Disability Representative Sr.

SEDGWICK

Southfield, MI, US
Hybrid
Disability plan interpretation
Medical documentation analysis
Return to work negotiation
Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation

Job Summary

  • Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation.
  • Reviews and analyzes complex medical information to determine if the claimant is disabled as defined by the disability plan.
  • Communicates clearly and timely with claimant and client on all aspects of claims process by phone, written correspondence and/or claims system.

Matching Summary

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

Skills & Requirements

Must-have

  • Disability plan interpretation
  • Medical documentation analysis
  • Return to work negotiation
  • Investigative efforts coordination
  • Claim determination
  • Benefit calculation and payment

Nice-to-have

  • Caring culture
  • Work-life balance
  • Collaborative team environment
  • Client relationship management

Key Requirements

  • High School diploma or GED
  • Three (3) years of experience
  • Knowledge of ERISA regulations
  • Knowledge of state and federal FMLA regulations
  • State certification or licensing preferred

Work Rights

Not specified

Tailored Resume

Cover Letter