Remote Disability Clinical Specialist (RN/LCSW)

Sedgwick; Memphis (TN); Remote; USD 70,000 - 100,000; Full time

Job summary

Sedgwick is seeking a Clinical Reviewer to perform standard medical claim evaluations and guide disability decisions from a remote setting. You will consult with providers and employees, review medical data, and ensure documentation supports the claim.

The role requires a Bachelor's degree and active RN/LVN/LPN or similar licenses, plus about four years in a medical or insurance environment. Strong communication, analytical, and teamwork skills are essential.

Qualifications

• Bachelor’s degree or equivalent preferred.
• Current RN, LVN, LPN, CRC, COHN CVE, LPC and/or LCSW Licenses required.
• Clinical expertise maintained with CEUs to keep licenses current.
• Four (4) years of related experience in medical/insurance settings.

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/providers to discuss clinical status and work status.
• Offers follow-up recommendations for ongoing medical management.
• Maintains high-quality audit scores and serves as clinical resource to examiners.

Skills

Medical knowledge

Communication skills

Microsoft Office

Analytical skills

Organizational skills

Interpersonal skills

Critical thinking

Team player

Education

Bachelor's degree

RN/LVN/LPN/CRC/COHN CVE/LPC/LCSW license

Tools

EMR systems

Job description

Sedgwick is seeking a Clinical Reviewer to perform standard medical claim evaluations and guide disability decisions from a remote setting. You will consult with providers and employees, review medical data, and ensure documentation supports the claim.

The role requires a Bachelor's degree and active RN/LVN/LPN or similar licenses, plus about four years in a medical or insurance environment. Strong communication, analytical, and teamwork skills are essential.