Clinical Consultant
Core
Evaluate medical documentation to assess disability claims and functional capabilities, providing clinical insight on complex conditions to support return-to-work planning.
Role type
Senior IC clinical consultant (disability claims)
Builds
Disability claims decisions and return-to-work plans
Domain
Insurance / Disability Claims
Deliverable
dashboards & analysis
Required skills
Medical documentation evaluation, Clinical insight on complex conditions, Return-to-work planning, Stakeholder consultation, Critical thinking, Time management
Preferred skills
Rehabilitation setting experience, Occupational Health, Case/Care Management, Workers compensation
Technologies
Microsoft Office (Outlook, Word, Excel), Clinical systems
Responsibilities
Evaluate medical documentation to assess disability claims and functional capabilities; Provide clinical insight on complex medical conditions, treatment plans, and recovery timelines; Collaborate with claims professionals to synthesize facts and support quality decisions; Educate and consult with physicians, vocational counselors, employers, and other stakeholders; Communicate medical determinations via phone and written reports; Support return-to-work (RTW) planning through evaluation of restrictions, accommodations, and functional potential.