Senior Disability Representative - Make a Meaningful Impact
By joining Sedgwick, you'll be part of something truly meaningful. Sedgwick is a global leader in claims management, and we are driven by empathy, expertise, and impact. Right now, we are looking for experienced, compassionate professionals to join us as Senior Disability Representatives.
Location Dubuque, IA : 4141 Westmark Drive, Dubuque, IA 52002 Cedar Rapids, IA : 333 1st Street SE Ste. 200 Cedar Rapids IA 52401 Coralville, IA : 3273 Ridgeway Drive Coralville IA 52241 Dublin, OH : 5500 Glendon Court Dublin OH 43016 New Albany, OH : 7795 Walton Parkway New Albany, OH 43054 Chicago, IL : 175 W. Jackson Blvd. 12th Fl. Chicago IL 60604 Indianapolis, IN : 8909 Purdue Road Suite 501 Indianapolis, IN 46268 Irving, TX : 2201 W. Royal Lane Suite 125 Irving, TX 75063 Memphis, TN : 8125 Sedgwick Way, Memphis TN 38125 Southfield, MI : 300 Galleria Officentre Southfield MI 48034 Orlando, FL : 12650 Ingenuity Dr Orlando FL 32826 Eden Prairie, MN : 11000 Prairie Lakes Drive Eden Prairie, MN 55344 West Hills, CA : 8521 Fallbrook Ave West Hills, CA 91304
Primary Purpose As a Senior Disability Representative, you will be the go‑to guide for individuals navigating the challenges of disability claims. Your role blends technical expertise with human connection—interpreting medical documentation, determining benefits, and championing return‑to‑work strategies while delivering service that is empathetic, precise, and impactful.
What You’ll Do Own complex disability claims from start to finish with confidence and independence. Decode medical records and disability plans to determine eligibility and next steps. Manage claims involving comorbidities, ADA accommodations, and concurrent plans. Partner with healthcare providers and employers to create successful return‑to‑work outcomes. Communicate with clarity, compassion, and professionalism every single time. Coordinate investigative efforts and vendor referrals when needed. Build strong client relationships while upholding Sedgwick’s gold‑standard quality.
Essential Functions and Responsibilities Independently evaluate complex disability claims and recommend approval or denial in alignment with the disability plan. Carefully review and interpret detailed medical records to assess eligibility. Oversee multifaceted claims involving comorbid conditions, overlapping benefit plans, ADA accommodations, and cases that fall outside standard guidelines. Apply clinical resources such as duration guidelines and consult with in‑house clinicians to support case assessments when necessary. Calculate benefits due under the disability plan and ensure timely processing of payments, approvals, and adjustments. Clearly communicate with claimants regarding required documentation, timelines, and claim status through phone calls, written correspondence, and system updates. Engage with healthcare providers to establish expectations for return‑to‑work timelines and accommodations. Manage complex disability claims with a focus on medical compliance, duration control, and adherence to plan provisions. Maintain consistent and transparent communication with claimants and clients throughout the claims process via phone, written updates, and system documentation. Coordinate investigative efforts to ensure thorough and appropriate claim reviews. Identify when claims require external support and arrange referrals to vendors for services such as physician advisor reviews, surveillance, independent medical evaluations, and functional capability assessments. Facilitate return‑to‑work negotiations with or without accommodations, collaborating with the claimant’s physician and employer. Escalate cases to the team lead or clinical case management for further review when appropriate. Build and maintain professional relationships with clients, delivering high‑quality customer service. Meet or exceed the organization’s quality standards and program requirements.
Additional Functions and Responsibilities Perform other duties as assigned.
Qualifications Education & Licensing High school diploma or GED is required. Bachelor’s degree from an accredited college or university is preferred. State certification or licensing in statutory leaves is preferred or may be required depending on local regulations.
Experience Preferred: Three (3) years of experience in benefits or disability case/claims management, or an equivalent combination of education and experience.
Skills & Knowledge Solid understanding of ERISA regulations, disability offsets and deductions, medical management practices, and Social Security Disability application procedures. Familiarity with federal and state FMLA regulations. Working knowledge of medical terminology and duration management. Strong verbal and written communication skills, including the ability to present information clearly. Proficiency in Microsoft Office and general computer systems. Analytical mindset with strong interpretive and critical thinking abilities. Comfortable navigating ambiguity and making informed decisions. Excellent organizational and multitasking capabilities. Collaborative team player with a commitment to performance excellence. Skilled in negotiation and autonomous decision‑making within established procedures. Ability to exercise sound judgment and maintain discretion.
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.
