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Disability Specialist
94199 San Francisco, California
Western University of Health Sciences
Posted 4 days ago
Job Viewed
Job Description
Posting Details
About WesternU
As you take your first step onto a Western University of Health Sciences campus, each path, each person, each structure comes with a transformative story. WesternU is more than the practice of medicine. We are defined by character and culture.
At WesternU, you will discover humanism at the heart of every interaction: a warm welcome, a sincere smile, a positive word, a kind deed, a thoughtful gesture. You will see students work together on case studies; a parade of pets in campus parks; student clubs offering opportunities for career growth and community involvement; and faculty, staff and students designing their future and the future of WesternU. We display a collaborative mindset in how we operate, educate, and serve others.
Although, geographically, we are two campuses - as humanists, we are one: to enhance and extend the quality of life in our communities and achieve excellence in everything we do. We attract diverse, professional faculty, staff and students that thrive in an environment of humanistic health care education. Join our team of faculty and staff and make a difference.
Posting Details
Position Title
Disability Specialist
Position Control Number
S04107
Type of Position
Staff
Position Status
Full-time
Campus
Western University Campus-Pomona, CA
Position Location
California
Department
4201-Harris Family Center for Disability and Health Policy
Job Summary
Under general supervision from the Director of HFCDHP and lead work direction from the Associate Director of HFCDHP, the Disability Specialist provides services to students requesting accommodations through an interactive process, assessment for the presence and severity of disabling conditions, and the study of medical/psychological/educational documents in conjunction with the Americans with Disabilities Act (ADA) of 1990, the ADA Amendments Act (ADAAA) of 2008, and Section 504 of the Rehabilitation Act of 1973, and applicable Western University of Health Sciences (WesternU) and HFCDHP policies and procedures to provide reasonable academic accommodations.
Knowledge, Skills and Abilities
Individuals must possess the knowledge, as well as the following skills and abilities or be able to perform the essential functions of the job, with or without reasonable accommodation, using some other combination of skills and abilities.
1. Excellent verbal and written communication skills. Must be able to effectively interact with faculty, staff, administration, students, healthcare professionals, and outside contacts; ability to communicate with others in person, by telephone, and by email; and facilitate presentations at all levels.
2. Excellent computer skills including the ability to navigate Microsoft 365 and Zoom, Teams, draft and format documents in Word, Excel, Access, Outlook, Publisher and any other software program required for this position.
3. Thorough knowledge of the principles of individual and group behavior, individual counseling, research, and interview techniques. Ability to obtain factual and interpretive information through interviews.
4. General knowledge of the principles, practices and trends of the student services field as well as general knowledge of the policies, procedures, and practices of the program area to which assigned; general knowledge, or the ability to rapidly acquire such knowledge, of the organizational procedures and activities of WesternU colleges.
5. Ability to analyze complex situations accurately and adopt effective courses of action; advise students individually and in groups on complex student-related matters; determine appropriate courses of action and proper techniques to utilize while engaged with individuals in personal interactions of an argumentative or sensitive nature; interpret and evaluate descriptions and explanations of problems brought forward by individuals or student organizations; analyze and define the problem, draw valid conclusions, and project consequences of various alternative courses of action.
6. Ability to carry out a variety of professionally complex assignments without detailed instructions; and establish and maintain cooperative working relationships with a variety of individuals. Ability to use initiative and resourcefulness in planning work assignments and in implementing long range program improvements.
7. Ability to reason logically; ability to collect, compile, analyze and evaluate data and make verbal or written presentation based on these data.
8. Ability to recognize multicultural, multi-sexed and multi-aged value systems and work accordingly.
9. Ability to establish and maintain cooperative working relationships with a variety of individuals to include faculty, WesternU administrators, student organizations, and other private and public agencies and others in committee work, student advising, and community contacts.
Required Qualifications
- Education: Possess a master's degree in special education, counseling, guidance, psychology, social work, or a related field.
- Experience: 3-5 years of experience in assessing students with disabilities. Prior experience reviewing, evaluating, and determining academic accommodations for college students with disabilities preferred. Knowledge of ADA and disability legislation as it relates to higher education. An understanding of how to analyze documentation used to assess students with disabilities. Knowledge of college student growth and development.
Preferred Qualifications
Essential Job Duties
Key Responsibilities
Counseling:
Authorizes accommodations for students with disabilities enrolled at WesternU requesting accommodation, on a case-by-case basis that are commensurate with the student's verified disability(ies) and are in accordance with the ADA, ADAAA, Section 504 of the Rehabilitation Act of 1973, applicable WesternU and HFCDHP policies and procedures through an interactive process and study of medical and educational documents as they supplement the students' presentation; creates student accommodation plans; conducts routine follow up and assessment of needs; and maintains records of encounters. The Disability Specialist employs the following measures to assign accommodation:
- Assesses for the presence and severity of visual, physical, psychological, hearing, and other disabilities that may affect academic achievement (permanent and temporary).
- Interviews and assesses students' accommodation needs through an interactive process and a thorough review of medical/psychological/educational documents and other pertinent information that may be of a sensitive or confidential nature.
- Solicits medical/psychological/educational documents when necessary to clarify the student's functional limitations in the academic setting to inform appropriate accommodation decisions.
- Troubleshoots functional limitations and their persistent adverse effect on academic achievement.
- Authorizes and explains accommodations to include department policies and guidelines and how to request and access them.
- Documents the encounter and disposition timely in the student's file.
- Drafts accommodation memorandums of students' accommodations based on established policies and procedures.
- Contributes to innovation in disability counseling services through consistent assessment and by working with department staff, faculty, and other campus professionals to design student success programs and services and advise and connect students to on and off campus resources based on need.
