Clinical Disability Claims Specialist

Sedgwick; Iowa; On-site; USD 60,000 - 90,000; Full time

Job summary

Sedgwick is seeking a Disability Clinical Specialist to perform clinical evaluations on complex claims and guide medical decisions that impact employee absence from work. You will consult with providers and employees, ensuring documentation supports the disability determination and client requirements.

The role emphasizes clear communication, teamwork, and strong analytical skills, with responsibilities to review medical information, provide follow-up recommendations, and support claims

Qualifications

• Bachelor's degree or equivalent preferred; professional licenses required as listed.
• Four years of related experience in medical/psychological or physical industrial medicine.
• CEUs required to maintain licenses and designations.

Responsibilities

• Perform standard clinical reviews of referred medical claims.
• Review medical documentation and interpret impact on job functions.
• Communicate with employees and providers about status.
• Provide follow-up medical management recommendations.
• Maintain quality audit scores.
• Serve as clinical resource to claims examiners.

Skills

Medical knowledge

Communication skills

Computer skills

Analytical skills

Organizational skills

Interpersonal skills

Teamwork

Critical thinking

Education

Bachelor's degree or equivalent

RN/LVN/LPN license

CRC/COHN CVE license

LPC/LCSW license

Tools

Microsoft Office

Job description

Sedgwick is seeking a Disability Clinical Specialist to perform clinical evaluations on complex claims and guide medical decisions that impact employee absence from work. You will consult with providers and employees, ensuring documentation supports the disability determination and client requirements.

The role emphasizes clear communication, teamwork, and strong analytical skills, with responsibilities to review medical information, provide follow-up recommendations, and support claims