Disability Representative Sr
On-site · Coralville, Iowa, United States
Job Summary
Disability Representative Sr responsible for disability case management and complex claim determinations based on medical documentation and plan interpretation, including determining benefits due and making timely payments/adjustments; manages complex claims with comorbidities and ADA accommodations, coordinates investigations, negotiates return-to-work with or without accommodations, and coordinates referrals to outside vendors or physician advisors. Responsible for reviewing medical information to determine disability status, ensuring compliance with duration guidelines and plan provisions, communicating with claimants and providers, and maintaining professional client relationships. Travel as required. Sedgwick is an Equal Opportunity Employer and emphasizes a diverse, equitable workplace.
Required Qualifications
- High School diploma or GED required; Bachelor's degree preferred
- Three (3) years of benefits or disability case/claims management experience or equivalent combination of education and experience preferred
- Knowledge of ERISA regulations, disability duration and medical management practices, and Social Security procedures
- Working knowledge of FMLA regulations; medical terminology
- Excellent oral and written communication; strong negotiation and analytical skills
- Ability to manage ambiguity; strong organizational and multitasking skills
- Ability to work in a team environment; ability to meet performance competencies
- Proficiency with Microsoft Office; autonomous judgment within procedures
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