Remote Accommodations Clinical Specialist- Bilingual French, Hindi, Bengali or more

Lensa; Carson City (NV); Remote; USD 63,000 - 65,000; Full time

Job summary

Lensa is seeking a Remote Accommodations Clinical Specialist to perform standard clinical evaluations on claims requiring further review. The ideal candidate will evaluate claims, work closely with medical documentation, and communicate effectively with stakeholders. A Bachelor’s degree is preferred alongside required CRC or RN licensing. Join us to support individuals while achieving work-life balance in a highly recognized workplace.

Qualifications

• Bachelor's preferred; current CRC or RN license required.
• 4 years related experience or claims management.
• Skills in return-to-work, medical knowledge, and claims management.

Responsibilities

• Evaluate complex claims for medically supported work restrictions.
• Review medical claims and document decision rationale.
• Communicate with employees and providers on clinical status.

Skills

Return-to-work procedures

Claims management

Medical knowledge

Communication

Computer skills

Analytical skills

Organizational skills

Interpersonal skills

Judgment

Teamwork

Education

Bachelor's degree preferred

Current CRC or RN license required

Job description

Remote Accommodations Clinical Specialist- Bilingual French, Hindi, Bengali or more

Lensa is the leading career site for job seekers at every stage of their career. Our client, Sedgwick, is seeking professionals. Apply via Lensa today!

Join Sedgwick and be part of a meaningful mission. With 33,000 colleagues, we serve people facing the unexpected. Grow your career, enjoy our caring culture, and achieve work-life balance.

Recognitions include Newsweek's America's Greatest Workplaces, Great Place to Work certification, and Fortune's Best Workplaces in Financial Services & Insurance.

Language Requirements

We are looking for bilingual candidates in any of these languages:

• French
• Dutch
• Hindi
• Bengali
• German
• Mandarin
• Portuguese

Work Hours

Must be able to work within these hours (Monday - Friday):

• 8:00 am to 4:00 pm CST
• 11:00 am to 7:00 pm CST
• 5:00 pm to 1:00 am CST
• 11:00 pm to 7:00 am CST
• 1:00 am to 9:00 am CST

Candidates must reside within the United States.

Primary Purpose

Perform standard clinical evaluations on claims requiring additional review based on medical condition, client requirements, or complexity. Consult with providers and employees, providing case direction and ensuring medical information supports employee absence or return to work, within disability and accommodation guidelines.

Responsibilities

• Evaluate complex claims for objective, medically supported work restrictions and accommodations.
• Review medical claims to ensure accurate information and document decision rationale.
• Assess medical documentation to substantiate disability and interpret impact on job functions.
• Communicate professionally with employees and providers regarding clinical status and work capacity.
• Provide follow-up recommendations for ongoing medical management.
• Maintain high-quality audit scores.
• Guide claims examiners on medical management and claim decisions.

Additional Duties

• Backup for disability claims as needed.
• Perform other duties and travel as required.

Qualifications

Education & Licensing: Bachelor's preferred; current CRC or RN license required. Maintain licenses with CEUs.

Experience: 4 years related experience or claims management, including 1 year in return-to-work or accommodations.

Skills & Knowledge: Return-to-work procedures, claims management, medical knowledge, communication, computer skills, analytical skills, organizational skills, interpersonal skills, judgment, teamwork, and performance competency adherence.

Work Environment

Includes mental, physical, and auditory/visual considerations, with accommodations as needed. Travel may be required.

Compensation ranges from $63,000 to $65,000 annually, with a comprehensive benefits package. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If your experience doesn't match every qualification, consider applying anyway. We value diverse skills and backgrounds.

Sedgwick leads in risk and claims management, leveraging advanced AI technology. With over 33,000 colleagues and 10,000 clients globally, we provide innovative solutions in claims, benefits, and risk management.