Disability Clinical Specialist: Medical Claims

Sedgwick; Iowa; On-site; USD 85,000 - 105,000; Full time

Job summary

Sedgwick is seeking a Disability Clinical Specialist to perform clinical evaluations and review medical information supporting disability claims. You will consult with providers and employees, ensure documentation substantiates absence from work, and contribute to high-quality claim decisions.

This role requires strong clinical knowledge and clear communication with stakeholders. The ideal candidate has a bachelor’s-level credential and active clinical licensure; reliability, analytical

Qualifications

• Bachelor's degree or equivalent preferred.
• Current RN, LVN, LPN, CRC, COHN CVE, LPC and/or LCSW Licenses required.
• Clinical expertise must be kept current with CEUs.

Responsibilities

• Perform standard clinical reviews of referred medical claims per client requirements.
• Review medical documentation to support disability determinations.
• Communicate updates with employees and providers via phone or written correspondence.
• Provide follow-up recommendations for medical management of claims.

Skills

Clinical judgment

Communication

Analytical skills

Teamwork

Organization

Education

RN license or equivalent

Tools

Microsoft Office

Job description

Sedgwick is seeking a Disability Clinical Specialist to perform clinical evaluations and review medical information supporting disability claims. You will consult with providers and employees, ensure documentation substantiates absence from work, and contribute to high-quality claim decisions.

This role requires strong clinical knowledge and clear communication with stakeholders. The ideal candidate has a bachelor’s-level credential and active clinical licensure; reliability, analytical