Disability Claims Clinical Specialist

Guardian Life; Carmel (IN); Hybrid; USD 59,000 - 89,000; Full time

Job summary

Guardian Life is seeking a Clinical Specialist to support timely disability claim decisions using practical nursing experience. You will obtain medical information, define functional limitations, and collaborate with claimants, providers, and case managers to gather evidence.

In this mobile role, prefer candidates near Guardian offices with travel as needed. A valid LPN/LVN license and at least two years of clinical experience are required, with strong communication and organizational skills.

Qualifications

• Preferred qualifications include disability claims support or medical case management.
• Experience obtaining and reviewing medical documentation from treating providers.
• LPN or LVN license in good standing from an accredited nursing program.
• Minimum of two years of clinical or medical office experience.
• Excellent written and verbal communication skills.
• Ability to exercise independent, sound judgment in decision-making.
• Strong time-management, organizational, and multitasking abilities.
• Self-motivated and able to work both independently and with multiple professionals.

Responsibilities

• Review claim file information and obtain medical documentation such as disability certifications and treatment plans.
• Identify missing information to support disability claim adjudication using medical knowledge.
• Document precise details on certification dates, treatment plans, and functional information.
• Collaborate with Claims Case Managers, claimants, and treating providers to collect information promptly.
• Support vendor management by coordinating services and following up on vendor reports as needed.
• Adapt to changing business needs and assist the team in meeting customer and departmental requirements.

Skills

LPN/LVN license

Clinical experience

Medical documentation review

Excellent communication

Independent judgment

Time management

Microsoft Office & OneNote

Disability claims knowledge

Education

LPN or LVN from an accredited nursing program

Tools

Microsoft Office

OneNote

Job description

Guardian Life is seeking a Clinical Specialist to support timely disability claim decisions using practical nursing experience. You will obtain medical information, define functional limitations, and collaborate with claimants, providers, and case managers to gather evidence.

In this mobile role, prefer candidates near Guardian offices with travel as needed. A valid LPN/LVN license and at least two years of clinical experience are required, with strong communication and organizational skills.