Key Responsibilities
Case Management:
Routinely assesses the provision of accommodations, provides disability-related counseling to enrolled students; addresses student concerns; works with them to resolve issues that may arise; and provides referrals to on and off campus entities to address needs. Routinely identifies by GPA, length of time to degree and severity of functional limitations, students that are at high risk for academic failure and meets with them to develop innovative accommodation plans and connect them to resources that will better meet their needs. Consults with the Director and Associate Director of HFCDHP regarding accessibility and accommodation challenges on assigned caseload. Coordinates students' requests for surrogates with on campus departments. Assists students with connecting to appropriate HFCDHP staff for notetaking and Smartpen services, exam accommodation services, sign language and Remote Communication Access Realtime Translation (CART) services, assistive technology, accessible furniture, and alternative media. Serves as an advocate for the student within WesternU and with outside service agencies. Orients students to campus evacuation procedures and provides class schedules to risk management and Campus Security for all students that cannot self-evacuate in a campus emergency.
Key Responsibilities
Collaboration:
Promotes disability awareness among faculty, staff, and students through in-service trainings. Provides guidance on disability-related legislation to WesternU staff and faculty. Assists in the development and implementation of special programs focusing on students with disabilities access, success, and retention. Consults with colleagues at post-secondary education institutions and at workshops. Develops and maintains close working relationships with disabled student counseling personnel in feeder schools to aid in student transition. Represents department by serving on department, division, university-wide and community committees. Contributes articles related to disabilities to the department's e-newsletter and social media platforms.
Key Responsibilities
Diversity and Ethics:
- Attends diversity and ethics, and disability law trainings and demonstrates sensitivity to the diverse socioeconomic, cultural, ethnic, disability, and sexual orientation of students.
- Other duties as assigned and in keeping with the classification.
Posting Details Continued
Work Schedule
Monday-Friday 8am thru 5:00 pm. Some overtime may be required for HFCDHP events.
Working at WesternU
We believe in making an impact in the lives of our employees, personally, and professionally. Every employee has different individual and/or family needs. We offer benefits that are both comprehensive and flexible to address your unique needs. We believe work-life harmony is positive and achievable.
We offer competitive salaries, generous paid time off, insurance plans, reimbursements, and retirement benefits. Additionally,
• Our faculty, staff, and administrators are 100% focused on student success.
• Our University culture creates the context for a nurturing and supportive environment.
• Faculty, staff, and students can expect to make deep, personal relationships within the University community.
• As a Faculty, Staff, or Student at WesternU, you can focus on work that you love, be your authentic self, and lead to the future with innovation in health sciences.
• WesternU's core value of humanism encourages all to bring their whole self in all that they do.
• We are committed to fostering a culture of respect, equity, collaboration, and fun at all levels for all people!
Expected Pay Scale
Minimum
$30.00
Maximum
$32.85
About WesternU
As you take your first step onto a Western University of Health Sciences campus, each path, each person, each structure comes with a transformative story. WesternU is more than the practice of medicine. We are defined by character and culture.
At WesternU, you will discover humanism at the heart of every interaction: a warm welcome, a sincere smile, a positive word, a kind deed, a thoughtful gesture. You will see students work together on case studies; a parade of pets in campus parks; student clubs offering opportunities for career growth and community involvement; and faculty, staff and students designing their future and the future of WesternU. We display a collaborative mindset in how we operate, educate, and serve others.
Although, geographically, we are two campuses - as humanists, we are one: to enhance and extend the quality of life in our communities and achieve excellence in everything we do. We attract diverse, professional faculty, staff and students that thrive in an environment of humanistic health care education. Join our team of faculty and staff and make a difference.
Posting Details
Position Title
Disability Specialist
Position Control Number
S04107
Type of Position
Staff
Position Status
Full-time
Campus
Western University Campus-Pomona, CA
Position Location
California
Department
4201-Harris Family Center for Disability and Health Policy
Job Summary
Under general supervision from the Director of HFCDHP and lead work direction from the Associate Director of HFCDHP, the Disability Specialist provides services to students requesting accommodations through an interactive process, assessment for the presence and severity of disabling conditions, and the study of medical/psychological/educational documents in conjunction with the Americans with Disabilities Act (ADA) of 1990, the ADA Amendments Act (ADAAA) of 2008, and Section 504 of the Rehabilitation Act of 1973, and applicable Western University of Health Sciences (WesternU) and HFCDHP policies and procedures to provide reasonable academic accommodations.
Knowledge, Skills and Abilities
Individuals must possess the knowledge, as well as the following skills and abilities or be able to perform the essential functions of the job, with or without reasonable accommodation, using some other combination of skills and abilities.
1. Excellent verbal and written communication skills. Must be able to effectively interact with faculty, staff, administration, students, healthcare professionals, and outside contacts; ability to communicate with others in person, by telephone, and by email; and facilitate presentations at all levels.
2. Excellent computer skills including the ability to navigate Microsoft 365 and Zoom, Teams, draft and format documents in Word, Excel, Access, Outlook, Publisher and any other software program required for this position.
3. Thorough knowledge of the principles of individual and group behavior, individual counseling, research, and interview techniques. Ability to obtain factual and interpretive information through interviews.
4. General knowledge of the principles, practices and trends of the student services field as well as general knowledge of the policies, procedures, and practices of the program area to which assigned; general knowledge, or the ability to rapidly acquire such knowledge, of the organizational procedures and activities of WesternU colleges.
5. Ability to analyze complex situations accurately and adopt effective courses of action; advise students individually and in groups on complex student-related matters; determine appropriate courses of action and proper techniques to utilize while engaged with individuals in personal interactions of an argumentative or sensitive nature; interpret and evaluate descriptions and explanations of problems brought forward by individuals or student organizations; analyze and define the problem, draw valid conclusions, and project consequences of various alternative courses of action.
6. Ability to carry out a variety of professionally complex assignments without detailed instructions; and establish and maintain cooperative working relationships with a variety of individuals. Ability to use initiative and resourcefulness in planning work assignments and in implementing long range program improvements.
