Disability Clinical Specialist

This is a fully remote position, open to applicants in Florida, +3 more states.

📋 Description

• Conduct standard clinical evaluations and assessments of referred disability claims.

• Analyze medical documentation and utilize clinical expertise to validate disability claims and evaluate their effect on job performance.

• Engage with employees and providers to discuss clinical status, progress, and work capabilities.

• Offer follow-up recommendations for the continuous medical management of claims.

• Attain satisfactory quality audit scores.

• Serve as a clinical resource for claims examiners regarding medical claim management, terminology, and decision-making.

• Provide support for critical disability claims on an as-needed basis.

• Execute additional duties as assigned.

• Travel as necessary.

⛳️ Requirements

• Bachelor's degree or equivalent is preferred.

• Current RN, LVN, LPN, CRC, COHN CVE, LPC, and/or LCSW licenses are required.

• Valid license, registration, and/or professional designations as mandated by the jurisdiction.

• Maintain licenses and designations through required continuing education units (CEUs).

• A minimum of four (4) years of relevant experience or a combination of education and experience is necessary.

• Experience in a direct medical/psychological environment or physical industrial medicine is preferred.

• Previous experience in insurance or a related field.

• Familiarity with current medical practices in healthcare management, including but not limited to orthopedics, general medicine, general surgery, mental health, obstetrics, oncology, and rehabilitation.

• Exceptional oral and written communication skills, along with presentation abilities.

• Proficient in computer applications, including a working knowledge of Microsoft Office.

• Strong analytical and interpretive capabilities.

• Excellent organizational and multitasking abilities.

• Outstanding interpersonal skills.

• Capacity to exercise sound judgment and critical thinking.

• Ability to collaborate effectively in a team setting.

• Capability to meet or surpass Performance Competencies.

• Ability to remain seated at a desk for extended periods while utilizing a computer and phone system.

• Travel as necessary.

🏝️ Benefits

• Work-life balance.

• Reasonable accommodations when applicable and appropriate.

• A diverse, equitable, and inclusive workplace.