Senior Disability Representative

Sedgwick

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

Posted 9/17/2026full-timeCedar Rapids • Florida • United StatesSenior💰 $23 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in disability case management, including complex claim determinations and compliance with ERISA and FMLA regulations. Proficient in analyzing medical documentation and managing relationships with claimants, clients, and providers to ensure effective communication and timely claims processing.

Highest-signal resume keywords

Disability Case ManagementERISA RegulationsFMLA RegulationsMedical TerminologyAnalytical Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ManagementMedical Documentation AnalysisBenefits DeterminationDuration ManagementNegotiation Skills

Soft Skills

Excellent CommunicationOrganizational SkillsMultitasking SkillsDecision-Making SkillsTeam Collaboration

Tools & Technologies

Microsoft Office

Certifications & Qualifications

State Certification in Statutory Leaves

Industry Keywords

Disability ClaimsWorkers CompensationSSDIADA AccommodationsClaims Process

About the role

Key responsibilities & impact

Provide disability case management and complex claim determinations based on medical documentation and disability plan interpretation
Determine benefits due and make timely payments, approvals, and adjustments for workers compensation, SSDI, and other disability offsets
Review and analyze complex medical information to determine disability under the applicable plan
Oversee complex claims involving comorbidities, concurrent plans, complex ADA accommodations, and claims outside typical guidelines
Utilize clinical resources in case assessment
Inform claimants about required documentation, time frames, payment information, and claims status
Communicate with claimants, clients, and providers regarding the claims process and return-to-work expectations
Medically manage complex disability claims in compliance with duration control guidelines and plan provisions
Coordinate investigations and thoroughly review contested claims
Evaluate and arrange referrals to outside vendors, physician advisors, surveillance, independent medical evaluations, and functional capability evaluations
Negotiate return to work with or without accommodations through the claimant’s physician and employer
Refer cases for additional review when appropriate
Maintain professional client relationships and provide excellent customer service
Meet the organization’s quality program minimum requirements
Perform 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 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 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 program
Flexible spending account or health savings account
Other additional voluntary benefits
Reasonable accommodations
Hybrid work arrangement
Work-life balance
Career growth opportunities