Disability Representative Sr

Search Filters Location Time Type Job Category More Search for Jobs page is loaded 521 JOBS FOUND Jump to selected job details CAT Repair Solution Site Auto Appraiser locations US Telecommuter posted on Posted 11 Days Ago R69518 Perfil técnico para el Área de Marítimo y Transportes (Murcia) locations 6 Locations posted on Posted 30 Days Ago R71231 Especialistas en Medioambiente

• Barcelona y Madrid locations 2 Locations posted on Posted 30+ Days Ago R71196 Surety Bond Desk Adjuster locations Telecommuter TX posted on Posted 30+ Days Ago R70864 Property Desk Adjuster
• Dallas, TX. locations 2 Locations posted on Posted 30+ Days Ago R70712 Commercial Property Claims Desk Adjuster
• Remote after training locations 2 Locations posted on Posted 30+ Days Ago R70705 Rec Marine Adjuster locations 4 Locations posted on Posted 30+ Days Ago R70708 Property Adjuster
• Sheffield/Lincoln locations Lincoln posted on Posted 30+ Days Ago R66246 Junior Claims Handler Multibranche locations Hoogeveen posted on Posted Today R70678 Rekenkundig Expert locations 2 Locations posted on Posted Today R65324 Patient Care Coordinator locations Telecommuter FL posted on Posted Yesterday R72233 Claims Examiner
• General Liability
• Public Entity Exp. Required locations 2 Locations posted on Posted Yesterday R72236 Claims Representative
• Workers Compensation |

Jurisdiction:

IL, IN, KS, MI, MO, NE, WI and MN |

Licensing:

Required locations Telecommuter MI posted on Posted Yesterday R72142 Case Coordinator locations Telecommuter OH posted on Posted Yesterday R72241 Workers Compensation Claims Examiner |

NJ, PA, VA, DE

Jurisdictions locations Marlton, NJ posted on Posted Yesterday

R71032 VP

Strategic Project Manager locations 30 Locations posted on Posted Yesterday R72077 Future Medical Claims Adjuster locations Concord, CA posted on Posted Yesterday R69197 Service Center Representative

• Summer Student locations CAN-Telecommute-ON posted on Posted Yesterday R72229 Service Center Representative
• Summer Student locations CAN-Telecommute-ON posted on Posted Yesterday R72230 Service Center Representative
• Summer Student locations CAN-Telecommute-ON posted on Posted Yesterday

R72231 1 2 3 4 5 1

• 20 of 521 jobs Return to selected search result Disability Representative Sr Apply locations Dublin, OH posted on Posted 2 Days Ago job requisition id R70601 By joining Sedgwick, you'll be part of something truly meaningful.

It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Disability Representative Sr Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:

Dublin, OH :

5500 Glendon Court Dublin

OH 43016 PRIMARY PURPOSE

: Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation including determining benefits due and making timely payments/approvals and adjustments, medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations; coordinates investigative efforts, thoroughly reviews contested claims, negotiates return to work with or without job accommodations, and evaluates and arranges appropriate referral of claims to outside vendors.

ESSENTIAL

FUNCTIONS and

RESPONSIBILITIES

Makes independent claim determinations, based on the information received, to approve complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan. Reviews and analyzes complex medical information (i.e. attending physician statements, office notes, operative reports, etc.) to determine if the claimant is disabled as defined by the disability plan. Oversees additional facets of complex claims including but not limited to comorbidities, concurrent plans, complex ADA accommodations, and claims outside of typical guidelines. Utilizes the appropriate clinical resources in case assessment (i.e. duration guidelines, in-house clinicians), as needed. Determines benefits due pursuant to a disability plan, makes timely claims payments/approvals and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets. Informs claimants of documentation required to process claims, required time frames, payment information and claims status by phone, written correspondence and/or claims system. Communicates with the claimants' providers to set expectations regarding return to work. Medically manages complex disability claims ensuring compliance with duration control guidelines and plan provisions. Communicates clearly and timely with claimant and client on all aspects of claims process by phone, written correspondence and/or claims system. Coordinates investigative efforts ensuring appropriateness; provides thorough review of contested claims. Evaluates and arranges appropriate referral of claims to outside vendors or physician advisor reviews, surveillance, independent medical evaluation, functional capability evaluation, and/or related disability activities. Negotiates return to work with or without job accommodations via the claimant's physician and employer. Refers cases to team lead and clinical case management for additional review when appropriate. Maintains professional client relationships and provides excellent customer service. Meets the organization's quality program(s) minimum requirements.

ADDITIONAL

FUNCTIONS and

RESPONSIBILITIES

Performs other duties as assigned.

QUALIFICATIONS

Education & Licensing 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. Experience Three (3) years of benefits or disability case/claims management experience or equivalent combination of education and experience preferred. Skills & Knowledge 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

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental :

Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical :

Ability to sit at a desk for extended periods while operating a computer and phone system. Travel as required.

