Disability Clinical Specialist

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

📋 Description

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

• Analyze medical documentation and utilize clinical expertise to validate disabilities and evaluate their impact on job performance.

• Engage with employees and healthcare providers regarding clinical conditions, progress, and work capabilities.

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

• Attain suitable quality audit scores.

• Serve as a clinical resource for claims examiners concerning medical management, terminology, and claims decisions.

• Provide ad hoc backup support for critical disability claims.

• Execute other assigned tasks as needed.

• Travel as necessary.

⛳️ Requirements

• Bachelor's degree or equivalent preferred.

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

• Active license, registration, and/or professional designations as required by the jurisdiction.

• Completion of necessary continuing education units (CEUs) to maintain licenses and designations.

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

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

• Previous experience in insurance or a related field.

• Familiarity with current medical practices in healthcare management, including areas such as orthopedics, general medicine, surgery, mental health, obstetrics, oncology, and rehabilitation.

• Exceptional oral and written communication skills, including the ability to present effectively.

• Proficient in computer skills, especially with Microsoft Office.

• Strong analytical and interpretive abilities.

• Excellent organizational and multitasking capabilities.

• Outstanding interpersonal skills.

• Capacity to exercise judgment and critical thinking.

• Ability to collaborate effectively within a team.

• Capability to meet or exceed performance competencies.

• Ability to sit at a desk for extended durations while using a computer and phone system.

• Travel as required.

🏝️ Benefits

• Work-life balance.

• Reasonable accommodations considered.

• Equal Opportunity Employer.

• Drug-Free Workplace.

• Commitment to diversity, equity, and inclusion in the workplace.