RN Disability Claims Clinical Consultant (Remote)

Guardian; United States; Remote; USD 69,000 - 113,000; Full time

Job summary

Guardian Life is seeking an RN Clinical Consultant to support disability claim evaluations. You will review medical information, assess functional capacity, and provide clinical guidance to inform claim decisions.

The role requires independent judgment, strong communication, and collaboration with treating providers, claimants, and case managers. Based in the United States with remote options, you will manage a high-volume workload while maintaining quality and timely resolutions, contributing

Qualifications

• Active RN license required and current in good standing.
• Minimum 5 years direct acute patient care experience.
• Minimum 3 years as a clinical consultant in LTD/STD (LTD preferred).
• Strong knowledge of medical conditions and their impact on function.
• Excellent verbal and written communication skills.
• Analytical, critical thinking and research skills.
• Ability to exercise independent judgment and make clinical decisions.
• Strong organizational and time-management capabilities.
• Proficiency with Microsoft Office (Word/Excel/PowerPoint).
• Ability to adapt to changing business needs in a dynamic environment.

Responsibilities

• Review short- and long-term disability cases to evaluate medical documentation and functional limits.
• Analyze illness/injury/treatment impacts on daily living and work capabilities with clinical recommendations.
• Collaborate with treaters, claimants, case managers and vocational specialists to plan treatment and return-to-work.
• Serve as clinical SME educating claims staff on medical conditions and functional outcomes.
• Coordinate independent medical reviews and ensure timely resolution of complex questions.
• Manage high-volume workload while prioritizing customer needs and quality.
• Provide ongoing mentoring and training to claims staff on medical implications.

Skills

Excellent verbal and written comms

Analytical and critical thinking

Independent judgment

Organizational and time management

MS Office proficiency (Word, Excel, PP

Adaptability to changing needs

Knowledge of medical conditions and EF

Collaborative, team-oriented

Education

Active RN license

BSN preferred

CCM certification preferred

Tools

DCMS

ClaimFacts

iProcess

Job description

Guardian Life is seeking an RN Clinical Consultant to support disability claim evaluations. You will review medical information, assess functional capacity, and provide clinical guidance to inform claim decisions.

The role requires independent judgment, strong communication, and collaboration with treating providers, claimants, and case managers. Based in the United States with remote options, you will manage a high-volume workload while maintaining quality and timely resolutions, contributing