Disability Claims Clinical Specialist

Sedgwick; Iowa Center (IA); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Equal Opportunity Employer

Drug-Free Workplace

Job summary

Sedgwick is seeking a Disability Clinical Specialist to perform standard clinical evaluations on claims requiring additional review based on medical condition, client requirements, and complexity. You will consult with providers and employees, provide case direction, and ensure medical information substantiates the need for employee absence from work.

In this role, you will review medical documentation, communicate findings clearly by phone or written notes, and contribute to quality audits.

Qualifications

• Bachelor's degree or equivalent preferred; active RN/LVN/LPN/CRC/COHN CVE/LPC/LCSW licenses required.
• Four years of related medical/psychological or industrial medicine experience.
• Excellent written and oral communication, including presentation skills.

Responsibilities

• Performs standard clinical reviews of referred medical claims to ensure adequate information.
• Reviews documentation to substantiate disability and impact on job functions.
• Communicates findings with employees and providers by phone or in writing.
• Provides follow-up recommendations for medical management of claims.
• Acts as clinical resource to claims examiners for medical guidance.
• Backups for key disability claims and travel as required.

Skills

Clinical communication

Teamwork

Analytical skills

Organizational skills

Judgment and decision making

Interpersonal skills

Problem solving

Education

Bachelor's degree or equivalent preferred

Professional licenses (RN/LVN/LPN/CRC/COHN CVE/LPC/LCSW)

Tools

Microsoft Office

Job description

Sedgwick is seeking a Disability Clinical Specialist to perform standard clinical evaluations on claims requiring additional review based on medical condition, client requirements, and complexity. You will consult with providers and employees, provide case direction, and ensure medical information substantiates the need for employee absence from work.

In this role, you will review medical documentation, communicate findings clearly by phone or written notes, and contribute to quality audits.