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Disability Representative Sr.

Sedgwick

1 Positions

ID: R56820

Posted On 10/03/2025

Job Overview

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Disability Representative Sr.

Senior Disability Representative – Make a Meaningful Impact

**Dubuque, IA** : 4141 Westmark Drive, Dubuque, IA 52002

**Cedar Rapids, IA** : 333 1st Street SE Ste. 200 Cedar Rapids IA 52401

**Coralville, IA:** 3273 Ridgeway Drive Coralville IA 52241

**Dublin, OH** : 5500 Glendon Court Dublin OH 43016

**New Albany, OH** : 7795 Walton Parkway New Albany, OH 43054

**Chicago, IL :** 175 W. Jackson Blvd. 12th Fl. Chicago IL 60604

**Indianapolis, IN:** 8909 Purdue Road Suite 501 Indianapolis, IN 46268

**Irving, TX** : 2201 W. Royal Lane Suite 125 Irving, TX 75063

**Memphis, TN :** 8125 Sedgwick Way, Memphis TN 38125

**Southfield, MI** : 300 Galleria Officentre Southfield MI 48034

**Orlando, FL :** 12650 Ingenuity Dr Orlando FL 32826

**Eden Prairie, MN** : 11000 Prairie Lakes Drive Eden Prairie, MN 55344

**West Hills, CA** : 8521 Fallbrook Ave West Hills, CA 91304

**PRIMARY PURPOSE** :

At Sedgwick,** **caring counts** **. We’re a global leader in claims management, and we’re looking for experienced, compassionate professionals to join us as** **Senior Disability Representatives** **. If you’re someone who thrives in a collaborative environment, values integrity, and wants to make a real difference in people’s lives—this is your opportunity.

What You’ll Do

As a Senior Disability Representative, you’ll be a trusted guide for individuals navigating complex disability claims. You’ll use your expertise to assess medical documentation, determine benefits, and support return-to-work strategies—all while delivering exceptional service with empathy and precision.

Key responsibilities include:

Independently evaluating and managing complex disability claims.

Interpreting medical records and disability plans to determine eligibility.

Handling claims involving comorbidities, ADA accommodations, and concurrent plans.

Collaborating with healthcare providers and employers to facilitate return-to-work.

Communicating clearly and compassionately with claimants and clients.

Coordinating investigative efforts and referrals to external vendors when needed.

Maintaining strong client relationships and upholding Sedgwick’s quality standards.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Independently evaluates complex disability claims and makes approval decisions based on received documentation, or recommends denial to the team lead in alignment with the disability plan.

Carefully reviews and interprets detailed medical records—including attending physician statements, office notes, and operative reports—to assess whether the claimant meets the plan’s definition of disability.

Oversees multifaceted claims involving comorbid conditions, overlapping benefit plans, ADA accommodations, and cases that fall outside standard guidelines.

Applies clinical resources such as duration guidelines and consults with in-house clinicians to support case assessments when necessary.

Calculates benefits due under the disability plan and ensures timely processing of payments, approvals, and adjustments—including offsets for workers’ compensation, Social Security Disability Income (SSDI), and other applicable sources.

Clearly communicates with claimants regarding required documentation, timelines, payment details, and claim status through phone calls, written correspondence, and system updates.

Engages with healthcare providers to establish expectations for return-to-work timelines and accommodations.

Manages complex disability claims with a focus on medical compliance, duration control, and adherence to plan provisions.

Maintains consistent and transparent communication with claimants and clients throughout the claims process via phone, written updates, and system documentation.

Coordinates investigative efforts to ensure thorough and appropriate claim reviews.

Identifies when claims require external support and arranges referrals to vendors for services such as physician advisor reviews, surveillance, independent medical evaluations, and functional capability assessments.

Facilitates return-to-work negotiations with or without accommodations, collaborating with the claimant’s physician and employer.

Escalates cases to the team lead or clinical case management for further review when appropriate.

Builds and maintains professional relationships with clients, delivering high-quality customer service.

Meets or exceeds the organization’s quality standards and program requirements.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

Performs other duties as assigned.

QUALIFICATIONS

Education & Licensing

High school diploma or GED is required.

Bachelor’s degree from an accredited college or university is preferred.

State certification or licensing in statutory leaves is preferred or may be required depending on local regulations.

Experience

Preferred: Three (3) years of experience in benefits or disability case/claims management, or an equivalent combination of education and experience.

Skills & Knowledge

Solid understanding of ERISA regulations, disability offsets and deductions, medical management practices, and Social Security Disability application procedures.

Familiarity with federal and state FMLA regulations.

Working knowledge of medical terminology and duration management.

Strong verbal and written communication skills, including the ability to present information clearly.

Proficiency in Microsoft Office and general computer systems.

Analytical mindset with strong interpretive and critical thinking abilities.

Comfortable navigating ambiguity and making informed decisions.

Excellent organizational and multitasking capabilities.

Collaborative team player with a commitment to performance excellence.

Skilled in negotiation and autonomous decision-making within established procedures.

Ability to exercise sound judgment and maintain discretion.

WORK ENVIRONMENT

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

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

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

**Auditory/Visual** **:** Hearing, vision and talking

Ready to Make a Difference?

Apply today and become part of a team that’s redefining care and support in the workplace. At Sedgwick, your work matters—and so do you.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

_As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $20.39 - $24.00 USD Hourly_ _. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._

Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Primary Contact

1645458383738

Amanda Strothman

,

Phone

Phone

Phone

Fax

[email protected]

Email

True

False

True

Job Details

Categories

Insurance

Technical

Location

Dubuque, IA

Job Type

Employee

Full/Part

Full Time

Company ID

8326

Job REQ #

R56820

\# Positions

1

Start Date

20251003

End Date

20251103

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Sedgwick

About the Company

Career Development

Our goal is to make Sedgwick CMS a place where great people can do great things for our clients. This commitment is evidenced by our colleague development program and supported by our multi-dimensional learning resources.

We invest in the education of our colleagues by providing training and learning resources that focus on our culture, procedures, systems and performance expectations. We evaluate the educational needs of our colleagues through performance discussions and evaluations. These needs are filled either through Sedgwick CMS University and through industry certification programs and other external educational resources . Sedgwick CMS University curriculum offerings take colleagues from orientation to technical training to supervisory and managerial development. Through Sedgwick CMS University, we provide our colleagues continuous development of professional skills and the ability to deliver quality service to our clients.

Colleague Orientation

We offer a required colleague orientation program that allows us to verify and document the training provided to new colleagues. This program is called Personal Responsibility in Developing Excellence (PRIDE) and is the first component of our comprehensive career development process. This program introduces and orients new and transitioning colleagues to our company and to their new position. PRIDE will take colleagues through the first 90 days of their new position. Objectives of this program focus on providing colleagues an increased awareness of who we are, where we are going, and how they can help us get there.

Career Paths

Career path options are identified through an ongoing process of discussion and collaboration between colleagues and their managers. On an ongoing basis, our managers counsel colleagues regarding their career path, new opportunities, and additional training and development requirements to help them reach their individual goals.