Top 154 Claims advisor Jobs in Dallas, Tx

Disability Representative Sr
Sedgwick —Irving, TX
- Hybrid work
- Writing skills
- Office
- High school diploma or GED
- Health savings account
- Disability insurance
Claim Specialist- Auto Injury-Hybrid
State Farm —Richardson, TX
- $66,071.85 - $83,535.93 a year
- Overtime
- Hybrid work
- Customer service
- Mid-level
- Office
- Paid holidays
- Health insurance
Claim Specialist - Property Field Inspection
State Farm —Dallas, TX
- $59,059.65 - $90,000.00 a year
- Overtime
- Mid-level
- Residential
- Analysis skills
- Paid holidays
- Health insurance
Strategic Credit & Collections Lead - 3PL
McKesson —Irving, TX
- $27.45 - $45.75 an hour
- Research
- Analysis skills
- Continuous improvement
14d
Warranty Administrator
W.W.Williams Company —Irving, TX
- Full-time
- High school diploma or GED
- Communication skills
- Entry level
- Paid training
- Paid holidays
Quick Apply
Insurance Sales Advisor (Career Growth & High Earnings) (copy)
The Powell Agency —Plano, TX
- $65,000 - $100,000 a year
- Full-time
- Mid-level
- Office
- Computer skills
- Paid time off
- Opportunities for advancement
Quick Apply
3d
Bilingual Parts Purchasing Specialist
CACTUS JACKS AUTO —Irving, TX
- From $20 an hour
- Full-time
- Bilingual
- Background check
- Clean driving record
- Health insurance
- Dental insurance
Quick Apply
Senior Commercial Litigation Associate Attorney (7 Years)
Career Crafters —Dallas, TX
- Full-time
- 7 years
- Writing skills
- Mentoring
- Health savings account
- Disability insurance
Quick Apply
3h
Attorney
State Farm Mutual Automobile Insurance Company —Dallas, TX
- $115,000 - $160,000 a year
- Full-time
- Hybrid work
- Mid-level
- 3 years
- US work authorization
- Paid holidays
- Health insurance
After-Sales Technical Support Engineer-Electrical Vehicles
DCD Vehicle Corp —Lancaster, TX
- $60,000 - $100,000 a year
- Full-time
- Mid-level
- Continuous improvement
- Travel
- Health insurance
- Dental insurance
Quick Apply
Associate, Portfolio Compliance, Legal, & Risk Management
NEON SOLUTIONS SERVICES LLC —Plano, TX
- Writing skills
- Analysis skills
- Bachelor's degree
Claims Appraiser - Auto Estimatics
State Farm —Dallas, TX
- $59,059.65 - $82,000.00 a year
- Overtime
- Mid-level
- Driver's License
- Clean MVR report
- Paid holidays
- Health insurance
Executive Claims Examiner, Miscellaneous Professional E&O
Markel Service Inc. —Plano, TX
- $97,520 - $134,090 a year
- Email
- Writing skills
- Mid-level
- Travel
- AD&D insurance
- Employee stock purchase plan
Quick Apply
6d
Credit & Collections Manager — 3PL Accounts Receivable
McKesson —Irving, TX
- $69,300 - $115,500 a year
- Research
- Supervising experience
- Experience equivalent to degree accepted
9d
VSC Claims Adjuster
Ethos Group —Irving, TX
- Monday to Friday
- ASE Certification
- Mechanic experience
- Computer literacy
- Health insurance
- Dental insurance
Assoc Partner, Consult Partner - Cloud / Healthcare (Payors)
Kyndryl —Dallas, TX
- $185,760 - $401,160 a year
- Full-time
- Remote
- Senior level
- AI
- Leadership
- Health insurance
- Dental insurance
Director, Head of Third-Party Claims
Revantage Corporate Services, LLC —Dallas, TX
- $170,000 - $200,000 a year
- Full-time
- Hybrid work
- 11+ years
- Office
- Residential
- Paid holidays
- Health insurance
Quick Apply
Vice President of Litigation
Korn Ferry International —Dallas, TX
- $350,000 - $400,000 a year
- 11+ years
- Office
- Presentation skills
Glide Customer Success Manager
McKesson —Irving, TX
- $84,700 - $141,100 a year
- Microsoft Outlook
- Word processing
- Bachelor of Science
13d
EHS Manager
Earthtones Companies —Midlothian, TX
- $110,000 - $135,000 a year
- Full-time
- Spanish
- Clean driving record
- Management
- Health insurance
- Dental insurance
Quick Apply

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Disability Representative Sr

Sedgwick -
Irving, TX

Apply Now

Job Details

Benefits

Health savings account
Disability insurance
Health insurance
Dental insurance
Paid time off
Vision insurance
401(k) matching
Life insurance

Qualifications

High school diploma or GED

Full 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 Sr

Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:

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

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

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

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

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

Performs other duties as assigned.

QUALIFICATIONS

Education & Licensing
High School diploma or GED required. Bachelor's degree from an accredited university or college preferred. State certification or licensing in statutory leaves is preferred or may be required based on state regulations.

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

Skills & Knowledge

Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices and Social Security application procedures
Knowledge of state and federal FMLA regulations
Working knowledge of medical terminology and duration management
Excellent oral and written communication, including presentation skills
Proficient computer skills including working knowledge of Microsoft Office
Analytical, interpretive, and critical thinking skills
Ability to manage ambiguity
Strong organizational and multitasking skills
Ability to work in a team environment
Ability to meet or exceed performance competencies as required by program
Effective decision-making and negotiation skills
Ability to exercise judgement autonomously within established procedures

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

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

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

Auditory/Visual : Hearing, vision and talking

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

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $23.00 -$25.00 USD Hourly. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

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

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

Apply Now

Refine Your Search

claims advisor jobs in dallas, tx

Disability Representative Sr

Claim Specialist- Auto Injury-Hybrid

Claim Specialist - Property Field Inspection

Strategic Credit & Collections Lead - 3PL

Warranty Administrator

Insurance Sales Advisor (Career Growth & High Earnings) (copy)

Bilingual Parts Purchasing Specialist

Senior Commercial Litigation Associate Attorney (7 Years)

Attorney

After-Sales Technical Support Engineer-Electrical Vehicles

Associate, Portfolio Compliance, Legal, & Risk Management

Claims Appraiser - Auto Estimatics

Executive Claims Examiner, Miscellaneous Professional E&O

Credit & Collections Manager — 3PL Accounts Receivable

VSC Claims Adjuster

Assoc Partner, Consult Partner - Cloud / Healthcare (Payors)

Director, Head of Third-Party Claims

Vice President of Litigation

Glide Customer Success Manager

EHS Manager

I want to receive the latest job alert for claims advisor in dallas, tx

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