Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.
A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.
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Disability Clinical Specialist
**PRIMARY PURPOSE** **:** To perform standard and complex clinical evaluations as determined by clinical screenings and patient assessments. To consult providers and employees by providing case direction. Ensures medical information corroborates the need for employee absence from work.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
Performs and completes complex clinical reviews of referred medical claims to ensure accurate information is received by employees and providers
Makes regular timely, appropriate contact with employees and/or providers to discuss clinical status, progress, and work status.
Substantiates disability and provides follow-up recommendations for ongoing medical management of claims
Ensures appropriate recommendations are made on claims.
Assists with clinical training, onboarding, examiner presentations, and processes change assessments
Assists with updating clinical teamsite and training references.
Analyzes work queues and assignment workloads to ensure appropriate requirements are met
Assists with escalations
Acts as a backup for the team lead and mentors less experience specialists.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
Performs other duties as assigned.
Supports the organization's quality program(s).
Travels as required.
**QUALIFICATIONS**
**Education & Licensing**
Bachelor's degree from an accredited college or university preferred. Current RN, LVN, CRC, COHN CVD, 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 acquitision of the necessary CEUs to maintain licenses and designations.
**Experience**
Six (6) years of related experience or equivalent combination of education and experience required.
**Skills & Knowledge**
Excellent oral and written communication skills, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Proven management/leadership skills
Excellent negotiating skills
Ability to create and complete comprehensive, accurate and constructive written reports
Ability to work in a team environment
Ability to meet or exceed Performance Competencies
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental** **:** 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; and ability to meet deadlines
**Physical** **:** Computer keyboarding, travel as required
**Auditory/Visual** **:** Hearing, vision and talking
**NOTE** **:** Credit security clearance, confirmed via a background credit check, is required for this position.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
**If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.**
**Taking care of people is at the heart of everything we do. Caring counts**
Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing - one where caring counts. Watch this video to learn more about us. (