Disability Clinical Specialist

Company	Sedgwick Claims Management Services
Location	Iowa, USA, Texas, USA, Florida, USA, Tennessee, USA, Ohio, USA, Michigan, USA, United States
Salary	$Not Provided – $Not Provided
Type	Full-Time
Degrees	Bachelor’s
Experience Level	Mid Level, Senior

Bachelor’s degree or equivalent preferred
RN, LVN, CRC, COHN CVD, LPC and/or LCSW preferred
Current license, registration and/or professional designations as required within the jurisdiction
Four (4) years of related experience or equivalent combination of education and experience required to include experience in a direct medical/psychological setting or physical industrial medicine and previous insurance experience
Knowledge of current medical practices in health care management in a variety of areas (including, but not limited to, orthopedics, general medicine for acute and chronic conditions, general surgery, mental health, obstetrics, oncology, and physical and occupational rehabilitation)
Oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies

Performs clinical review of referred claims; documents decision rationale; and completes medical review of all claims to ensure information substantiates disability
Provides clear and appropriate follow-up recommendations for ongoing medical management of claims; ensures appropriate recommendations are made on claims
Makes timely, appropriate contact with employee and/or providers to discuss employee’s clinical status, progress and work status
Achieves appropriate quality audit scores on a consistent basis
Acts as clinical resource to colleagues within the program
Performs other duties as assigned
Supports the organization’s quality program(s)
Travels as required