Remote Disability Claims Clinical Specialist

Sedgwick Claims Management Services Ltd; Northern (KY); Remote; USD 70,000 - 100,000; Full time

Job summary

Sedgwick is seeking a Disability Clinical Specialist who performs standard clinical evaluations on claims, consulting with providers and employees to substantiate the need for employee absence from work. The role requires strong medical knowledge, communication skills, and the ability to analyze complex medical information.

Remote, full-time position across multiple states, with travel as needed. The candidate should have a Bachelor's degree and relevant licenses, plus at least four years of

Qualifications

• Bachelor's degree or equivalent preferred.
• RN, LVN, LPN, CRC, COHN CVE, LPC and/or LCSW licenses required.
• Four (4) years of related experience in medical/psychological settings or physical industrial medicine and insurance experience.

Responsibilities

• Performs standard clinical reviews of referred medical claims per 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 and ensures quality.

Skills

Medical knowledge

Communication skills

MS Office

Analytical skills

Multitasking

Team collaboration

Critical thinking

Education

Bachelor's degree or equivalent

Job description

Sedgwick is seeking a Disability Clinical Specialist who performs standard clinical evaluations on claims, consulting with providers and employees to substantiate the need for employee absence from work. The role requires strong medical knowledge, communication skills, and the ability to analyze complex medical information.

Remote, full-time position across multiple states, with travel as needed. The candidate should have a Bachelor's degree and relevant licenses, plus at least four years of