Medical Consultant
Core
Provide expert medical analysis of claims files and underwriting applications to determine functional capacity, accuracy of diagnoses, and treatment plans for insurance claims.
Role type
Medical Consultant (Physician/Board Certified)
Builds
Medical opinions and forensic analysis supporting disability and life insurance claims
Domain
Insurance / Healthcare
Required skills
Medical diagnosis, functional capacity assessment, treatment plan evaluation, prognosis determination, regulatory compliance, medical ethics, stakeholder communication, data analysis, second opinion coordination, high-volume case management
Preferred skills
Mentoring peers, providing medical education to non-medical staff, collaborative team analysis
Technologies
Claims management systems, telehealth platforms
Responsibilities
Provide timely medical direction and forensic analysis for claims; consult with fellow medical consultants; assess medical data to determine functional capacity; communicate with healthcare providers to gather information; make referrals for second opinions; manage high volumes of assigned work while maintaining turnaround times
Seniority
Senior, hands-on IC