Clinical Specialist - Disability Claims & Medical Data

Guardian Life Insurance Company; Bethlehem (Northampton County); Hybrid; USD 59,000 - 89,000; Full time

Job summary

Guardian Life Insurance Company seeks a Clinical Specialist to leverage nursing experience to support disability claim decisions. You will obtain certification dates, treatment plans, and functional limitations from claimants and providers, collaborating with case managers and vendors to ensure timely information collection.

In this mobile role, you will travel to Guardian offices as needed, prioritize competing demands, and maintain current medical knowledge.

Qualifications

• Licensed Practical or Vocational Nurse (LPN/LVN) with valid license in good standing.
• Experience supporting disability claims or medical case management preferred.
• Excellent written and verbal communication skills.

Responsibilities

• Review claim file information and obtain medical documentation for disability adjudication.
• Identify missing or pertinent information to support decisions.
• Coordinate with Claims Case Managers, claimants and providers for timely outreach.
• Assist with vendor utilization and reporting as needed.

Skills

Clinical knowledge

Communication

Independent worker

Time management

Multitasking

Microsoft Office

OneNote

Education

LPN or LVN license

Tools

Microsoft Office

OneNote

Job description

Guardian Life Insurance Company seeks a Clinical Specialist to leverage nursing experience to support disability claim decisions. You will obtain certification dates, treatment plans, and functional limitations from claimants and providers, collaborating with case managers and vendors to ensure timely information collection.

In this mobile role, you will travel to Guardian offices as needed, prioritize competing demands, and maintain current medical knowledge.