Remote Disability Clinician & Claims Specialist

Sedgwick; Dallas (TX); Remote; USD 85,000 - 105,000; Full time

Job summary

Sedgwick is seeking a Disability Clinical Specialist to perform standard clinical evaluations on claims that require additional review based on medical condition and client requirements. You will consult with providers and employees, ensuring medical information substantiates the need for employee absence and supports claim decisions.

Qualifications include a Bachelor's degree or equivalent and current licensure (RN/LVN/LPN/CRC/COHN CVE/LPC/LCSW).

Qualifications

• Bachelor's degree or equivalent preferred.
• Current RN, LVN, LPN, CRC, COHN CVE, LPC or LCSW licenses required.
• Clinical expertise must be kept current with CEUs.

Responsibilities

• Performs standard clinical reviews of referred medical claims per client requirements.
• Completes medical review and interprets impact on work ability.
• Communicates with employees and providers about status and recommendations.
• Provides follow-up recommendations for ongoing medical management of claims.
• Maintains quality audit scores and supports claims examiners with medical guidance.
• Acts as a clinical resource on medical management of claims.

Skills

Oral and written communication

Analytical skills

Organizational skills

Multitasking

Interpersonal skills

Judgement and critical thinking

Education

Bachelor's degree or equivalent

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

Tools

Microsoft Office

Job description

Sedgwick is seeking a Disability Clinical Specialist to perform standard clinical evaluations on claims that require additional review based on medical condition and client requirements. You will consult with providers and employees, ensuring medical information substantiates the need for employee absence and supports claim decisions.

Qualifications include a Bachelor's degree or equivalent and current licensure (RN/LVN/LPN/CRC/COHN CVE/LPC/LCSW).