Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Disability Representative Sr.
Chicago, IL · On-site
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Disability Representative Sr.
Chicago, IL · On-site
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Disability Representative Sr
Chicago, IL · On-site
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Disability Representative Sr
Chicago, IL · On-site
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Disability Representative Sr
Chicago, IL · On-site
Refers cases to team lead and clinical case management for additional review when appropriate ... Experience Three (3) years of benefits or disability case/claims management experience or ...
Disability Representative Sr
Chicago, IL · On-site
Refers cases to team lead and clinical case management for additional review when appropriate ... Experience Three (3) years of benefits or disability case/claims management experience or ...
Disability Representative Sr
Irving, TX · On-site
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Disability Representative Sr
Irving, TX · On-site
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Disability Representative Sr.
Irving, TX · On-site
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Disability Representative Sr.
Irving, TX · On-site
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Disability Representative Sr
Chicago, IL · On-site
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Disability Representative Sr
Chicago, IL · On-site
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
OPS Medical Disability Case Records Specialist - 64801365
Orlando, FL · On-site
$18.40/hr
OPS Medical Disability Case Records Specialist - 64801365 Pay Plan: Temp Position Number: 64801365 ... Reviews medical disability and associated medical documents to determine if additional ...
OPS Medical Disability Case Records Specialist - 64801365
Orlando, FL · On-site
$18.40/hr
OPS Medical Disability Case Records Specialist - 64801365 Pay Plan: Temp Position Number: 64801365 ... Reviews medical disability and associated medical documents to determine if additional ...
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Provides disability case management and complex claim determinations based on medical documentation ... Refers cases to team lead and clinical case management for additional review when appropriate.
Disability Case Reviewer information
See salary details
$19.23 - $24.76
3% of jobs
$24.76 - $30.29
6% of jobs
$35.30 is the 25th percentile. Wages below this are outliers.
$30.29 - $35.82
17% of jobs
$35.82 - $41.35
20% of jobs
The median wage is $42.45 / hr.
$41.35 - $46.88
16% of jobs
$46.88 - $52.40
11% of jobs
$53.59 is the 75th percentile. Wages above this are outliers.
$52.40 - $57.93
7% of jobs
$57.93 - $63.46
6% of jobs
$63.46 - $68.99
5% of jobs
$68.99 - $74.52
4% of jobs
$74.52 - $80.05
3% of jobs
$19
$47
$80
How much do disability case reviewer jobs pay per hour?
As of Sep 9, 2026, the average hourly pay for disability case reviewer in the United States is $47.53, according to ZipRecruiter salary data. Most workers in this role earn between $35.34 and $57.45 per hour, depending on experience, location, and employer.
What is a disability case reviewer?
Disability Case Reviewers are professionals who evaluate and review claims for disability benefits to determine if applicants meet the necessary medical and legal criteria. They carefully assess medical records, employment history, and other relevant documentation to ensure claims are processed accurately and fairly. These reviewers often work for government agencies, insurance companies, or healthcare organizations, and play a critical role in ensuring that disability benefits are awarded to those who qualify under established guidelines.
How does a disability case reviewer typically collaborate with other professionals during the case evaluation process?
Disability Case Reviewers often work closely with a multidisciplinary team, including medical professionals, vocational specialists, and claims adjusters. They review and interpret medical records, consult with healthcare providers for clarification, and sometimes participate in team meetings to ensure comprehensive case assessments. Effective communication and collaboration are essential, as reviewers must synthesize information from various sources to make informed and fair recommendations. This team-based approach helps ensure that each case is reviewed thoroughly and in accordance with relevant policies and regulations.
What are the key skills and qualifications needed to thrive as a disability case reviewer, and why are they important?
To excel as a Disability Case Reviewer, you typically need a background in healthcare, social work, or a related field, along with knowledge of disability regulations and case management principles. Familiarity with case management software, medical records systems, and sometimes certifications like Certified Disability Management Specialist (CDMS) or Certified Case Manager (CCM) is valuable. Strong attention to detail, critical thinking, and clear communication skills are essential for evaluating complex cases and interacting with claimants and providers. These competencies ensure accurate and fair determinations, compliance with regulations, and effective service to individuals with disabilities.
What cities are hiring for Disability Case Reviewer jobs?
Cities with the most Disability Case Reviewer job openings:
What are popular job titles related to Disability Case Reviewer jobs?
For Disability Case Reviewer jobs, the most frequently searched job titles are:
Disability Representative Sr.
Southfield, MI • On-site
York Risk Services •
1 - 5K employees1,001 - 5,000 employees
Full-time
Re-posted 26 days ago
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:
Southfield, MI : 300 Galleria Officentre Southfield MI 48034
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.
Sedgwickis 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.
About York Risk Services
Sourced by ZipRecruiter