Disability Clinical Specialist - Remote
$62,500–$62,500 year
RemoteUnited States
Job Summary
Conduct standard clinical reviews of referred medical claims to ensure documentation substantiates disability and interprets the impact of conditions on job functions. Consult with providers and employees via phone or writing to discuss clinical status, progress, and work status while providing follow-up recommendations for ongoing medical management. Apply practical clinical knowledge to interpret claim decisions and act as a clinical resource to guide claims examiners on medical terminology and substantiation. Maintain appropriate quality audit scores and serve as a backup for key disability claims on an ad hoc basis. Requires current RN, LVN, LPN, CRC, COHN CVE, LPC, and/or LCSW licenses and four years of related experience in a direct medical or psychological setting. Fully remote US position with a starting salary of $62,500 USD annually.
Required Qualifications
- Current RN, LVN, LPN, CRC, COHN CVE, LPC and/or LCSW Licenses required
- Current license, registration and/or professional designations as required within the jurisdiction
- Clinical expertise must be kept current by acquisition of the necessary CEUs to maintain licenses and designations
- Four (4) years of related experience or equivalent combination of experience and education required
- Experience in a direct medical/psychological setting
- Experience in physical industrial medicine
- Previous insurance or related 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)
- 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
- Clear and conceptual thinking ability
- Excellent judgment, troubleshooting, problem solving, analysis, and discretion
- Ability to handle work-related stress
- Ability to handle multiple priorities simultaneously
- Ability to meet deadlines
- Ability to sit at a desk for extended periods while operating a computer and phone system
- Hearing, vision and talking
Desired Qualifications
- Bachelor's degree or equivalent preferred
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