Remote Disability Claims Clinical Specialist

Sedgwick; Houston (TX); Remote; USD 70,000 - 90,000; Full time

Benefits offered by this job

Telecommute options

Travel required

Job summary

Sedgwick is seeking a qualified clinical reviewer to perform standard evaluations on disability claims and coordinate with providers to substantiate absence from work. This full-time telecommuter role supports multiple states.

You will review medical records, communicate status to claimants and providers, and offer follow-up recommendations. A CRC license and four years of related experience are required, with strong analytical and written communication skills.

Qualifications

• Bachelor's degree or equivalent; CRC license may be required.
• Four years of related experience in medical/psychological or physical industrial medicine settings.
• Knowledge of medical practices across multiple areas.

Responsibilities

• Performs standard clinical reviews of referred medical claims to ensure adequate information is received to support the claim and documents decision rationale.
• Completes medical review of all claims and interprets impact on the ability to perform job functions.
• Communicates with employees/providers about clinical status and work status.
• Provides follow-up recommendations for ongoing medical management of claims.

Skills

Clinical reviews

Medical knowledge

Communication

MS Office

Analytical skills

Organizational skills

Interpersonal skills

Critical thinking

Teamwork

Performance standards

Education

Bachelor's degree or equivalent

CRC License

Tools

Microsoft Office

Job description

Sedgwick is seeking a qualified clinical reviewer to perform standard evaluations on disability claims and coordinate with providers to substantiate absence from work. This full-time telecommuter role supports multiple states.

You will review medical records, communicate status to claimants and providers, and offer follow-up recommendations. A CRC license and four years of related experience are required, with strong analytical and written communication skills.