Senior Disability Claims Strategist

Sedgwick; Los Angeles (CA); In loco; USD 36.000 - 39.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical benefits

Dental benefits

Vision benefits

401k with company match

PTO

Disability insurance

Life insurance

Employee assistance

HSA/FSA

Descrizione del lavoro

Sedgwick is seeking a Sr. Disability Representative in Los Angeles to manage complex disability claims, review medical documentation, determine benefits, and coordinate return-to-work plans with physicians and employers.

You will apply ERISA rules and ADA accommodations while maintaining high-quality service for claimants and clients. Required 3 years of disability benefits experience, strong analytical and communication skills, and a Bachelor's degree (or higher).

Competenze

• Knowledge of ERISA regulations, offsets and deductions
• Knowledge of state and federal FMLA regulations
• Proficiency in medical terminology and duration management
• Excellent oral and written communication skills
• Analytical and critical thinking abilities

Mansioni

• Makes independent claim determinations on complex disability claims or recommends denial
• Reviews complex medical information to determine disability under plan rules
• Manages complex claims including comorbidities and ADA accommodations
• Coordinates return-to-work with physicians and employers
• Determines benefits and processes timely payments/adjustments
• Communicates required documentation and claims status to claimants
• Interacts with providers to set expectations for return to work
• Ensures compliance with duration guidelines and plan provisions
• Refers cases for outside reviews when needed
• Maintains client relationships and delivers quality service

Conoscenze

ERISA knowledge

FMLA knowledge

Medical terminology

Communication skills

Microsoft Office

Analytical thinking

Decision making

Negotiation

Autonomy

Teamwork

Formazione

Bachelor's degree preferred

State certification/licensing in statutory leaves preferred

Strumenti

Microsoft Office

Descrizione del lavoro

Sedgwick is seeking a Sr. Disability Representative in Los Angeles to manage complex disability claims, review medical documentation, determine benefits, and coordinate return-to-work plans with physicians and employers.

You will apply ERISA rules and ADA accommodations while maintaining high-quality service for claimants and clients. Required 3 years of disability benefits experience, strong analytical and communication skills, and a Bachelor's degree (or higher).