Advocacy Coordination Specialist

Join Sedgwick and become part of a caring culture that values your contributions. With 33,000 colleagues committed to helping people facing the unexpected, your career can thrive here. Enjoy a balanced work-life dynamic and the potential for meaningful impact in the lives of others. Recognized by Newsweek as one of America's Greatest Workplaces and certified as a Great Place to Work®, Sedgwick is also a Fortune Best Workplace in Financial Services & Insurance. Advocacy Coordination Specialist Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence: 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 West Hills, CA: 8521 Fallbrook Ave West Hills, CA 91304 PRIMARY PURPOSE: As the Advocacy Coordination Specialist, you will actively research, resolve, and manage escalated inquiries across various lines of business. This includes Family Medical Leave (FMLA), complex paid and unpaid state and military leaves, accommodations, and disability claims. Your role will involve providing exceptional customer service infused with care and empathy while ensuring accurate claims processing and compliance with regulatory requirements. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Independently determine claims outcomes based on received information to approve complex claims or recommend claims denial to the team lead. Analyze and authorize leave, accommodation, disability, and statutory claims while determining benefits due in compliance with client plans, federal and state regulations. Adjust claims payments and evaluate file interfaces to aid in payment research and resolution. Communicate clearly and professionally with claimants and clients regarding the claims process, including approvals, decision authority levels, and issue resolutions via phone, written correspondence, or claims systems. Facilitate claim resolutions and address escalated inquiries involving claimants, human resources, and medical offices, aiming for one-call resolutions. Ensure claims files are accurately coded and contain sufficient documentation. Review and analyze complex medical information to ascertain if claimants meet disability criteria defined by disability plans while managing the claims process to completion. Guide claimants and clients in what documentation is required for claim processing, including payment details and status updates. Determine benefits, manage timely claims payments, and adjust for areas such as workers compensation and Social Security Disability Income (SSDI). Maintain professional relationships with clients, adhering to specific service level expectations, regulations, and reporting. Meet organizational quality program minimum requirements. ADDITIONAL FUNCTIONS AND RESPONSIBILITIES: Perform other duties as assigned. QUALIFICATIONS: Education & Licensing: High school diploma or GED required; a Bachelor's degree from an accredited college or university is preferred. Experience: Three (3) years of relevant experience or an equivalent combination of experience and education is required, including at least two (2) years of disability claims experience. Familiarity with HR systems like SMART, SIR, GAIN is preferred. Internal candidates should have knowledge of TAMS, Juris, viaOne express, and mySedgwick. Skills & Knowledge: Strong understanding of ERISA regulations, state and federal FMLA, ADAAA, Social Security application processes, offsets, and disability procedures. Proficient in medical terminology and duration management. Advanced computer proficiency, especially in Microsoft Office. Exceptional call handling and de-escalation techniques. Excellent verbal and written interpersonal communication skills. Strong analytical, interpretive, and critical thinking abilities. Decisive and effective judgment skills. Capability to manage ambiguity with poise. Organizational and multitasking skills are essential. Ability to autonomously exercise judgment within established procedures. Commitment to teamwork and exceeding performance metrics. WORK ENVIRONMENT: You will be required to adhere to a set schedule with established break times. Reasonable accommodations will be considered when appropriate. Mental: This role requires clear thinking, solid judgment, effective problem-solving skills, and the ability to handle multiple priorities and deadlines while managing work-related stress. Physical: Ability to sit for extended periods at a desk, utilizing a computer and phone system. Travel as required. Auditory/Visual: Ability to hear, see, and communicate effectively. NOTE: A credit security clearance is required for this position, confirmed through a background check. The duties outlined are designed to provide a general overview of the role but are not exhaustive. Management may add or modify responsibilities as necessary. Sedgwick offers competitive compensation for roles adhered to jurisdictional transparency laws. Actual salary varies based on skills, experience, and location, with a starting range of $23-$25 per hour for this position. A comprehensive benefits package, including medical, dental, vision, 401(k), PTO, and more, is provided. Sedgwick is an Equal Opportunity Employer and maintains a drug-free workplace. If you're enthusiastic about this role but feel your experience may not fully align with every qualification, we encourage you to apply. Sedgwick values diversity and recognizes that each individual has a unique set of skills and experiences that could be a perfect fit for this position or others. Join Sedgwick, the leading global partner in risk and claims administration, aiding clients navigate unforeseen challenges with unmatched perspective, expertise, and advanced technology.

Created: 2026-03-10