Senior Disability Representative

Sedgwick

. Provides disability case management and complex claim determinations based on medical documentation and applicable disability plan interpretation .

Posted 10/26/2026full-timeChicago • Illinois • United StatesSenior💰 $23 - $32 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in disability case management, including complex claim determinations and medical documentation analysis. Proficient in ERISA regulations, FMLA compliance, and effective communication with claimants and providers.

Highest-signal resume keywords

Disability Case ManagementERISA Regulations KnowledgeFMLA Regulations KnowledgeAnalytical And Critical Thinking SkillsEffective Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Disability Claims ManagementMedical Documentation AnalysisBenefit DeterminationClaims ProcessingMedical Terminology KnowledgeDecision-Making SkillsNegotiation SkillsMultitasking SkillsPerformance Competencies ManagementStatutory Leaves Certification

Soft Skills

Organizational SkillsTeam CollaborationCustomer Service SkillsAbility To Manage AmbiguityPresentation Skills

Tools & Technologies

Microsoft Office

Certifications & Qualifications

State Certification In Statutory Leaves

Industry Keywords

Disability Plan InterpretationComorbidities ManagementADA AccommodationsSocial Security Application ProceduresFunctional Capability Evaluations

About the role

Key responsibilities & impact

Provides disability case management and complex claim determinations based on medical documentation and applicable disability plan interpretation
Determines benefits due and makes timely payments, approvals, and adjustments
Medically manages disability claims involving comorbidities, concurrent plans, complex ADA accommodations, and claims outside typical guidelines
Reviews and analyzes complex medical information to determine disability eligibility
Uses clinical resources in case assessment
Informs claimants about required documentation, time frames, payment information, and claim status
Communicates with claimants, providers, and clients regarding the claims process and return-to-work expectations
Coordinates investigative efforts and reviews contested claims
Arranges referrals to outside vendors and physician advisor reviews, surveillance, independent medical evaluations, and functional capability evaluations
Negotiates return to work with or without job accommodations
Refers cases for additional team lead and clinical case management review
Maintains professional client relationships and provides customer service
Meets organizational quality program requirements
Performs other duties as assigned

Requirements

What you’ll need

High School diploma or GED required
State certification or licensing in statutory leaves may be required based on state regulations
Three (3) years of benefits or disability case/claims management experience or equivalent combination of education and experience preferred
Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices, and Social Security application procedures
Knowledge of state and federal FMLA regulations
Working knowledge of medical terminology and duration management
Excellent oral and written communication, including presentation skills
Proficient computer skills including working knowledge of Microsoft Office
Analytical, interpretive, and critical thinking skills
Ability to manage ambiguity
Strong organizational and multitasking skills
Ability to work in a team environment
Ability to meet or exceed performance competencies as required by program
Effective decision-making and negotiation skills
Ability to exercise judgment autonomously within established procedures
Ability to sit at a desk for extended periods while operating a computer and phone system
Travel as required

Benefits

Comp & perks

Medical insurance
Dental insurance
Vision insurance
401(k) and matching
Paid time off (PTO)
Disability insurance
Life insurance
Employee assistance
Flexible spending account or health savings account
Additional voluntary benefits
Reasonable accommodations
Work-life balance
Career growth opportunities