7. Ability to reason logically; ability to collect, compile, analyze and evaluate data and make verbal or written presentation based on these data.
8. Ability to recognize multicultural, multi-sexed and multi-aged value systems and work accordingly.
9. Ability to establish and maintain cooperative working relationships with a variety of individuals to include faculty, WesternU administrators, student organizations, and other private and public agencies and others in committee work, student advising, and community contacts.
Required Qualifications
- Education: Possess a master's degree in special education, counseling, guidance, psychology, social work, or a related field.
- Experience: 3-5 years of experience in assessing students with disabilities. Prior experience reviewing, evaluating, and determining academic accommodations for college students with disabilities preferred. Knowledge of ADA and disability legislation as it relates to higher education. An understanding of how to analyze documentation used to assess students with disabilities. Knowledge of college student growth and development.
Preferred Qualifications
Essential Job Duties
Key Responsibilities
Counseling:
Authorizes accommodations for students with disabilities enrolled at WesternU requesting accommodation, on a case-by-case basis that are commensurate with the student's verified disability(ies) and are in accordance with the ADA, ADAAA, Section 504 of the Rehabilitation Act of 1973, applicable WesternU and HFCDHP policies and procedures through an interactive process and study of medical and educational documents as they supplement the students' presentation; creates student accommodation plans; conducts routine follow up and assessment of needs; and maintains records of encounters. The Disability Specialist employs the following measures to assign accommodation:
- Assesses for the presence and severity of visual, physical, psychological, hearing, and other disabilities that may affect academic achievement (permanent and temporary).
- Interviews and assesses students' accommodation needs through an interactive process and a thorough review of medical/psychological/educational documents and other pertinent information that may be of a sensitive or confidential nature.
- Solicits medical/psychological/educational documents when necessary to clarify the student's functional limitations in the academic setting to inform appropriate accommodation decisions.
- Troubleshoots functional limitations and their persistent adverse effect on academic achievement.
- Authorizes and explains accommodations to include department policies and guidelines and how to request and access them.
- Documents the encounter and disposition timely in the student's file.
- Drafts accommodation memorandums of students' accommodations based on established policies and procedures.
- Contributes to innovation in disability counseling services through consistent assessment and by working with department staff, faculty, and other campus professionals to design student success programs and services and advise and connect students to on and off campus resources based on need.
Key Responsibilities
Case Management:
Routinely assesses the provision of accommodations, provides disability-related counseling to enrolled students; addresses student concerns; works with them to resolve issues that may arise; and provides referrals to on and off campus entities to address needs. Routinely identifies by GPA, length of time to degree and severity of functional limitations, students that are at high risk for academic failure and meets with them to develop innovative accommodation plans and connect them to resources that will better meet their needs. Consults with the Director and Associate Director of HFCDHP regarding accessibility and accommodation challenges on assigned caseload. Coordinates students' requests for surrogates with on campus departments. Assists students with connecting to appropriate HFCDHP staff for notetaking and Smartpen services, exam accommodation services, sign language and Remote Communication Access Realtime Translation (CART) services, assistive technology, accessible furniture, and alternative media. Serves as an advocate for the student within WesternU and with outside service agencies. Orients students to campus evacuation procedures and provides class schedules to risk management and Campus Security for all students that cannot self-evacuate in a campus emergency.
Key Responsibilities
Collaboration:
Promotes disability awareness among faculty, staff, and students through in-service trainings. Provides guidance on disability-related legislation to WesternU staff and faculty. Assists in the development and implementation of special programs focusing on students with disabilities access, success, and retention. Consults with colleagues at post-secondary education institutions and at workshops. Develops and maintains close working relationships with disabled student counseling personnel in feeder schools to aid in student transition. Represents department by serving on department, division, university-wide and community committees. Contributes articles related to disabilities to the department's e-newsletter and social media platforms.
Key Responsibilities
Diversity and Ethics:
- Attends diversity and ethics, and disability law trainings and demonstrates sensitivity to the diverse socioeconomic, cultural, ethnic, disability, and sexual orientation of students.
- Other duties as assigned and in keeping with the classification.
Posting Details Continued
Work Schedule
Monday-Friday 8am thru 5:00 pm. Some overtime may be required for HFCDHP events.
Working at WesternU
We believe in making an impact in the lives of our employees, personally, and professionally. Every employee has different individual and/or family needs. We offer benefits that are both comprehensive and flexible to address your unique needs. We believe work-life harmony is positive and achievable.
We offer competitive salaries, generous paid time off, insurance plans, reimbursements, and retirement benefits. Additionally,
• Our faculty, staff, and administrators are 100% focused on student success.
• Our University culture creates the context for a nurturing and supportive environment.
• Faculty, staff, and students can expect to make deep, personal relationships within the University community.
• As a Faculty, Staff, or Student at WesternU, you can focus on work that you love, be your authentic self, and lead to the future with innovation in health sciences.
• WesternU's core value of humanism encourages all to bring their whole self in all that they do.
• We are committed to fostering a culture of respect, equity, collaboration, and fun at all levels for all people!
Expected Pay Scale
Minimum
$30.00
Maximum
$32.85
View Now
0
Disability Representative
60684 Chicago, Illinois
Sedgwick
Posted 1 day ago
Job Viewed
Job Description
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
**Our teams connect! We collaborate in office.**
**All candidates must live near:**
**Chicago, IL :** 175 W. Jackson Blvd. 12th Fl. Chicago IL 60604
Are you looking for an impactful job requiring that offers an opportunity to develop a professional career? Bring your 2+ years' experience in a office setting or medical experience and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands.
+ An assigned mentor and manager who will guide you on your career journey.
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE OF THE ROLE:**
To process claims and determine benefits due pursuant to a disability plan; to make timely payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets; and to ensure the ongoing processing of claims.
