Disability Clinical Specialist

This is a fully remote position, open to applicants in Iowa.

📋 Description

• Conduct standard clinical assessments and evaluations of disability claims that need further review due to medical conditions, client specifications, or complexity factors.

• Analyze medical documentation and leverage clinical expertise to validate disability claims and interpret their effects on job responsibilities.

• Engage with employees and healthcare providers through phone and written communication regarding clinical conditions, progress updates, and work status.

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

• Achieve satisfactory quality audit results.

• Serve as a clinical resource for claims examiners on medical terminology, medical management practices, and claim adjudications.

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

• Execute other assigned tasks.

• Travel as necessary.

⛳️ Requirements

• Bachelor's degree or equivalent preferred.

• Active RN, LVN, LPN, CRC, COHN CVE, LPC and/or LCSW license(s) required.

• Current licensure, registration, and/or professional certifications as mandated within the jurisdiction.

• Maintain clinical proficiency through required continuing education units (CEUs) to uphold licenses and certifications.

• Four (4) years of relevant experience or an equivalent mix of experience and education required.

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

• Previous experience in insurance or related fields.

• Familiarity with contemporary medical practices in healthcare management, encompassing orthopedics, acute and chronic conditions, general surgery, mental health, obstetrics, oncology, and physical and occupational rehabilitation.

• Exceptional oral and written communication skills, including proficiency in presentations.

• Strong computer skills, including a working knowledge of Microsoft Office.

• Analytical and interpretative abilities.

• Excellent organizational and multitasking capabilities.

• Strong interpersonal skills.

• Ability to apply sound judgment and critical thinking.

• Capacity to thrive in a collaborative team environment.

• Ability to meet or surpass Performance Competencies.

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

• Travel as necessary.

🏝️ Benefits

• Work-life balance.

• Reasonable accommodations considered.

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

• Drug-free workplace.