Representative Sr in Eden Prairie, MN to provide disability case management and determine benefits under complex medical documentation and disability plan interpretation.

You will review medical information, coordinate with providers, negotiate return-to-work accommodations, ensure timely payments, and collaborate with claims teams to support accurate, compliant resolutions.

This role requires strong communication, ERISA knowledge, and careful attention to detail.