Remote RN Clinical Consultant — Disability Claims Expert

Guardian Life; Carson City (NV); Remote; USD 69,000 - 113,000; Full time

Job summary

Guardian Life seeks a registered nurse to serve as an RN Clinical Consultant, analyzing medical information, assessing functional capacity, and guiding disability claim decisions. This role requires clinical expertise, collaboration with providers, and a commitment to customer outcomes.

You will review short- and long-term disability documentation, educate claims staff, coordinate reviews, and support return-to-work planning from a fully remote US base.

Qualifications

• Active RN license required.
• Minimum 5 years of direct acute patient care experience.
• Minimum 3 years as a clinical consultant in LTD/STD (LTD preferred).
• Knowledge of medical conditions and their impact on function and disability duration.
• Excellent verbal and written communication skills.

Responsibilities

• Review short- and long-term disability claims to evaluate medical documentation, functional limitations, and recovery timelines.
• Analyze illness, injury, and treatment plans affecting a claimant's ability to perform daily activities.
• Collaborate with treating providers, claimants, case managers, and vocational specialists to promote appropriate treatment plans and return-to-work opportunities.
• Educate claims professionals on medical conditions, interventions, and disability outcomes.
• Coordinate independent medical reviews and assessments to ensure accuracy and timely resolution of complex questions.
• Manage high-volume workload while prioritizing customer needs and supporting quality improvement initiatives.
• Provide ongoing mentoring and training to claims staff regarding medical and functional impacts of injuries and illnesses.

Skills

Verbal and written communication

Clinical assessment

Independent judgment

Time management

Education

Active RN license

5 years acute patient care

3 years LTD/STD clinical consultant

BSN (preferred)

CCM designation (preferred)

Tools

DCMS

ClaimFacts

iProcess

Microsoft Word

Microsoft Excel

PowerPoint

Job description

Guardian Life seeks a registered nurse to serve as an RN Clinical Consultant, analyzing medical information, assessing functional capacity, and guiding disability claim decisions. This role requires clinical expertise, collaboration with providers, and a commitment to customer outcomes.

You will review short- and long-term disability documentation, educate claims staff, coordinate reviews, and support return-to-work planning from a fully remote US base.