Senior Disability Claims Specialist - Bilingual (French)

Sedgwick; Orlando (FL); On-site; USD 70,000 - 90,000; Full time

Job summary

Sedgwick in Orlando, FL seeks a Senior Disability Representative who is fluent in French to manage complex disability claims. You will assess medical documentation, determine benefits due, and ensure timely payments and adjustments.

You will coordinate with providers, negotiate return-to-work, and refer cases for outside review when needed, while upholding ERISA and FMLA requirements. A strong communicator with a collaborative mindset thrives here.

Qualifications

• Three years of benefits or disability case/claims management experience.
• Knowledge of ERISA, FMLA, and disability duration practices.
• Excellent written and verbal communication.
• Proficient with MS Office and computer systems.
• Ability to manage multiple priorities and work in a team.
• Bilingual in English and French is a plus.

Responsibilities

• Makes independent claim determinations to approve complex disability claims or recommends denial.
• Reviews complex medical information to determine disability status per plan.
• Oversees comorbidities, ADA accommodations, and referrals to vendors/physician reviews.
• Negotiates return to work with or without accommodations with providers and employers.
• Explains required documentation, timeframes, and payment details to claimants.
• Maintains professional client relationships and ensures quality service.
• Supports adherence to ERISA, FMLA, and other regulations.
• Participates in qualification for program quality standards.

Skills

Disability claims

ERISA knowledge

Complex case management

Communication skills

Negotiation

Legal/regulatory compliance

Bilingual French

Education

High School Diploma or GED

Bachelor's degree preferred

State licensing preferred

Job description

Sedgwick in Orlando, FL seeks a Senior Disability Representative who is fluent in French to manage complex disability claims. You will assess medical documentation, determine benefits due, and ensure timely payments and adjustments.

You will coordinate with providers, negotiate return-to-work, and refer cases for outside review when needed, while upholding ERISA and FMLA requirements. A strong communicator with a collaborative mindset thrives here.