**ARE YOU AN IDEAL CANDIDATE?**
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
**ESSENTIAL RESPONSIBLITIES MAY INCLUDE**
+ Makes claim determinations to approve non-complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Determines benefits due, makes timely claims payments 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 either by phone, written correspondence and/or claims system.
**QUALIFICATIONS**
+ Education & Licensing: High school diploma or GED required.
+ Skills: Strong oral and written communication, computer literate - including Microsoft Office, organizational skills required
+ PC literate, including Microsoft Office products, Windows environment.
+ Must meet minimum typing requirements.
+ Experience: Clerical or customer service experience or equivalent combination of education and experience preferred
**TAKING CARE OF YOU**
+ Entry-level colleagues are offered a world class training program with a comprehensive curriculum.
+ An assigned mentor and manager that will support and guide you on your career journey.
+ Career development and promotional growth opportunities
+ A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more.
Work environment requirements:
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking.
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
_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 (16.00 - 19.00). 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.**
**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**
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
**Our teams connect! We collaborate in office.**
**All candidates must live near:**
**Chicago, IL :** 175 W. Jackson Blvd. 12th Fl. Chicago IL 60604
Are you looking for an impactful job requiring that offers an opportunity to develop a professional career? Bring your 2+ years' experience in a office setting or medical experience and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands.
+ An assigned mentor and manager who will guide you on your career journey.
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE OF THE ROLE:**
To process claims and determine benefits due pursuant to a disability plan; to make timely payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets; and to ensure the ongoing processing of claims.
**ARE YOU AN IDEAL CANDIDATE?**
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
**ESSENTIAL RESPONSIBLITIES MAY INCLUDE**
+ Makes claim determinations to approve non-complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Determines benefits due, makes timely claims payments 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 either by phone, written correspondence and/or claims system.
**QUALIFICATIONS**
+ Education & Licensing: High school diploma or GED required.
+ Skills: Strong oral and written communication, computer literate - including Microsoft Office, organizational skills required
+ PC literate, including Microsoft Office products, Windows environment.
+ Must meet minimum typing requirements.
+ Experience: Clerical or customer service experience or equivalent combination of education and experience preferred
**TAKING CARE OF YOU**
+ Entry-level colleagues are offered a world class training program with a comprehensive curriculum.
+ An assigned mentor and manager that will support and guide you on your career journey.
+ Career development and promotional growth opportunities
+ A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more.
Work environment requirements:
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking.
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
_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 (16.00 - 19.00). 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.**
**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**
View Now
1
Disability Representative
32806 Orlando, Florida
Sedgwick
Posted 1 day ago
Job Viewed
Job Description
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
**Disability Representative**
**Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near:**
**Orlando, FL :** 12650 Ingenuity Dr Orlando FL 32826
Are you looking for an impactful job requiring that offers an opportunity to develop a professional career? Bring your 2+ years' experience in a office setting or medical experience and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands.
+ An assigned mentor and manager who will guide you on your career journey.
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE OF THE ROLE:**
To process claims and determine benefits due pursuant to a disability plan; to make timely payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets; and to ensure the ongoing processing of claims.
**ARE YOU AN IDEAL CANDIDATE?**
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
**ESSENTIAL RESPONSIBLITIES MAY INCLUDE**
+ Makes claim determinations to approve non-complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Determines benefits due, makes timely claims payments 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 either by phone, written correspondence and/or claims system.
**QUALIFICATIONS**
+ Education & Licensing: High school diploma or GED required.
+ Skills: Strong oral and written communication, computer literate - including Microsoft Office, organizational skills required
+ PC literate, including Microsoft Office products, Windows environment.
+ Must meet minimum typing requirements.
+ Experience: Clerical or customer service experience or equivalent combination of education and experience preferred
**TAKING CARE OF YOU**
+ Entry-level colleagues are offered a world class training program with a comprehensive curriculum.
+ An assigned mentor and manager that will support and guide you on your career journey.
+ Career development and promotional growth opportunities
+ A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more.
Work environment requirements:
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking.
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
_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 a specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (16.00 - 19.50). 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.**
**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**
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
**Disability Representative**
**Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near:**
**Orlando, FL :** 12650 Ingenuity Dr Orlando FL 32826
Are you looking for an impactful job requiring that offers an opportunity to develop a professional career? Bring your 2+ years' experience in a office setting or medical experience and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands.
+ An assigned mentor and manager who will guide you on your career journey.
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE OF THE ROLE:**
To process claims and determine benefits due pursuant to a disability plan; to make timely payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets; and to ensure the ongoing processing of claims.
**ARE YOU AN IDEAL CANDIDATE?**
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
**ESSENTIAL RESPONSIBLITIES MAY INCLUDE**
+ Makes claim determinations to approve non-complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Determines benefits due, makes timely claims payments 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 either by phone, written correspondence and/or claims system.
**QUALIFICATIONS**
+ Education & Licensing: High school diploma or GED required.
+ Skills: Strong oral and written communication, computer literate - including Microsoft Office, organizational skills required
+ PC literate, including Microsoft Office products, Windows environment.
+ Must meet minimum typing requirements.
+ Experience: Clerical or customer service experience or equivalent combination of education and experience preferred
**TAKING CARE OF YOU**
+ Entry-level colleagues are offered a world class training program with a comprehensive curriculum.
+ An assigned mentor and manager that will support and guide you on your career journey.
+ Career development and promotional growth opportunities
+ A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more.
Work environment requirements:
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking.
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
_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 a specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (16.00 - 19.50). 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.**
**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**
View Now
2
Disability Representative
52004 Dubuque, Iowa
Sedgwick
Posted 1 day ago
Job Viewed
Job Description
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
**Disability Representative**
**Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near our center of excellence in Dubuque, Iowa.**
**Dubuque, IA** : 4141 Westmark Drive, Dubuque, IA 52002
Are you looking for an impactful job requiring that offers an opportunity to develop a professional career? Bring your 2+ years' experience in a office setting or medical experience and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands.
