Strategic Advocacy Claims Specialist

Sedgwick; Irving (TX); On-site; USD 54,000 - 74,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401k with match

PTO

Disability insurance

Life insurance

Employee assistance

Job summary

Sedgwick is seeking an Advocacy Coordination Team Specialist to actively research, resolve, and administer escalated inquiries for FMLA, disability, and related leaves across lines of business. You will review medical information, determine benefits due, and ensure accurate claims processing within regulatory guidelines. The role requires 3 years of related experience (2 in disability claims) and strong communication, analytical, and multitasking skills.

The schedule is 11:00 a.m. – 7:00 p.m.

Qualifications

• High school diploma or GED required.
• Bachelor’s degree from an accredited college or university preferred.
• Three years of related experience with two years in disability claims.
• Experience with HR systems such as SMART, SIR, GAIN or similar preferred.
• Internal candidates benefit from familiarity with TAMS, Juris, viaOne express, and mySedgwick.

Responsibilities

• Researches, resolves, and administers escalated inquiries for all leaves and disability claims.
• Determines benefits due and processes payments and approvals.
• Communicates clearly with claimants and clients via phone, email, or claims system.
• Maintains documentation and ensures accuracy in claims processing and regulatory compliance.
• Works to achieve one-call resolution and adheres to client requirements and SLAs.

Skills

ERISA regulations

FMLA knowledge

Disability procedures

Medical terminology

Microsoft Office

Call handling

Interpersonal communication

Analytical thinking

Education

High school diploma or GED

Bachelor’s degree preferred

Tools

SMART

SIR

GAIN

mySedgwick

Job description

Sedgwick is seeking an Advocacy Coordination Team Specialist to actively research, resolve, and administer escalated inquiries for FMLA, disability, and related leaves across lines of business. You will review medical information, determine benefits due, and ensure accurate claims processing within regulatory guidelines. The role requires 3 years of related experience (2 in disability claims) and strong communication, analytical, and multitasking skills.

The schedule is 11:00 a.m. – 7:00 p.m.