Accommodations Clinical Specialist-Bilingual French – Hindi – Bengali or more

Accommodations Clinical Specialist-Bilingual French – Hindi – Bengali or more

Requirements

• Bachelor’s degree from an accredited college or university preferred
• Current Certified Rehabilitation Counselor (CRC) or Registered Nurse (RN) license required
• 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, including one (1) year of return-to-work or job accommodation experience OR four (4) years of claims management experience
• Good working knowledge of return-to work or job accommodation procedures
• Good technical knowledge of claims management procedures
• 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)
• Excellent oral and written communication, including presentation skills
• Proficient computer skills including working knowledge of Microsoft Office
• Analytical and interpretive skills
• Strong organizational and multitasking skills
• Excellent interpersonal skills
• Ability to exercise judgement and critical thinking skills
• Ability to work in a team environment
• Ability to meet or exceed Performance Competencies

Responsibilities

• Consults on and evaluates complex claims to determine objective, quantifiable, medically supported work restrictions/accommodations
• Performs standard disability clinical reviews of referred medical claims based on client requirements to ensure accurate and sufficient information is received by employees and providers, documenting decision rationale
• Completes medical reviews of all claims by assessing medical documentation and applying clinical knowledge to substantiate disability and interpret the impact on job functions
• Communicates clearly and professionally with employees and providers, discussing clinical status, progress, and work status via phone or writing
• Provides clear follow-up recommendations for ongoing medical management of claims, ensuring appropriate recommendations are made
• Consistently achieves high-quality audit scores
• Acts as a clinical resource to claims examiners, offering guidance on medical management of claims, including comprehension of medical terminology and substantiating claim decisions
• Acts as a backup for key disability claims on an ad hoc basis
• Performs other duties as assigned
• Travels as required

Preferred Qualifications

• Bachelor’s degree from an accredited college or university preferred