Senior Disability Claims Specialist (Hybrid)

NADR; Southfield (MI); Hybrid; USD 55,000 - 85,000; Full time

Job summary

Sedgwick is hiring for a Senior Disability Representative to manage complex disability claims. The role involves evaluating medical information, determining benefits, and coordinating return-to-work plans. You will partner with providers, clients, and internal teams to ensure compliant, timely decisions.

The position requires ERISA knowledge, strong communication, and the ability to handle high-priority cases in a hybrid work setting near Southfield, MI.

Qualifications

• Requires HS diploma or GED; bachelor's degree preferred.
• 3 years of benefits or disability claims experience or equivalent.
• Knowledge of ERISA regulations and FMLA.
• Strong communication and analytical skills.
• Ability to work in a team and manage multiple priorities.

Responsibilities

• Makes independent claim determinations on complex disability claims.
• Reviews complex medical information to determine disability status.
• Manages complex claims including comorbidities and accommodations.
• Coordinates with providers and external vendors for referrals.
• Negotiates return to work with or without accommodations.

Skills

ERISA knowledge

Disability claims

Negotiation

Medical terminology

Communication skills

Problem solving

Teamwork

MS Office

Education

High School diploma or GED

Bachelor's degree preferred

State certification/licensing for statutory leaves preferred

Tools

Microsoft Office

Claims software

Medical records systems

Job description

Sedgwick is hiring for a Senior Disability Representative to manage complex disability claims. The role involves evaluating medical information, determining benefits, and coordinating return-to-work plans. You will partner with providers, clients, and internal teams to ensure compliant, timely decisions.

The position requires ERISA knowledge, strong communication, and the ability to handle high-priority cases in a hybrid work setting near Southfield, MI.