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

Lensa; Lansing (MI); Remote; USD 63,000 - 65,000; Full time

Job summary

A leading company is seeking a Remote Accommodations Clinical Specialist who is bilingual in French, Hindi, Bengali, or other languages. This role involves evaluating claims, consulting with providers, and ensuring compliance with medical guidelines. Candidates must have a Bachelor's degree and relevant certifications, with a competitive salary range of $63,000 to $65,000 annually.

Benefits

Medical, dental, and vision benefits

401k

PTO

Disability and life insurance

Qualifications

• Bachelor's degree preferred; CRC or RN license required.
• Four years of related experience, including one year of return-to-work experience.

Responsibilities

• Performs clinical evaluations on claims requiring additional review.
• Consults with providers and employees to ensure medical information supports claims.

Skills

Communication

Analytical skills

Interpersonal skills

Multitasking

Education

Bachelor's degree from an accredited college or university

Certified Rehabilitation Counselor (CRC) or Registered Nurse (RN) license

Tools

Microsoft Office

Job description

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

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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!

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work

Fortune Best Workplaces in Financial Services & Insurance

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

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

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 live within the United States.

PRIMARY PURPOSE

Performs standard clinical evaluations on claims that require additional review based on medical condition, client requirement, and/or complexity. Consults with providers and employees by providing case direction and ensures medical information substantiates the need for employee absence from work or to facilitate and monitor successful return to work of claimants within appropriate disability duration and accommodation guidelines.

ESSENTIAL FUNCTIONS And RESPONSIBILITIES

• Consults on and evaluates complex claims to determine objective, quantifiable, medically supported work restrictions/accommodations.
• Performs standard disability clinical reviews of referred medical claims based on client requirements to ensure accurate and sufficient information is received by employees and providers, documenting decision rationale.
• Completes medical reviews of all claims by assessing medical documentation and applying clinical knowledge to substantiate disability and interpret the impact on job functions.
• Communicates clearly and professionally with employees and providers, discussing clinical status, progress, and work status via phone or writing.
• Provides clear follow-up recommendations for ongoing medical management of claims, ensuring appropriate recommendations are made.
• Consistently achieves high-quality audit scores.
• Acts as a clinical resource to claims examiners, offering guidance on medical management of claims, including comprehension of medical terminology and claim decisions.

ADDITIONAL FUNCTIONS And RESPONSIBILITIES

• Acts as a backup for key disability claims on an ad hoc basis.
• Performs other duties as assigned.
• Travels as required.

Qualifications

Education & Licensing

Bachelor's degree from an accredited college or university preferred. Current Certified Rehabilitation Counselor (CRC) or Registered Nurse (RN) license required. Current license, registration, and/or professional designations as required within the jurisdiction. Clinical expertise must be maintained through CEUs.

Experience

Four (4) years of related experience or equivalent, including one (1) year of return-to-work or job accommodation experience OR four (4) years of claims management experience.

Skills & Knowledge

• Good knowledge of return-to-work or job accommodation procedures.
• Good technical knowledge of claims management procedures.
• Knowledge of current medical practices across various healthcare areas.
• Excellent communication and presentation skills.
• Proficient in Microsoft Office and computer skills.
• Analytical, interpretive, organizational, and multitasking skills.
• Interpersonal skills and critical thinking ability.
• Ability to work in a team and meet performance standards.

WORK ENVIRONMENT

Consideration for reasonable accommodations when applicable. The environment includes mental, physical, and auditory/visual aspects as described in the full description.

The statements in this document are general and not exhaustive. Management may add or change duties as needed.

Compensation ranges from $63,000 to $65,000 annually, influenced by experience, skills, and location. Benefits include medical, dental, vision, 401k, PTO, disability, life insurance, and more.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If your experience doesn't match every qualification, consider applying anyway! Sedgwick values diversity, equity, and inclusion, and recognizes unique skills and experiences.

Sedgwick is a global leader in risk and claims management, utilizing advanced AI technology. With over 33,000 colleagues and 10,000 clients worldwide, Sedgwick offers comprehensive solutions in claims administration and related fields. For more information, visit sedgwick.com.