Disability Clinical Specialist

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

📋 Description

• Conduct standard clinical assessments on disability claims that necessitate further review.

• Collaborate with providers and employees on case management and medical information.

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

• Communicate with employees and providers regarding clinical status, progress updates, and work eligibility.

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

• Attain satisfactory quality audit scores.

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

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

• Travel as necessary.

• Execute additional responsibilities as assigned.

⛳️ Requirements

• Preferred: Bachelor's degree or equivalent.

• Required: Current RN, LVN, LPN, CRC, COHN, CVE, LPC, and/or LCSW license(s).

• Must possess current licensure, registration, and/or professional designations as mandated by the jurisdiction.

• Maintain up-to-date clinical expertise through required continuing education units (CEUs).

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

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

• Prior experience in insurance or a related field is advantageous.

• Knowledge of contemporary medical practices in health care management, including orthopedics, general medicine, surgery, mental health, obstetrics, oncology, and both physical and occupational rehabilitation.

• Strong oral and written communication skills, including the ability to deliver presentations.

• Competent computer skills with a working knowledge of Microsoft Office.

• Possess analytical and interpretive capabilities.

• Excellent organizational and multitasking abilities.

• Strong interpersonal skills.

• Ability to demonstrate sound judgment and critical thinking.

• Capability to function effectively in a team-oriented setting.

• Ability to meet or exceed established Performance Competencies.

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

• Travel as necessary.

🏝️ Benefits

• Medical insurance.

• Dental insurance.

• Vision insurance.

• 401(k) plan with matching contributions.

• Paid Time Off (PTO).

• Disability insurance.

• Life insurance.

• Employee assistance programs.

• Flexible spending account or health savings account.

• Additional voluntary benefits.

• Work-life balance initiatives.

• Reasonable accommodations provided when applicable and appropriate.