+ An assigned mentor and manager who will guide you on your career journey.
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**ARE YOU AN IDEAL CANDIDATE?**
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
**PRIMARY PURPOSE** : Provides disability case management and routine 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; coordinates investigative efforts, thoroughly reviewing 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 claim determinations, based on the information received, to approve routine disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Reviews and analyzes routine medical information (i.e. attending physical statements, office notes, off work notes, etc.) or consults with a nurse to determine if the claimant is disabled as defined by the disability plan.
+ Utilizes the appropriate clinical resources in case assessment (i.e. duration guidelines, in-house clinicians) regularly.
+ Determines benefits due, makes timely claims payments 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 routine 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 as appropriate to team lead and clinical case management to assist with claim determination.
+ Meets the organization's quality program(s) minimum requirements.
+ Maintains professional client relationships and provides excellent customer service.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
**QUALIFICATIONS**
**Education & Licensing**
High school diploma or GED required.
**Experience**
Two (2) years of related experience or equivalent combination of education and experience required. One (1) year of office or customer service experience required. One (1) year of benefits or claims management 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
+ 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 with limited supervision
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental:** Clear and conceptual thinking ability; excellent judgment 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
**TAKING CARE OF YOU**
+ Entry-level colleagues are offered a world class training program with a comprehensive curriculum.
+ An assigned mentor and manager that will support and guide you on your career journey.
+ Career development and promotional growth opportunities
+ A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more.
**NOTE:** Credit security clearance, confirmed via a background credit check, is required for this position.
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.
#claimsexaminer
#entrylevel
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.**
**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**
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
**Disability Representative**
**Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near our center of excellence in Dubuque, Iowa.**
**Dubuque, IA** : 4141 Westmark Drive, Dubuque, IA 52002
Are you looking for an impactful job requiring that offers an opportunity to develop a professional career? Bring your 2+ years' experience in a office setting or medical experience and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands.
+ An assigned mentor and manager who will guide you on your career journey.
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**ARE YOU AN IDEAL CANDIDATE?**
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
**PRIMARY PURPOSE** : Provides disability case management and routine 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; coordinates investigative efforts, thoroughly reviewing 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 claim determinations, based on the information received, to approve routine disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Reviews and analyzes routine medical information (i.e. attending physical statements, office notes, off work notes, etc.) or consults with a nurse to determine if the claimant is disabled as defined by the disability plan.
+ Utilizes the appropriate clinical resources in case assessment (i.e. duration guidelines, in-house clinicians) regularly.
+ Determines benefits due, makes timely claims payments 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 routine 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 as appropriate to team lead and clinical case management to assist with claim determination.
+ Meets the organization's quality program(s) minimum requirements.
+ Maintains professional client relationships and provides excellent customer service.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
**QUALIFICATIONS**
**Education & Licensing**
High school diploma or GED required.
**Experience**
Two (2) years of related experience or equivalent combination of education and experience required. One (1) year of office or customer service experience required. One (1) year of benefits or claims management 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
+ 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 with limited supervision
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental:** Clear and conceptual thinking ability; excellent judgment 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
**TAKING CARE OF YOU**
+ Entry-level colleagues are offered a world class training program with a comprehensive curriculum.
+ An assigned mentor and manager that will support and guide you on your career journey.
+ Career development and promotional growth opportunities
+ A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more.
**NOTE:** Credit security clearance, confirmed via a background credit check, is required for this position.
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.
#claimsexaminer
#entrylevel
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.**
**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**
View Now
3
Disability Representative
52401 Cedar Rapids, Iowa
Sedgwick
Posted 1 day ago
Job Viewed
Job Description
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
**Disability Representative**
**Our teams connect! We collaborate in-office and have a hybrid work arrangement. All candidates must live near:**
**Cedar Rapids, IA** : 333 1st Street SE Ste. 200 Cedar Rapids IA 52401
Are you looking for an impactful job requiring that offers an opportunity to develop a professional career? Bring your 2+ years' experience in a office setting or medical experience and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands.
+ An assigned mentor and manager who will guide you on your career journey.
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE** : Provides disability case management and routine 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; coordinates investigative efforts, thoroughly reviewing contested claims, negotiates return to work with or without job accommodations, and evaluates and arranges appropriate referral of claims to outside vendors.
**ARE YOU AN IDEAL CANDIDATE?**
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Makes claim determinations, based on the information received, to approve routine disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Reviews and analyzes routine medical information (i.e. attending physical statements, office notes, off work notes, etc.) or consults with a nurse to determine if the claimant is disabled as defined by the disability plan.
+ Utilizes the appropriate clinical resources in case assessment (i.e. duration guidelines, in-house clinicians) regularly.
+ Determines benefits due, makes timely claims payments 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 routine 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 as appropriate to team lead and clinical case management to assist with claim determination.
+ Meets the organization's quality program(s) minimum requirements.
+ Maintains professional client relationships and provides excellent customer service.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
**QUALIFICATIONS**
**Education & Licensing**
High school diploma or GED required.
**Experience**
Two (2) years of related experience or equivalent combination of education and experience required. One (1) year of office or customer service experience required. One (1) year of benefits or claims management 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
+ 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 with limited supervision
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental:** Clear and conceptual thinking ability; excellent judgment 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
**NOTE:** Credit security clearance, confirmed via a background credit check, is required for this position.
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.
#entrylevel
#claimsexaminer
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.**
**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**
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
**Disability Representative**
**Our teams connect! We collaborate in-office and have a hybrid work arrangement. All candidates must live near:**
**Cedar Rapids, IA** : 333 1st Street SE Ste. 200 Cedar Rapids IA 52401
Are you looking for an impactful job requiring that offers an opportunity to develop a professional career? Bring your 2+ years' experience in a office setting or medical experience and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands.
