Disability Claims Clinical Specialist (CRC)

Sedgwick; Lorida (FL); On-site; USD 90,000 - 110,000; Full time

Job summary

Sedgwick is seeking an Accommodation Clinical Specialist to perform standard clinical evaluations on claims requiring review based on medical condition, client requirements, and complexity. You will consult with providers and employees, ensuring medical information substantiates the need for employee absence from work.

You will review medical documentation, interpret disability impact on job functions, and communicate status clearly to employees and providers.

Qualifications

• Bachelor’s degree or equivalent preferred.
• Current CRC License required.
• Clinical expertise must be kept current with CEUs.

Responsibilities

• Performs standard clinical reviews of referred medical claims based on client requirements.
• Reviews medical documentation to substantiate disability and impact on job functions.
• Communicates with employees and providers to discuss clinical status and work status.
• Provides follow-up recommendations for ongoing medical management of claims.
• Acts as clinical resource to claims examiners on medical management of claims.
• Travels as required.

Skills

Medical knowledge

Communication

Microsoft Office

Analytical skills

Organizational skills

Interpersonal skills

Judgement

Team player

Education

Bachelor's degree

CRC license

Tools

Microsoft Office

Job description

Sedgwick is seeking an Accommodation Clinical Specialist to perform standard clinical evaluations on claims requiring review based on medical condition, client requirements, and complexity. You will consult with providers and employees, ensuring medical information substantiates the need for employee absence from work.

You will review medical documentation, interpret disability impact on job functions, and communicate status clearly to employees and providers.