FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates clinical expertise in evaluating disability claims, applying medical knowledge to assess job function impacts, and providing recommendations for medical management. Proficient in communication and collaboration with employees and providers to ensure effective claim processing.
Highest-signal resume keywords
Current RN LicenseClinical Evaluation SkillsMedical Documentation ReviewAnalytical SkillsExcellent Communication Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical EvaluationMedical Documentation ReviewDisability Claims ManagementAnalytical SkillsCritical ThinkingKnowledge of Medical PracticesExperience in Direct Medical SettingInsurance ExperienceOrganizational SkillsMultitasking
Soft Skills
Excellent Oral CommunicationExcellent Written CommunicationInterpersonal SkillsTeam CollaborationJudgment
Tools & Technologies
Microsoft Office
Certifications & Qualifications
RN LicenseLVN LicenseLPN LicenseCRC CertificationCOHN CertificationCVE CertificationLPC LicenseLCSW License
Industry Keywords
Disability ClaimsHealth Care ManagementOrthopedicsMental HealthOccupational RehabilitationAcute ConditionsChronic ConditionsGeneral SurgeryObstetricsOncology
About the role
Key responsibilities & impact- Perform standard clinical evaluations and reviews of disability claims requiring additional review based on medical condition, client requirements, or complexity
- Review medical documentation and apply clinical knowledge to substantiate disability and interpret impacts on job functions
- Communicate with employees and providers by phone and in writing regarding clinical status, progress, and work status
- Provide follow-up recommendations for ongoing medical management of claims
- Achieve appropriate quality audit scores
- Act as a clinical resource to claims examiners on medical terminology, medical management, and claim decisions
- Provide backup for key disability claims on an ad hoc basis
- Perform other assigned duties
- Travel as required
Requirements
What you’ll need- Bachelor's degree or equivalent preferred
- Current RN, LVN, LPN, CRC, COHN CVE, LPC and/or LCSW license(s) required
- Current license, registration and/or professional designations as required within the jurisdiction
- Maintain clinical expertise through 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 or physical industrial medicine
- Previous insurance or related experience
- Knowledge of current medical practices in health care management, including orthopedics, 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 judgment and critical thinking skills
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies
- Ability to sit at a desk for extended periods while operating a computer and phone system
- Travel as required
Benefits
Comp & perks- Work-life balance
- Reasonable accommodations considered
- Diversity, equity, and inclusion workplace
- Drug-free workplace