Senior Disability Claims Specialist

Sedgwick Claims Management Services Ltd; United States; A distancia; USD 29.000 - 33.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical benefits

Dental benefits

Vision benefits

401k and matching

PTO

Descripción de la vacante

Sedgwick Claims Management Services Ltd. is seeking a Disability Representative Sr to manage complex disability claims and perform determinations based on medical documentation and plan interpretation.

You will coordinate with clinicians, claimants, and clients to ensure timely payments and appropriate accommodations. The role requires strong knowledge of ERISA, disability duration guidelines, and ability to navigate conflicting medical information while maintaining high service levels and

Formación

• High School diploma or GED required; Bachelor's preferred in related field.
• Knowledge of ERISA regulations, disability duration practices, and Social Security procedures is essential.
• Strong communication, negotiation, and analytical skills with ability to manage complex claims.

Responsabilidades

• Make independent claim determinations to approve complex disability claims or recommend denial per plan.
• Review complex medical information to determine disability under the plan definitions.
• Coordinate with providers and claimants; ensure timely payments and accurate adjustments.

Conocimientos

ERISA regulations

Disability duration knowledge

Communication skills

Negotiation skills

Microsoft Office

Analytical thinking

Educación

High School diploma or GED

Bachelor's degree preferred

Herramientas

Microsoft Office

Claims processing systems

Descripción del empleo

Sedgwick Claims Management Services Ltd. is seeking a Disability Representative Sr to manage complex disability claims and perform determinations based on medical documentation and plan interpretation.

You will coordinate with clinicians, claimants, and clients to ensure timely payments and appropriate accommodations. The role requires strong knowledge of ERISA, disability duration guidelines, and ability to navigate conflicting medical information while maintaining high service levels and