Auditory/Visual :

Hearing, vision and talking The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $ 23.00 USD Hourly . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles. Similar Jobs (1) Disability Representative Sr locations Dublin, OH posted on Posted 2 Days Ago About Us Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see sedgwick.com Read More Search Filters Location Time Type Job Category More Search for Jobs page is loaded 521 JOBS FOUND Jump to selected job details CAT Repair Solution Site Auto Appraiser locations US Telecommuter posted on Posted 11 Days Ago R69518 Perfil técnico para el Área de Marítimo y Transportes (Murcia) locations 6 Locations posted on Posted 30 Days Ago R71231 Especialistas en Medioambiente

• Barcelona y Madrid locations 2 Locations posted on Posted 30+ Days Ago R71196 Surety Bond Desk Adjuster locations Telecommuter TX posted on Posted 30+ Days Ago R70864 Property Desk Adjuster
• Dallas, TX. locations 2 Locations posted on Posted 30+ Days Ago R70712 Commercial Property Claims Desk Adjuster
• Remote after training locations 2 Locations posted on Posted 30+ Days Ago R70705 Rec Marine Adjuster locations 4 Locations posted on Posted 30+ Days Ago R70708 Property Adjuster
• Sheffield/Lincoln locations Lincoln posted on Posted 30+ Days Ago R66246 Junior Claims Handler Multibranche locations Hoogeveen posted on Posted Today R70678 Rekenkundig Expert locations 2 Locations posted on Posted Today R65324 Patient Care Coordinator locations Telecommuter FL posted on Posted Yesterday R72233 Claims Examiner
• General Liability
• Public Entity Exp. Required locations 2 Locations posted on Posted Yesterday R72236 Claims Representative
• Workers Compensation |

Jurisdiction:

IL, IN, KS, MI, MO, NE, WI and MN |

Licensing:

Required locations Telecommuter MI posted on Posted Yesterday R72142 Case Coordinator locations Telecommuter OH posted on Posted Yesterday R72241 Workers Compensation Claims Examiner |

NJ, PA, VA, DE

Jurisdictions locations Marlton, NJ posted on Posted Yesterday

R71032 VP

Strategic Project Manager locations 30 Locations posted on Posted Yesterday R72077 Future Medical Claims Adjuster locations Concord, CA posted on Posted Yesterday R69197 Service Center Representative

• Summer Student locations CAN-Telecommute-ON posted on Posted Yesterday R72229 Service Center Representative
• Summer Student locations CAN-Telecommute-ON posted on Posted Yesterday R72230 Service Center Representative
• Summer Student locations CAN-Telecommute-ON posted on Posted Yesterday

R72231 1 2 3 4 5 1

• 20 of 521 jobs Return to selected search result Disability Representative Sr Apply locations Dublin, OH posted on Posted 2 Days Ago job requisition id R70601 By joining Sedgwick, you'll be part of something truly meaningful.

It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Disability Representative Sr Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:

Dublin, OH :

5500 Glendon Court Dublin

OH 43016 PRIMARY PURPOSE

: Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation including determining benefits due and making timely payments/approvals and adjustments, medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations; coordinates investigative efforts, thoroughly reviews contested claims, negotiates return to work with or without job accommodations, and evaluates and arranges appropriate referral of claims to outside vendors.

ESSENTIAL

FUNCTIONS and

RESPONSIBILITIES

Makes independent claim determinations, based on the information received, to approve complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan. Reviews and analyzes complex medical information (i.e. attending physician statements, office notes, operative reports, etc.) to determine if the claimant is disabled as defined by the disability plan. Oversees additional facets of complex claims including but not limited to comorbidities, concurrent plans, complex ADA accommodations, and claims outside of typical guidelines. Utilizes the appropriate clinical resources in case assessment (i.e. duration guidelines, in-house clinicians), as needed. Determines benefits due pursuant to a disability plan, makes timely claims payments/approvals and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets. Informs claimants of documentation required to process claims, required time frames, payment information and claims status by phone, written correspondence and/or claims system. Communicates with the claimants' providers to set expectations regarding return to work. Medically manages complex disability claims ensuring compliance with duration control guidelines and plan provisions. Communicates clearly and timely with claimant and client on all aspects of claims process by phone, written correspondence and/or claims system. Coordinates investigative efforts ensuring appropriateness; provides thorough review of contested claims. Evaluates and arranges appropriate referral of claims to outside vendors or physician advisor reviews, surveillance, independent medical evaluation, functional capability evaluation, and/or related disability activities. Negotiates return to work with or without job accommodations via the claimant's physician and employer. Refers cases to team lead and clinical case management for additional review when appropriate. Maintains professional client relationships and provides excellent customer service. Meets the organization's quality program(s) minimum requirements.

ADDITIONAL

FUNCTIONS and

RESPONSIBILITIES

Performs other duties as assigned.

QUALIFICATIONS

Education & Licensing 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. Experience Three (3) years of benefits or disability case/claims management experience or equivalent combination of education and experience preferred. Skills & Knowledge 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

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental :

Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical :

Ability to sit at a desk for extended periods while operating a computer and phone system. Travel as required.

Auditory/Visual :

Hearing, vision and talking The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $ 23.00 USD Hourly . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles. Similar Jobs (1) Disability Representative Sr locations Dublin, OH posted on Posted 2 Days Ago About Us Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see sedgwick.com Read More