+ An assigned mentor and manager who will guide you on your career journey.
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE** : Provides disability case management and routine 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; coordinates investigative efforts, thoroughly reviewing contested claims, negotiates return to work with or without job accommodations, and evaluates and arranges appropriate referral of claims to outside vendors.
**ARE YOU AN IDEAL CANDIDATE?**
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Makes claim determinations, based on the information received, to approve routine disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Reviews and analyzes routine medical information (i.e. attending physical statements, office notes, off work notes, etc.) or consults with a nurse to determine if the claimant is disabled as defined by the disability plan.
+ Utilizes the appropriate clinical resources in case assessment (i.e. duration guidelines, in-house clinicians) regularly.
+ Determines benefits due, makes timely claims payments 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 routine 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 as appropriate to team lead and clinical case management to assist with claim determination.
+ Meets the organization's quality program(s) minimum requirements.
+ Maintains professional client relationships and provides excellent customer service.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
**QUALIFICATIONS**
**Education & Licensing**
High school diploma or GED required.
**Experience**
Two (2) years of related experience or equivalent combination of education and experience required. One (1) year of office or customer service experience required. One (1) year of benefits or claims management 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
+ 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 with limited supervision
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental:** Clear and conceptual thinking ability; excellent judgment 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
**NOTE:** Credit security clearance, confirmed via a background credit check, is required for this position.
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.
#entrylevel
#claimsexaminer
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.**
**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**
View Now
4
Disability Representative
48086 Southfield, Michigan
Sedgwick
Posted 15 days ago
Job Viewed
Job Description
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
**Disability Representative**
**Our teams connect! We collaborate in office and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:**
**Southfield, MI** : 300 Galleria Officentre Southfield MI 48034
Are you looking for an impactful job requiring that offers an opportunity to develop a professional career? Bring your 2+ years' experience in a office setting or medical experience and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands.
+ An assigned mentor and manager who will guide you on your career journey.
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE OF THE ROLE:**
To process claims and determine benefits due pursuant to a disability plan; to make timely payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets; and to ensure the ongoing processing of claims.
**ARE YOU AN IDEAL CANDIDATE?**
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
**ESSENTIAL RESPONSIBLITIES MAY INCLUDE**
+ Makes claim determinations to approve non-complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Determines benefits due, makes timely claims payments 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 either by phone, written correspondence and/or claims system.
**QUALIFICATIONS**
+ Education & Licensing: High school diploma or GED required.
+ Skills: Strong oral and written communication, computer literate - including Microsoft Office, organizational skills required
+ PC literate, including Microsoft Office products, Windows environment.
+ Must meet minimum typing requirements.
+ Experience: Clerical or customer service experience or equivalent combination of education and experience preferred
**TAKING CARE OF YOU**
+ Entry-level colleagues are offered a world class training program with a comprehensive curriculum.
+ An assigned mentor and manager that will support and guide you on your career journey.
+ Career development and promotional growth opportunities
+ A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more.
Work environment requirements:
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking.
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
_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 a specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (16.00 - 19.50). 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.**
**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**
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
**Disability Representative**
**Our teams connect! We collaborate in office and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:**
**Southfield, MI** : 300 Galleria Officentre Southfield MI 48034
Are you looking for an impactful job requiring that offers an opportunity to develop a professional career? Bring your 2+ years' experience in a office setting or medical experience and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands.
+ An assigned mentor and manager who will guide you on your career journey.
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE OF THE ROLE:**
To process claims and determine benefits due pursuant to a disability plan; to make timely payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets; and to ensure the ongoing processing of claims.
**ARE YOU AN IDEAL CANDIDATE?**
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
**ESSENTIAL RESPONSIBLITIES MAY INCLUDE**
+ Makes claim determinations to approve non-complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Determines benefits due, makes timely claims payments 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 either by phone, written correspondence and/or claims system.
**QUALIFICATIONS**
+ Education & Licensing: High school diploma or GED required.
+ Skills: Strong oral and written communication, computer literate - including Microsoft Office, organizational skills required
+ PC literate, including Microsoft Office products, Windows environment.
+ Must meet minimum typing requirements.
+ Experience: Clerical or customer service experience or equivalent combination of education and experience preferred
**TAKING CARE OF YOU**
+ Entry-level colleagues are offered a world class training program with a comprehensive curriculum.
+ An assigned mentor and manager that will support and guide you on your career journey.
+ Career development and promotional growth opportunities
+ A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more.
Work environment requirements:
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking.
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
_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 a specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (16.00 - 19.50). 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.**
**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**
View Now
5
Disability Representative
75062 Irving, Texas
Sedgwick
Posted 15 days ago
Job Viewed
Job Description
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
**Disability Representative**
**Our teams connect! We collaborate in office and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:**
**Our Irving Office is located at: 2201 W. Royal Lane Suite 125 Irving, Tx 75063**
Are you looking for an impactful job requiring that offers an opportunity to develop a professional career? Bring your 2+ years' experience in a office setting or medical experience and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands.
+ An assigned mentor and manager who will guide you on your career journey.
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE OF THE ROLE:**
To process claims and determine benefits due pursuant to a disability plan; to make timely payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets; and to ensure the ongoing processing of claims.
**ARE YOU AN IDEAL CANDIDATE?**
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
**ESSENTIAL RESPONSIBLITIES MAY INCLUDE**
+ Makes claim determinations to approve non-complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Determines benefits due, makes timely claims payments 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 either by phone, written correspondence and/or claims system.
**QUALIFICATIONS**
+ Education & Licensing: High school diploma or GED required.
+ Skills: Strong oral and written communication, computer literate - including Microsoft Office, organizational skills required
+ PC literate, including Microsoft Office products, Windows environment.
