Senior Disability Claims Specialist - Hybrid

NADR; Irving (TX); Hybrid; USD 32,000 - 34,000; Full time

Job summary

Sedgwick is seeking a Disability Representative Sr in Irving, TX with hybrid work arrangements. You will manage disability claims using medical documentation and plan interpretation, determine benefits due, and coordinate investigations.

You’ll handle complex scenarios, including ADA accommodations, and ensure timely payments and referrals. Required knowledge includes ERISA, FMLA, and medical terminology, plus strong communication and analytical skills to maintain client relationships and meet

Qualifications

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

Responsibilities

• Makes independent claim determinations to approve complex disability claims.
• Reviews complex medical information to determine disability status.
• Oversees comorbidities, concurrent plans, and complex ADA accommodations.
• Coordinates investigative efforts and reviews contested claims.
• Negotiates return to work with or without job accommodations.

Skills

ERISA regulations

FMLA regulations

Medical terminology

Analytical thinking

Team collaboration

Decision making

Negotiation skills

Judgement under procedures

Education

High School diploma or GED

Bachelor's degree preferred

Tools

Microsoft Office

Job description

Sedgwick is seeking a Disability Representative Sr in Irving, TX with hybrid work arrangements. You will manage disability claims using medical documentation and plan interpretation, determine benefits due, and coordinate investigations.

You’ll handle complex scenarios, including ADA accommodations, and ensure timely payments and referrals. Required knowledge includes ERISA, FMLA, and medical terminology, plus strong communication and analytical skills to maintain client relationships and meet