Sedgwick · 1 month ago
Senior Disability Clinical Specialist
United States
Full-time
Remote
Senior Level
6+ years expSedgwick is a leading claims management services company dedicated to helping people facing unexpected challenges. The Senior Disability Clinical Specialist is responsible for performing clinical evaluations, consulting with providers and employees, and ensuring the accuracy of medical information related to employee absence from work.
BankingInsuranceRisk Management
No H1B
Security Clearance Required
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
Performs other duties as assigned
Supports the organization's quality program(s)
Travels as required
Qualification
Required
Bachelor's degree from an accredited college or university preferred
Current RN Licenses are 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
Six (6) years of related experience or equivalent combination of education and experience required
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
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
Computer keyboarding, travel as required
Hearing, vision and talking
Credit security clearance, confirmed via a background credit check, is required for this position
Company
Sedgwick
Sedgwick is the world’s leading risk and claims administration partner, helping clients thrive by navigating the unexpected.
10001+ employees
Funding
Current Stage
Late StageTotal Funding
$1.5BKey Investors
Altas PartnersLa Caisse
2024-09-12Private Equity· $1B
2018-12-01Private Equity
2018-09-12Acquired
Leadership Team
Michael Arbour
Chairman & Chief Executive Officer
Kalani Reelitz
Global Chief Financial Officer
Recent News
Morningstar.com
2025-11-10
2025-09-04
Company data provided by crunchbase