Ready to Make a Difference? Apply today and become part of a team that’s redefining care and support in the workplace. At Sedgwick, your work matters—and so do you.
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 $21.00 - $24.00 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.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.
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.
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Location Dubuque, IA : 4141 Westmark Drive, Dubuque, IA 52002 Cedar Rapids, IA : 333 1st Street SE Ste. 200 Cedar Rapids IA 52401 Coralville, IA : 3273 Ridgeway Drive Coralville IA 52241 Dublin, OH : 5500 Glendon Court Dublin OH 43016 New Albany, OH : 7795 Walton Parkway New Albany, OH 43054 Chicago, IL : 175 W. Jackson Blvd. 12th Fl. Chicago IL 60604 Indianapolis, IN : 8909 Purdue Road Suite 501 Indianapolis, IN 46268 Irving, TX : 2201 W. Royal Lane Suite 125 Irving, TX 75063 Memphis, TN : 8125 Sedgwick Way, Memphis TN 38125 Southfield, MI : 300 Galleria Officentre Southfield MI 48034 Orlando, FL : 12650 Ingenuity Dr Orlando FL 32826 Eden Prairie, MN : 11000 Prairie Lakes Drive Eden Prairie, MN 55344 West Hills, CA : 8521 Fallbrook Ave West Hills, CA 91304
Primary Purpose As a Senior Disability Representative, you will be the go‑to guide for individuals navigating the challenges of disability claims. Your role blends technical expertise with human connection—interpreting medical documentation, determining benefits, and championing return‑to‑work strategies while delivering service that is empathetic, precise, and impactful.
What You’ll Do Own complex disability claims from start to finish with confidence and independence. Decode medical records and disability plans to determine eligibility and next steps. Manage claims involving comorbidities, ADA accommodations, and concurrent plans. Partner with healthcare providers and employers to create successful return‑to‑work outcomes. Communicate with clarity, compassion, and professionalism every single time. Coordinate investigative efforts and vendor referrals when needed. Build strong client relationships while upholding Sedgwick’s gold‑standard quality.
Essential Functions and Responsibilities Independently evaluate complex disability claims and recommend approval or denial in alignment with the disability plan. Carefully review and interpret detailed medical records to assess eligibility. Oversee multifaceted claims involving comorbid conditions, overlapping benefit plans, ADA accommodations, and cases that fall outside standard guidelines. Apply clinical resources such as duration guidelines and consult with in‑house clinicians to support case assessments when necessary. Calculate benefits due under the disability plan and ensure timely processing of payments, approvals, and adjustments. Clearly communicate with claimants regarding required documentation, timelines, and claim status through phone calls, written correspondence, and system updates. Engage with healthcare providers to establish expectations for return‑to‑work timelines and accommodations. Manage complex disability claims with a focus on medical compliance, duration control, and adherence to plan provisions. Maintain consistent and transparent communication with claimants and clients throughout the claims process via phone, written updates, and system documentation. Coordinate investigative efforts to ensure thorough and appropriate claim reviews. Identify when claims require external support and arrange referrals to vendors for services such as physician advisor reviews, surveillance, independent medical evaluations, and functional capability assessments. Facilitate return‑to‑work negotiations with or without accommodations, collaborating with the claimant’s physician and employer. Escalate cases to the team lead or clinical case management for further review when appropriate. Build and maintain professional relationships with clients, delivering high‑quality customer service. Meet or exceed the organization’s quality standards and program requirements.
Additional Functions and Responsibilities Perform other duties as assigned.
Qualifications Education & Licensing High school diploma or GED is required. Bachelor’s degree from an accredited college or university is preferred. State certification or licensing in statutory leaves is preferred or may be required depending on local regulations.
Experience Preferred: Three (3) years of experience in benefits or disability case/claims management, or an equivalent combination of education and experience.
Skills & Knowledge Solid understanding of ERISA regulations, disability offsets and deductions, medical management practices, and Social Security Disability application procedures. Familiarity with federal and state FMLA regulations. Working knowledge of medical terminology and duration management. Strong verbal and written communication skills, including the ability to present information clearly. Proficiency in Microsoft Office and general computer systems. Analytical mindset with strong interpretive and critical thinking abilities. Comfortable navigating ambiguity and making informed decisions. Excellent organizational and multitasking capabilities. Collaborative team player with a commitment to performance excellence. Skilled in negotiation and autonomous decision‑making within established procedures. Ability to exercise sound judgment and maintain discretion.
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.
Ready to Make a Difference? Apply today and become part of a team that’s redefining care and support in the workplace. At Sedgwick, your work matters—and so do you.
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 $21.00 - $24.00 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.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.
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.
#J-18808-Ljbffr