Disability Claims Clinical Specialist

Sedgwick; Town of King (WI); On-site; USD 60,000 - 90,000; Full time

Job summary

Sedgwick is hiring a Disability Clinical Specialist to perform standard clinical evaluations and review complex claims, ensuring medical information substantiates the need for employee absence from work.

The role requires a Bachelor’s degree (or equivalent), four years in a medical/claims setting, and strong communication skills. Travel as needed; a collaborative, detail‑oriented professional will thrive here.

Qualifications

• Bachelor's degree or equivalent required; professional licenses as applicable.
• Four years of related medical/claims experience; background in clinical review or disability settings preferred.
• Strong written and verbal communication, analytical, and multitasking abilities.

Responsibilities

• Perform standard clinical reviews of referred medical claims per client requirements to ensure sufficient information.
• Review medical documentation to substantiate disability and the impact on job functions.
• Communicate findings clearly with employees and providers; provide follow-up recommendations for medical management.
• Serve as a clinical resource to claims examiners for medical guidance and decision support.

Skills

Medical reviews

Communication

Microsoft Office

Analytical thinking

Teamwork

Education

Bachelor's degree or equivalent

Tools

Microsoft Office

Job description

Sedgwick is hiring a Disability Clinical Specialist to perform standard clinical evaluations and review complex claims, ensuring medical information substantiates the need for employee absence from work.

The role requires a Bachelor’s degree (or equivalent), four years in a medical/claims setting, and strong communication skills. Travel as needed; a collaborative, detail‑oriented professional will thrive here.