Disability Clinical Specialist

🔥 0 minutes ago

🏈 Alabama, Florida, +2 more states – Remote

🏈 Alabama – Remote 🐊 Florida – Remote ⚜️ Louisiana – Remote 🎸 Tennessee – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

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Sedgwick

WebsiteLinkedInAll Job Openings

10,000+ employees

🏗️ Construction

💼 Consulting

🏥 Healthcare

Construction • Consulting • Healthcare

Sedgwick is a global provider of technology-enabled risk, benefits, and integrated business solutions. They help people and organizations by managing and mitigating risk with solutions in accident, health, disability, unemployment compensation, and liability claims administration, among others. Sedgwick offers services such as claims administration, building consulting, forensic accounting, and forensic engineering. Their specialties include property restoration, brand protection, and loss prevention across several industries, including agriculture, construction, and environmental sectors. The company emphasizes diversity, equity, and inclusion (DEI) as well as environmental, social, and governance (ESG) practices.

📋 Description

• Perform standard clinical evaluations and reviews of referred disability medical claims • Review medical documentation and apply clinical knowledge to substantiate disability and assess impact on job functions • Document decision rationale and ensure accurate, sufficient claim information • Communicate with employees and providers about clinical status, progress, and work status • Provide follow-up recommendations for ongoing medical management of claims • Achieve appropriate quality audit scores • Act as a clinical resource to claims examiners on medical management, terminology, and claim decisions • Provide ad hoc backup for key disability claims • Perform other assigned duties and travel as required

🎯 Requirements

• Bachelor's degree or equivalent preferred • Current RN, LVN, LPN, CRC, COHN CVE, LPC and/or LCSW license(s) required • Current license, registration and/or professional designations as required within the jurisdiction • Maintain clinical expertise through required CEUs to maintain licenses and designations • Four (4) years of related experience or equivalent combination of experience and education required • Experience in a direct medical/psychological setting or physical industrial medicine • Previous insurance or related experience • Knowledge of current medical practices in health care management, including orthopedics, general medicine, general surgery, mental health, obstetrics, oncology, and physical and occupational rehabilitation • Excellent oral and written communication, including presentation skills • Proficient computer skills, including working knowledge of Microsoft Office • Analytical and interpretive skills • Strong organizational and multitasking skills • Excellent interpersonal skills • Ability to exercise judgment and critical thinking skills • Ability to work in a team environment • Ability to meet or exceed Performance Competencies • Ability to handle work-related stress, multiple priorities, and deadlines • Ability to sit at a desk for extended periods while operating a computer and phone system • Travel as required

🏖️ Benefits

• Work-life balance • Caring culture • Reasonable accommodations when applicable and appropriate • Equal opportunity workplace • Drug-free workplace