+ Must meet minimum typing requirements.
+ Experience: Clerical or customer service experience or equivalent combination of education and experience preferred
**TAKING CARE OF YOU**
+ Entry-level colleagues are offered a world class training program with a comprehensive curriculum.
+ An assigned mentor and manager that will support and guide you on your career journey.
+ Career development and promotional growth opportunities
+ A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more.
Work environment requirements:
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking.
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
_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 a specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (16.00 - 20.00). 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.**
**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**
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
**Disability Representative**
**Our teams connect! We collaborate in office and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:**
**Our Irving Office is located at: 2201 W. Royal Lane Suite 125 Irving, Tx 75063**
Are you looking for an impactful job requiring that offers an opportunity to develop a professional career? Bring your 2+ years' experience in a office setting or medical experience and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands.
+ An assigned mentor and manager who will guide you on your career journey.
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE OF THE ROLE:**
To process claims and determine benefits due pursuant to a disability plan; to make timely payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets; and to ensure the ongoing processing of claims.
**ARE YOU AN IDEAL CANDIDATE?**
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
**ESSENTIAL RESPONSIBLITIES MAY INCLUDE**
+ Makes claim determinations to approve non-complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Determines benefits due, makes timely claims payments 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 either by phone, written correspondence and/or claims system.
**QUALIFICATIONS**
+ Education & Licensing: High school diploma or GED required.
+ Skills: Strong oral and written communication, computer literate - including Microsoft Office, organizational skills required
+ PC literate, including Microsoft Office products, Windows environment.
+ Must meet minimum typing requirements.
+ Experience: Clerical or customer service experience or equivalent combination of education and experience preferred
**TAKING CARE OF YOU**
+ Entry-level colleagues are offered a world class training program with a comprehensive curriculum.
+ An assigned mentor and manager that will support and guide you on your career journey.
+ Career development and promotional growth opportunities
+ A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more.
Work environment requirements:
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking.
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
_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 a specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (16.00 - 20.00). 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.**
**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**
View Now
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6
Disability Representative
75062 Irving, Texas
Sedgwick
Posted 15 days ago
Job Viewed
Job Description
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
**Our teams connect! We collaborate in office and have a hybrid work arrangement. All candidates must live near our Irving, TX center of excellence:**
**Our Irving Office is located at: 2201 W. Royal Lane Suite 125 Irving, Tx 75063**
Are you looking for an impactful job that offers the opportunity to develop a professional career? Bring your 1-2 years' experience in an office setting and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands
+ An assigned mentor and manager who will guide you on your career journey
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE** : Provides disability case management and routine 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; coordinates investigative efforts, thoroughly reviewing 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 claim determinations, based on the information received, to approve routine disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Reviews and analyzes routine medical information (i.e. attending physical statements, office notes, off work notes, etc.) or consults with a nurse to determine if the claimant is disabled as defined by the disability plan.
+ Utilizes the appropriate clinical resources in case assessment (i.e. duration guidelines, in-house clinicians) regularly.
+ Determines benefits due, makes timely claims payments 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 routine 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 as appropriate to team lead and clinical case management to assist with claim determination.
+ Meets the organization's quality program(s) minimum requirements.
+ Maintains professional client relationships and provides excellent customer service.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
**QUALIFICATIONS**
**Education & Licensing**
High school diploma or GED required. State certification or licensing in statutory leaves is preferred or may be required based on state regulations.
**Experience**
Two (2) years of related experience or equivalent combination of education and experience required. One (1) year of office or customer service experience required. One (1) year of benefits or claims management 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
+ 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 with limited supervision
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental:** Clear and conceptual thinking ability; excellent judgment 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 (16.00 - 23.00). 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.**
**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**
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
**Our teams connect! We collaborate in office and have a hybrid work arrangement. All candidates must live near our Irving, TX center of excellence:**
**Our Irving Office is located at: 2201 W. Royal Lane Suite 125 Irving, Tx 75063**
Are you looking for an impactful job that offers the opportunity to develop a professional career? Bring your 1-2 years' experience in an office setting and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands
+ An assigned mentor and manager who will guide you on your career journey
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE** : Provides disability case management and routine 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; coordinates investigative efforts, thoroughly reviewing 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 claim determinations, based on the information received, to approve routine disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Reviews and analyzes routine medical information (i.e. attending physical statements, office notes, off work notes, etc.) or consults with a nurse to determine if the claimant is disabled as defined by the disability plan.
+ Utilizes the appropriate clinical resources in case assessment (i.e. duration guidelines, in-house clinicians) regularly.
+ Determines benefits due, makes timely claims payments 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 routine 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 as appropriate to team lead and clinical case management to assist with claim determination.
+ Meets the organization's quality program(s) minimum requirements.
+ Maintains professional client relationships and provides excellent customer service.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
**QUALIFICATIONS**
**Education & Licensing**
High school diploma or GED required. State certification or licensing in statutory leaves is preferred or may be required based on state regulations.
**Experience**
Two (2) years of related experience or equivalent combination of education and experience required. One (1) year of office or customer service experience required. One (1) year of benefits or claims management 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
+ 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 with limited supervision
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental:** Clear and conceptual thinking ability; excellent judgment 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 (16.00 - 23.00). 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.**
**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**
View Now
7
Disability Representative
55344 Minneapolis, Minnesota
Sedgwick
Posted 15 days ago
Job Viewed
Job Description
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
**Disability Representative**
**Our teams connect! We collaborate onsite and have a hybrid work arrangement.** **All candidates must live near:**
**Eden Prairie, MN** : 11000 Prairie Lakes Drive Eden Prairie, MN 55344
Are you looking for an impactful job requiring that offers an opportunity to develop a professional career? Bring your 2+ years' experience in a office setting or medical experience and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands.
+ An assigned mentor and manager who will guide you on your career journey.
