Senior Disability Representative

Sedgwick

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

Posted 9/18/2026full-timeChicago • Illinois • United StatesSenior💰 $23 - $25 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

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 KnowledgeAnalytical and Critical Thinking SkillsEffective Communication SkillsDecision-Making and Negotiation Skills

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Disability Claims ManagementMedical Documentation AnalysisBenefits DeterminationWorkers Compensation KnowledgeSocial Security Application ProceduresMedical TerminologyDuration ManagementMicrosoft Office ProficiencyClaims Investigation CoordinationComplex ADA Accommodations

Soft Skills

Organizational SkillsMultitasking AbilitiesTeam CollaborationCustomer Service OrientationJudgment and Autonomy

Certifications & Qualifications

State Certification in Statutory Leaves

Industry Keywords

FMLA RegulationsDisability Duration ManagementClaim Status CommunicationReturn-to-Work NegotiationQuality Program Requirements

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, including comorbidities, concurrent plans, and complex ADA accommodations
Makes independent determinations to approve complex disability claims or recommends denial to the team lead
Reviews and analyzes complex medical information to determine whether claimants are disabled under the disability plan
Oversees complex claims outside typical guidelines
Uses appropriate clinical resources in case assessment
Determines benefits for workers compensation, SSDI, and other disability offsets
Informs claimants about required documentation, time frames, payment information, and claim status
Communicates with claimant providers regarding return-to-work expectations
Ensures compliance with duration control guidelines and plan provisions
Communicates with claimants and clients throughout the claims process
Coordinates investigations and reviews contested claims
Refers claims for vendor services, physician advisor reviews, surveillance, independent medical evaluations, and functional capability evaluations
Negotiates return to work with or without accommodations through the claimant’s physician and employer
Refers cases to team lead and clinical case management when appropriate
Maintains professional client relationships and provides customer service
Meets quality program minimum requirements
Performs other duties as assigned

Requirements

What you’ll need

High School diploma or GED required
Bachelor's degree from an accredited university or college preferred
State certification or licensing in statutory leaves is preferred or 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 judgement 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
PTO
Disability insurance
Life insurance
Employee assistance
Flexible spending or health savings account
Other additional voluntary benefits
Reasonable accommodations
Work-life balance