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Disability Claims Case Manager Jobs in Ohio (NOW HIRING)

Sedgwick

Disability Representative Sr

Dublin, OH · On-site

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 ...

Sedgwick

Disability Representative Sr

Dublin, OH · On-site

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 ...

Sedgwick

Disability Representative Sr

New Albany, OH · On-site

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 ...

Encova Insurance

Nurse Case Manager

Columbus, OH · On-site

$55K - $110K/yr

... disability costs. 6. Identify and monitor claims for task assignments to field case managers. 7. Evaluate accuracy of diagnoses of injuries or disabilities. 8. Document recommendations, contacts ...

Encova Insurance

Nurse Case Manager

Columbus, OH · On-site

$55K - $110K/yr

... disability costs. 6. Identify and monitor claims for task assignments to field case managers. 7. Evaluate accuracy of diagnoses of injuries or disabilities. 8. Document recommendations, contacts ...

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Disability Claims Case Manager information

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$15

$26

$45

How much do disability claims case manager jobs pay per hour?

As of Aug 24, 2026, the average hourly pay for disability claims case manager in Ohio is $26.26, according to ZipRecruiter salary data. Most workers in this role earn between $20.34 and $30.14 per hour, depending on experience, location, and employer.

What is the difference between Disability Claims Case Manager vs Disability Claims Adjuster?

AspectDisability Claims Case ManagerDisability Claims Adjuster
CredentialsTypically requires a bachelor’s degree in healthcare, social work, or related field; certifications like CPC or CRC are commonOften requires a bachelor’s degree; certifications such as CPC or AIC may be preferred
Work EnvironmentOffice-based, interacting with claimants, healthcare providers, and employersOffice or field-based, evaluating claims and inspecting medical or work sites
Employer & IndustryInsurance companies, government agencies, third-party administratorsInsurance companies, third-party administrators, government agencies

Disability Claims Case Managers and Disability Claims Adjusters both handle disability claims but differ mainly in focus. Case Managers coordinate care and support claimants throughout the process, while Adjusters evaluate and authorize claims. Both roles require relevant credentials and work in similar environments within the insurance industry.

How to become a disability claims case manager?

To become a disability claims case manager, candidates typically need a bachelor's degree in fields like social work, healthcare, or related areas. Relevant skills include strong communication, organization, and knowledge of insurance policies; some roles may require certification such as the Certified Disability Management Specialist (CDMS). Experience in claims processing or social services can also be beneficial for entry into this role.

What does a disability claims case manager for people with disabilities do?

A disability claims case manager for people with disabilities reviews and processes benefit claims, evaluates medical and supporting documentation, and communicates with claimants to determine eligibility. They often coordinate with healthcare providers and use case management software to ensure accurate and timely decisions, helping clients access appropriate disability benefits.

What is a disability claims case manager?

A disability claims case manager is a professional who reviews and processes disability insurance claims, ensuring applicants meet eligibility requirements. They evaluate medical documentation, coordinate with healthcare providers, and communicate decisions to claimants, often using case management software. Strong organizational skills and knowledge of insurance policies are essential for this role.

What are popular job titles related to Disability Claims Case Manager jobs in Ohio?

For Disability Claims Case Manager jobs in Ohio, the most frequently searched job titles are:

What job categories do people searching Disability Claims Case Manager jobs in Ohio look for?

The top searched job categories for Disability Claims Case Manager jobs in Ohio are:

What cities in Ohio are hiring for Disability Claims Case Manager jobs?

Cities in Ohio with the most Disability Claims Case Manager job openings:

Disability Claims Case Manager jobs near you

Disability Representative Sr

Sedgwick

Dublin, OH • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 15 days ago

Sedgwick rating

7.6

Company rating: 7.6 out of 10

Based on 327 frontline employees who took The Breakroom Quiz

212th of 311 rated insurance

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

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