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE OF THE ROLE:**
To process claims and determine benefits due pursuant to a disability plan; to make timely payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets; and to ensure the ongoing processing of claims.
**ARE YOU AN IDEAL CANDIDATE?**
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
**ESSENTIAL RESPONSIBLITIES MAY INCLUDE**
+ Makes claim determinations to approve non-complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Determines benefits due, makes timely claims payments 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 either by phone, written correspondence and/or claims system.
**QUALIFICATIONS**
+ Education & Licensing: High school diploma or GED required.
+ Skills: Strong oral and written communication, computer literate - including Microsoft Office, organizational skills required
+ PC literate, including Microsoft Office products, Windows environment.
+ Must meet minimum typing requirements.
+ Experience: Clerical or customer service experience or equivalent combination of education and experience preferred
**TAKING CARE OF YOU**
+ Entry-level colleagues are offered a world class training program with a comprehensive curriculum.
+ An assigned mentor and manager that will support and guide you on your career journey.
+ Career development and promotional growth opportunities
+ A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more.
Work environment requirements:
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking.
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
_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 a specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (16.00 - 19.50). 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.**
**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**
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
**Disability Representative**
**Our teams connect! We collaborate onsite and have a hybrid work arrangement.** **All candidates must live near:**
**Eden Prairie, MN** : 11000 Prairie Lakes Drive Eden Prairie, MN 55344
Are you looking for an impactful job requiring that offers an opportunity to develop a professional career? Bring your 2+ years' experience in a office setting or medical experience and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands.
+ An assigned mentor and manager who will guide you on your career journey.
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE OF THE ROLE:**
To process claims and determine benefits due pursuant to a disability plan; to make timely payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets; and to ensure the ongoing processing of claims.
**ARE YOU AN IDEAL CANDIDATE?**
We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.
**ESSENTIAL RESPONSIBLITIES MAY INCLUDE**
+ Makes claim determinations to approve non-complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Determines benefits due, makes timely claims payments 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 either by phone, written correspondence and/or claims system.
**QUALIFICATIONS**
+ Education & Licensing: High school diploma or GED required.
+ Skills: Strong oral and written communication, computer literate - including Microsoft Office, organizational skills required
+ PC literate, including Microsoft Office products, Windows environment.
+ Must meet minimum typing requirements.
+ Experience: Clerical or customer service experience or equivalent combination of education and experience preferred
**TAKING CARE OF YOU**
+ Entry-level colleagues are offered a world class training program with a comprehensive curriculum.
+ An assigned mentor and manager that will support and guide you on your career journey.
+ Career development and promotional growth opportunities
+ A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more.
Work environment requirements:
Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking.
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
_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 a specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (16.00 - 19.50). 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.**
**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**
View Now
8
Disability Representative
38111 Memphis, Tennessee
Sedgwick
Posted 15 days ago
Job Viewed
Job Description
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
**Disability Representative**
Are you looking for an impactful job that offers the opportunity to develop a professional career? Bring your 1-2 years' experience in an office setting and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands
+ An assigned mentor and manager who will guide you on your career journey
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE** : Provides disability case management and routine 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; coordinates investigative efforts, thoroughly reviewing 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 claim determinations, based on the information received, to approve routine disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Reviews and analyzes routine medical information (i.e. attending physical statements, office notes, off work notes, etc.) or consults with a nurse to determine if the claimant is disabled as defined by the disability plan.
+ Utilizes the appropriate clinical resources in case assessment (i.e. duration guidelines, in-house clinicians) regularly.
+ Determines benefits due, makes timely claims payments 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 routine 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 as appropriate to team lead and clinical case management to assist with claim determination.
+ Meets the organization's quality program(s) minimum requirements.
+ Maintains professional client relationships and provides excellent customer service.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
**QUALIFICATIONS**
**Education & Licensing**
High school diploma or GED required.
**Experience**
Two (2) years of related experience or equivalent combination of education and experience required. One (1) year of office or customer service experience required. One (1) year of benefits or claims management 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
+ 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 with limited supervision
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental:** Clear and conceptual thinking ability; excellent judgment 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
**NOTE:** Credit security clearance, confirmed via a background credit check, is required for this position.
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 (19.00 - 23.00). 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.**
**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**
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
**Disability Representative**
Are you looking for an impactful job that offers the opportunity to develop a professional career? Bring your 1-2 years' experience in an office setting and grow with us!
+ A stable and consistent work environment in an office and/or virtual setting
+ A training program to learn how to help employees and customers from some of the world's most reputable brands
+ An assigned mentor and manager who will guide you on your career journey
+ Career development and promotional growth opportunities through increasing responsibilities
+ A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs.
**PRIMARY PURPOSE** : Provides disability case management and routine 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; coordinates investigative efforts, thoroughly reviewing 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 claim determinations, based on the information received, to approve routine disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
+ Reviews and analyzes routine medical information (i.e. attending physical statements, office notes, off work notes, etc.) or consults with a nurse to determine if the claimant is disabled as defined by the disability plan.
+ Utilizes the appropriate clinical resources in case assessment (i.e. duration guidelines, in-house clinicians) regularly.
+ Determines benefits due, makes timely claims payments 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 routine 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 as appropriate to team lead and clinical case management to assist with claim determination.
+ Meets the organization's quality program(s) minimum requirements.
+ Maintains professional client relationships and provides excellent customer service.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
**QUALIFICATIONS**
**Education & Licensing**
High school diploma or GED required.
**Experience**
Two (2) years of related experience or equivalent combination of education and experience required. One (1) year of office or customer service experience required. One (1) year of benefits or claims management 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
+ 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 with limited supervision
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental:** Clear and conceptual thinking ability; excellent judgment 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
**NOTE:** Credit security clearance, confirmed via a background credit check, is required for this position.
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 (19.00 - 23.00). 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.**
**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**
View Now
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