Senior Disability Claims Specialist

Sedgwick Claims Management Services Ltd; Northern (KY); Hybrid; USD 32,000 - 33,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k and matching

PTO

Disability and life insurance

Employee assistance

FSA/HSA

Voluntary benefits

Job summary

Sedgwick Claims Management Services Ltd is seeking a Sr. Disability Representative to assess complex disability claims, review medical information, and determine benefits payable.

The role requires strong analytical skills and experience with ERISA regulations, as well as effective communication with claimants and providers. The position involves coordinating investigations, handling referrals to external vendors, and negotiating return-to-work arrangements while ensuring compliance with

Qualifications

• Education & Licensing: High School diploma or GED required; Bachelor's degree preferred; state licensing may be required.
• Experience: 3 years of benefits or disability case/claims management experience or equivalent.
• Skills & Knowledge: ERISA regulations, disability duration and medical management, excellent communication, and proficiency with Microsoft Office.

Responsibilities

• Makes independent claim determinations to approve complex disability claims.
• Reviews and analyzes complex medical information to determine disability status.
• Coordinates investigative efforts and negotiates return to work with or without accommodations.

Skills

ERISA knowledge

Disability claims experience

Analytical thinking

Communication skills

Microsoft Office

Education

Bachelor's degree preferred

Tools

Claim management system

Job description

Sedgwick Claims Management Services Ltd is seeking a Sr. Disability Representative to assess complex disability claims, review medical information, and determine benefits payable.

The role requires strong analytical skills and experience with ERISA regulations, as well as effective communication with claimants and providers. The position involves coordinating investigations, handling referrals to external vendors, and negotiating return-to-work arrangements while ensuring compliance with